The Centers for Medicare & Medicaid Services (CMS) has issued new guidance requiring skilled nursing facilities (SNFs) to provide more detailed disclosures about their ownership and management structures. These changes, reflected in the revised Form CMS-855A, took effect on October 1, 2024. A key aspect of the updated guidance is the mandatory disclosure of any additional disclosable parties (ADPs) associated with the SNF. This includes providing details about the organizational structure of each ADP and a description of their relationship to the facility and to one another.
What Are Additional Disclosable Parties (ADPs)?
ADPs include any person or entity involved with a SNF that meets one or more of the following conditions:
- Exercises operational, financial, or managerial control over the SNF or a part of it
- Leases or subleases real property to the SNF, or holds an interest of 5 percent or more in the real property
- Provides management or administrative services, clinical consulting services, or accounting/financial services to the facility
This definition also includes any ADP who:
- Provides policies or procedures for any of the SNF's operations
- Exercises financial control over the SNF
- Provides financial or cash management services to the SNF
- Owns a 5 percent or greater interest in the SNF's real property
The above criteria cover a significantly broad range of individuals and entities that provide services to the facility, including banks providing financing or asset management, public relations agencies, HR or technical assistance agencies, and clinical consultants. Even temporary or limited-service providers must be disclosed if they exert any level of control, regardless of the duration or extent of their services.
New Reporting Requirements on Form CMS-855A
The revised Form CMS-855A includes a new SNF Attachment that requires SNFs to disclose much more information about ADPs than previously:
- Disclose the organizational structure and relationships of each ADP
- Submit organizational charts illustrating ownership and control relationships
- Provide detailed information about officers, directors, and significant owners, including Social Security numbers, dates of birth, and tax identification numbers for individuals with significant ownership or managerial roles
CMS's guidance on these updated disclosure requirements applies exclusively to SNFs and is not applicable to other provider or supplier types completing Form CMS-855A.
As of October 1, 2024, SNFs must use the revised Form CMS-855A for enrollment, revalidation, or ownership changes. Significant ownership or managerial changes must be reported within 30 days, while all other updates must be submitted within 90 days. The revalidation application date for all SNFs is May 1, 2025, which also applies to SNFs that had a pending initial, revalidation, reactivation, or CHOW application as of October 1, 2024, and were requested to submit the SNF Attachment. The Attachment will not be due until May 1, 2025
For a complete overview of these requirements, you can review the CMS guidance document here.
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