The Centers for Medicare and Medicaid Services (CMS) has extended the deadline for skilled nursing facilities (SNFs) to revalidate their Medicare enrollments from May 1 to August 1, 2025. For many nursing facilities scrambling to meet the deadline, this extension arrived too late and has failed to address unanswered questions regarding the new reporting requirements.
Under the CMS Final Rule effective January 16, 2024, SNFs are required to disclose detailed information about their ownership and management structure. However, the regulations go further requiring this same information for other parties “associated” with the facility. These third parties, or “additional disclosable parties” as they are called, include any third party that “exercises operational, financial, or managerial control over the SNF or a part thereof.“ Additionally, they include any entity that “provides management or administrative services, management or clinical consulting services, or accounting or financial services to the facility.”
This broad definition creates uncertainty, particularly about whether an “additional disclosable party” should include vendors or contractors that merely provide services to the SNF, but do not exercise any control over the facility. The CMS 855A revalidation form complicates matters further by first requiring the facility to identify “any” entity that might possibly meet this definition, and then to indicate whether this entity exercises any operational or other control. Since the 855A form requires the SNFs to identify the “additional disclosable party” by name and provide ownership and management information for this entity, the task of completing the 855A form has become quite burdensome – especially if third parties are uncooperative or reluctant to share such information.
These challenges likely prompted CMS to extend the deadline and issue additional guidance on May 9. Although the guidance attempts to clarify questions concerning the 855A form, the guidance itself concedes that it does not fully resolve the question of who meets the definition of an “additional disclosable party,” stating:
“We respectfully note that CMS in its various guidance will be unable to address all conceivable factual scenarios within and among organizations or to individually identify every potential disclosable party … This is because there could be hundreds of such scenarios given the vast variety of organizational structures, relationships, personnel functions, services, occupations, etc. If the SNF is uncertain as to whether a certain party must be reported, it should disclose said party.“
This language effectively places the burden on SNFs to err on the side of over-disclosure, even when the applicability of the rule is unclear. It remains to be seen whether CMS will offer further relief to SNFs – either in the form of narrowed reporting requirements or safe harbors for good-faith efforts.
In the meantime, SNFs can hope that regulators will show leniency regarding 855A forms that contain unintentional omissions, especially where the omitted parties have no actual control over SNF operations. Nevertheless, SNFs should prepare for the possibility of enforcement scrutiny and take proactive steps to document their good faith compliance efforts.
If you have any questions about the CMS 855A revalidation form or compliance requirements for your skilled nursing facility, please contact partner Christopher J. Churchill or any member of Barley Snyder’s Senior Living Industry Group.
