On April 17, 2025, the Centers for Medicare and Medicaid Services (CMS) announced another extension of the deadline by which skilled nursing facilities (SNFs) must revalidate their Medicare enrollments:
Enrolled skilled nursing facilities should collect data on ownership, managerial, and related party information and submit their revalidation. CMS extended the deadline to August 1, 2025.1
Prior to the extension, the revalidation deadline for all Medicare-enrolled SNFs was May 1, 2025. However, as recently as April 9, 2025, CMS published guidance attempting to clarify new disclosure requirements.2 This round of revalidations comes in the wake of the Final Rule CMS published in the Federal Register on November 17, 20233, which became effective on January 16, 2024. These regulations set forth additional requirements for SNFs in disclosing ownership and control interests and additional disclosable parties (ADPs) as part of their Medicare enrollment.4
Under these regulations, SNFs must disclose the members of the facility's governing body, officers, directors, members, partners, trustees, managing employees, and additional disclosable parties (and their organizational structures)5, which include any person or entity who does any of the following:
(1)
- Exercises operational, financial, or managerial control over the facility or a part thereof;
- Provides policies or procedures for any of the operations of the facility; 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% of the total value of such real property.
(3) Provides—
- Management or administrative services;
- Management or clinical consulting services; or
- Accounting or financial services to the facility.6
As the basis for these disclosure requirements, CMS referenced concerns with private equity ownership of SNFs and its desire to assess the impact of such ownership on quality of patient care. CMS stated that:
Part of the challenge CMS faces in ensuring quality care at nursing homes is our lack of sufficient knowledge of all the parties associated with the nursing home's ownership, operations, and management. Without a complete understanding of the full scope of the facility's operations and its relationship with other persons and entities, it can be challenging to pinpoint the origin within the organization's overall structure of any quality-of-care problems, as well as whether taxpayer funding is being appropriately spent on care.7
Additionally, in response to comments regarding the administrative burden and operational difficulties these reporting requirements may impose on SNFs, CMS determined that "the importance of quality care and the potential saving of lives justifies additional burden on the part of the nursing facilities."8
CMS' public announcement does not cast light on its rationale for the deadline extension, but the sheer scope of the administrative lift for SNFs to comply with these reporting requirements may be a contributing factor. Given the Trump Administration's scrutiny of existing HHS guidance and even existing regulations that are deemed to be overly burdensome, we cannot rule out the possibility of a change in course as to CMS' focus on ownership and control transparency. Given the additional time for completion, providers should watch carefully for additional guidance with respect to the completion of their revalidations.
Footnotes
1 Centers for Medicare & Medicaid Services, 2025-04-17-MLNC (April 17, 2025) https://www.cms.gov/training-education/medicare-learning-network/newsletter/2025-04-17-mlnc#_Toc195616278.
2 Centers for Medicare & Medicaid Services, GUIDANCE FOR SNF ATTACHMENT ON FORM CMS-855A (April 9, 2025) https://www.cms.gov/files/document/guidance-snf-attachment-855a.pdf.
3 88 FR 80141 (Nov. 17, 2023).
4 42 C.F.R. § 424.516(g).
5 Id.
6 42 C.F.R. § 424.502.
7 88 FR 80141, 80147 (Nov. 17, 2023).
8 Id. at 80148.
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