- December 5, 2023
- Alerts
New CMS Disclosure Requirements for Nursing Homes
On November 17, 2023, the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) published a final rule (“Final Rule”) imposing new ownership disclosure requirements on Medicare skilled nursing facilities and Medicaid nursing facilities (“nursing homes”). Due to concerns over the quality of patient care in facilities owned by certain types of nursing facility owners, including private equity companies and real estate investment trusts, CMS believes these new disclosure requirements will allow them to monitor and hold nursing homes accountable.
Effective January 16, 2024, each nursing home will have to report detailed ownership information about its facility, including each member of the facility’s governing body; each person or entity who is an officer, director, member, partner, trustee, or managing employee of the facility; each person or entity who is an additional disclosable party of the facility; and the organizational structure of each additional disclosable party of the facility, with a description of their relationship to the facility and to one another. Nursing homes are required to report the required data upon initially enrolling in Medicare or Medicaid (which includes changes of ownership) and when revalidating their Medicare or Medicaid enrollment. Any changes to this information must be reported within the same timeframes for reporting enrollment data changes under federal regulation.
The Final Rule defines “additional disclosable party” as person or entity that (1) exercises operational, financial, or managerial control over the facility (in whole or in part) or provides policies or procedures for any of the facility’s operations, or provides financial or cash management services to the facility; (2) leases or subleases real property to the facility, or owns a whole or part interest equal to or exceeding 5 percent of the total value of that real property; or (3) provides management or administrative services, management or clinical consulting services, or accounting or financial services to the facility.
While New York, for example, enacted laws imposing their own disclosure requirements on nursing homes in Section 2803-x of the Public Health Law in 2021, requiring nursing homes to publicly list on their website their owners and publicly disclose and update the name and business address of any landlord of such facility's premises among other things, the Final Rule, applicable to nursing homes across the country, indicates that states have the discretion to “undertake stricter screening of providers” and require nursing homes to provide more data, as long as the minimum requirements of the Final Rule are met.[1]
Should you have any questions or need assistance complying with the new disclosure requirements, please contact the authors, the Garfunkel Wild attorney with whom you regularly work, or contact us at info@garfunkelwild.com.
Effective January 16, 2024, each nursing home will have to report detailed ownership information about its facility, including each member of the facility’s governing body; each person or entity who is an officer, director, member, partner, trustee, or managing employee of the facility; each person or entity who is an additional disclosable party of the facility; and the organizational structure of each additional disclosable party of the facility, with a description of their relationship to the facility and to one another. Nursing homes are required to report the required data upon initially enrolling in Medicare or Medicaid (which includes changes of ownership) and when revalidating their Medicare or Medicaid enrollment. Any changes to this information must be reported within the same timeframes for reporting enrollment data changes under federal regulation.
The Final Rule defines “additional disclosable party” as person or entity that (1) exercises operational, financial, or managerial control over the facility (in whole or in part) or provides policies or procedures for any of the facility’s operations, or provides financial or cash management services to the facility; (2) leases or subleases real property to the facility, or owns a whole or part interest equal to or exceeding 5 percent of the total value of that real property; or (3) provides management or administrative services, management or clinical consulting services, or accounting or financial services to the facility.
While New York, for example, enacted laws imposing their own disclosure requirements on nursing homes in Section 2803-x of the Public Health Law in 2021, requiring nursing homes to publicly list on their website their owners and publicly disclose and update the name and business address of any landlord of such facility's premises among other things, the Final Rule, applicable to nursing homes across the country, indicates that states have the discretion to “undertake stricter screening of providers” and require nursing homes to provide more data, as long as the minimum requirements of the Final Rule are met.[1]
Should you have any questions or need assistance complying with the new disclosure requirements, please contact the authors, the Garfunkel Wild attorney with whom you regularly work, or contact us at info@garfunkelwild.com.
[1] The new additional disclosable party requirement is essentially a requirement for nursing homes to disclose related party transactions, which have been the center of recent enforcement actions filed against nursing homes in New York State by the State Attorney General.