Overview
Skilled nursing facilities (SNFs) have long been required to report ownership and managerial control information to Medicare. Those disclosure obligations have been substantially broadened with the introduction of the CMS-855A SNF Attachment, which requires disclosure of information from additional disclosable parties (ADPs) who provide certain services to SNFs or exercise specified forms of control over them. However, after delaying the submission deadline twice, the Centers for Medicare & Medicaid Services (CMS) has now indefinitely suspended the SNF Attachment deadline.
In Depth
As discussed in a prior client alert, on November 17, 2023, CMS published the final rule, Medicare and Medicaid Programs; Disclosures of Ownership and Additional Disclosable Parties Information for Skilled Nursing Facilities and Nursing Facilities; Medicare Providers’ and Suppliers’ Disclosure of Private Equity Companies and Real Estate Investment Trusts (See 88 FR 80141) (the Final Rule). In addition to other disclosure requirements, the Final Rule implemented disclosure requirements set forth in the Affordable Care Act, which requires SNFs to disclose information on ADPs as part of their Medicare enrollment.
In 2024, CMS released a new SNF Attachment and subregulatory guidance document, which provided SNFs with guidance and frequently asked questions related to the completion of the SNF Attachment.
This guidance document has been updated over time, with the most recent updates confirming there is no deadline to submit the SNF Attachment. The suspension applies to all SNFs that had a pending initial, revalidation, reactivation, or change of ownership application as of October 1, 2024, and were asked to submit the SNF Attachment. CMS has indicated it will provide additional information in future updates, but it remains to be seen whether CMS will modify its forms or its guidance regarding ADP disclosures.
In its guidance, CMS encourages SNFs to make at least one edit to any pending application in the Provider Enrollment, Chain, and Ownership System every 120 calendar days to prevent the application from being deleted for inactivity. Applications that are “Opened for Corrections” must be submitted within 20 days, and applications that are “Rejected” must be reopened within 60 days, and modified every 120 days thereafter, to prevent deletion.
Takeaways
Although the submission deadline has been indefinitely suspended, the Final Rule that implemented the ADP reporting obligations remains an active regulation. SNFs should monitor CMS updates for further developments in the submission of the SNF Attachment and, if a deadline is implemented, anticipate working closely with ADPs to secure the required information in accordance with CMS guidance.