The Centers for Medicare and Medicaid Services (CMS) explained in a February 2024 MLN Matters article that hospices and skilled nursing facilities must act now to report their designated administrators and designated medical directors as “managing employees,” if they haven’t already done so.
In the Calendar Year 2024 Home Health Prospective Payment System final rule, published in November 2023, CMS revised its definition of managing employee (42 CFR §424.502) to explicitly note that this term includes, but is not limited to, a hospice or skilled nursing facility administrator and a hospice or skilled nursing facility medical director. CMS included the same regulatory change in the Disclosures of Ownership and Additional Disclosable Parties Information for Skilled Nursing Facilities and Nursing Facilities final rule, which also was published in November 2023.
In December, LeadingAge shared with members that this requirement would be effective as of January 2024, but there was some uncertainty about whether providers were required to submit the information now or may wait to do so as part of their standard revalidation process and timeline. A February revision to an earlier MLN article clarified that providers should not wait: “If a hospice or SNF hasn’t reported a medical director or administrator as a managing employee, they must report now.”
A hospice agency or skilled nursing facility that has not reported its administrator or medical director to Medicare should submit a Change of Information to its current enrollment information, using either PECOS or paper form 855A.
In a new 7-minute QuickCast, LeadingAge Director of Home Health and Hospice Operations and Policy Katy Barnett highlights what hospices and skilled nursing providers need to know about changes related to “managing employees.” These new requirements went into effect January 1, 2024, and providers have 90 days (or until March 31, 2024) to make changes. Also, if there is a change in the designated administrator or medical director in the future, that change must be reported.
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We also note that the complete CMS final rule on Disclosures of Ownership and Additional Disclosable Parties Information for Skilled Nursing Facilities and Nursing Facilities, which became effective January 16, 2024, establishes new reporting requirements for nursing homes that go beyond the administrator/medical director issue described above. However, CMS has not yet released guidance on implementation of those requirements, or corresponding changes to the Medicare Policy Manual or Form CMS-855A, with the exception of this Nov. 2023 MLN Matters Article addressing submission of information on private equity company or real estate investment trust ownership.
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