As noted previously, the Centers for Medicare & Medicaid Services (CMS) has updated the Medicare Enrollment Application Form 855A for compliance with nursing home transparency reporting requirements finalized in November 2023. To implement these new requirements, under which nursing homes will now report ownership, management, and related party data to CMS, CMS has announced that the Medicare Administrative Contractors will be completing off-cycle revalidation of all nursing homes from October through December 2024. The updated form and accompanying guidance has been released; however, LeadingAge has several remaining questions and concerns, many of which were raised in our April 14, 2023 comments on the proposed rule. LeadingAge has reached out to CMS for clarification on these issues.

A United States Government Accountability Office (GAO) report released October 2 to the House Committee on Energy and Commerce outlines users’ experiences with hospital pricing data before the Centers for Medicare and Medicaid Services (CMS)’s 2024 updates, details the updated requirements introduced in 2024, and assesses CMS’s enforcement of these regulations. Although this a hospital requirement, the push for transparency in pricing, ownership and others areas is growing throughout the health care sector–including in long-term care, particularly on the relationship between ownership, cost and quality. New CMS ownership, management, and related party transparency regulations for nursing homes go into effect this month.  Read more about the GAO’s report,  “Health Care Transparency – CMS Needs More Information on Hospital Pricing Data Completeness and Accuracy” here.

Following up on plans finalized in a November 2023 rule, the Centers for Medicare & Medicaid Services (CMS) has announced updates to the Medicare Provider Enrollment Application Form (CMS-855A); though not yet available, the updated form – and guidance accompanying its use – will be soon, according to the agency. At that time, nursing homes must use it to report certain ownership, management, and related party data as part of the revalidation process, which is conducted from October to December 2024. Get more information here.

The Centers for Medicare and Medicaid Services (CMS) on November 15 placed on display in the Federal Register a final rule requiring nursing homes enrolled in Medicare or Medicaid to disclose and submit certain ownership, managerial, and other information to CMS and state Medicaid agencies. LeadingAge President and CEO Katie Smith Sloan issued a press statement upon the rule’s release.

The action finalizes a proposal CMS released in February 2023, and the final regulatory language is the same as what CMS proposed, with two technical changes. CMS and states already collect some of the information addressed in the rule, but there would be new data submissions too, including additional disclosable parties and the addition of data elements to the CMS-855A form through which owning and managing entities of skilled nursing facilities would have to disclose whether they are either a private equity company or a Real Estate Investment Trust.

LeadingAge submitted comments on the proposed rule in April expressing support for transparency with respect to ownership and operation, but also asking CMS to take steps to clarify and lessen the burden of data submission. While the final rule does not incorporate changes from what CMS originally proposed, LeadingAge will continue to engage with CMS as it moves toward implementation of the requirements.

The rule takes effect January 16, 2024, but nursing homes will not be expected to comply until CMS and states (with respect to Medicaid enrollment) have completed additional work needed to collect the information the rule requires to be submitted. This CMS fact sheet provides an overview of the rule, and LeadingAge will soon publish an article with additional analysis.

On the day of the rule’s release, LeadingAge was quick to respond, quoted in media coverage in trade outlets McKnight’s Long-Term Care and Skilled Nursing News.

Read our full press release here.

USAToday and other national consumer and trade outlets sought LeadingAge comment on the Centers for Medicare & Medicaid Services (CMS)’ February 13, 2023 proposed rule aimed at increasing transparency of nursing home ownership and management. 

“We agree with the administration that ownership and financing of nursing homes should be transparent to help ensure that owners or associated businesses do not profit at the cost of quality care,” LeadingAge president and CEO Katie Smith Sloan told USAToday. “The proposed disclosure and reporting requirements set out in today’s proposed rule are a step in the right direction.”

Read our press release (LeadingAge Statement on HHS Announcement of Increased Transparency of Nursing Home Ownership) and links to additional coverage: 

• Bloomberg Law Nursing Home Ownership Must Be Clarified, Says HHS Proposal
• McKnight’s Long-Term Care News New CMS ownership proposal targets private equity, REITs and related parties
• Modern Healthcare Private equity targeted in CMS nursing home ownership regulation
• Skilled Nursing News CMS Proposes Rule Requiring More Nursing Home Ownership Transparency, Including REIT and Private Equity Disclosures

On the February 22 national nursing homes stakeholder call, CMS clarified that Skilled Nursing Facilities will submit information through the 855A form or PECOS upon enrollment and revalidation, while Medicaid-only nursing homes will submit information through a process outlined by the state.

CMS intends to release an updated 855A form for these purposes in summer 2023. Data will be made publicly available on the CMS data site within one year of publishing the final rule.

The Centers for Medicare and Medicaid Services (CMS) on Feb. 15, 2023, published a proposed rule requiring nursing homes enrolled in Medicare or Medicaid to disclose and submit certain ownership, managerial, and other information to CMS and state Medicaid agencies.

CMS framed the proposal as an important step in continuing to implement President Biden’s initiative to improve the quality and care available at nursing homes. “By making facility ownership and oversight more transparent, nursing home residents and their families will be more empowered to make informed decisions about care,” the agency noted in a press statement.

Read the full article for a summary of the proposed rule.