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Get ready! New disclosure requirements for Medicare enrolled skilled nursing facilities —effective 10/1/24

12/2/24

By: Michael J. Griffin

Per CMS Final Rule issued on 11/17/23 and implemented on 10/1/24 (88 FR 801401), Medicare-enrolled SNF’s face substantially increased burdens for disclosure of ownership and control information pursuant to revised Form 855A, which includes several new categories of required information in addition to the disclosures previously required. Enactment of the final rule is intended to address concerns that nursing facility quality has declined under new ownership structures commonly employed in the nursing home industry, i.e. private equity, REITs, and similar structures which frequently impose financial profitability metrics that are believed to lead to reduced staffing, services, supplies or equipment.

The new reporting requirements apply to new enrollments, off-cycle revalidations, and changes of ownership. They are incorporated into 42 CFR 424.516 (g) and require, in addition to the previously required disclosures, that enrolled SNF’s disclose: 

• Each member of the facility’s “governing body”, including the name, title, and period of service for each member; 

• Each person or entity who is an officer, director, member, partner, trustee, or managing employee of the facility, and their title and period of service: 

• Each person or entity who is an Additional Disclosable Party (“ADP”) of the facility; and 

• The organizational structure of each ADP and a description of the relationship of each ADP to the facility and each other. 

ADP is defined broadly to include operators, licensees, managers, administrative service providers, accountants, landlords, and REITS. Where an ADP is an entity, the new rules require that the facility disclose any person or entity that manages the entity, i.e. LLC, or that has any ownership interest in the LLC, regardless of percentage of ownership. Previously, the disclosure rules required disclosure of entities with a greater than 5% ownership interest. 

The new reporting requirements, which are included in Attachment 1 of revised form 855A, impose significantly increased burdens on nursing homes both in terms of the substance of information required to be disclosed and the form of such information. For example, applicants must disclose a wide range of ADP’s as well as organizational structure diagrams for these entities and charts detailing the interrelationships between them. These and other requirements will impose increased burdens on SNF’s both in terms of the time and resources required to comply with the rules and implementation of processes needed to collect and timely report changes in information. Nursing home owners and operators are well-advised to become familiar with these rules, and with the revised reporting form 855A, to ensure timely compliance. A failure to disclose or update the required information may lead to a denial or revocation of Medicare billing privileges.

For more information, please contact Michael J. Griffin at michael.griffin@fmglaw.com or your local FMG attorney.