CMS Indefinitely Suspends Off-Cycle Revalidation Deadline for Skilled Nursing Facilities
As published in recently updated guidance, the Centers for Medicare & Medicaid Services (CMS) is indefinitely suspending the off-cycle skilled nursing facility (SNF) provider enrollment revalidation due date. This suspension marks a significant departure from previous extensions, which were granted with specific expiration dates. For the first time, CMS has removed a fixed deadline, though whether it will eventually issue a deadline remains unknown.
This development is particularly welcome news for SNFs that have spent the last year adapting to major public policy shifts related to ownership and control disclosure obligations required by CMS. Since October 2024, SNFs have been grappling with heightened requirements from CMS concerning the disclosure of ownership and control interests. The indefinite suspension offers facilities a crucial reprieve from at least one pressing compliance deadline.
Obligations Remain Despite Indefinite Suspension
Despite the indefinite suspension, it is critical to note that the relief does not apply universally. For example, SNFs that are undergoing a change of ownership (CHOW) will not see their disclosure burdens lifted, at least for now. These facilities remain responsible for completing the detailed Attachment 1 ownership disclosures. Furthermore, they must continue to disclose all individuals and entities that hold operational, managerial or financial control over the facility, as detailed in a previous Holland & Knight alert.
Navigating the Evolving Skilled Nursing Facility Regulatory Compliance Environment
Particularly in light of an indefinite suspension, the regulatory compliance landscape for SNFs remains fluid, and effective compliance requires intentional navigation. Medicare Administrative Contractors (MACs), which process applications and oversee compliance in their respective jurisdictions, often have varied approaches and interpretations to Attachment 1 disclosure obligations and expectations, creating a disparate experience among facilities in terms of the depth and detail to which disclosures are expected and required, often dictated by the geographical region in which any given SNF operates.
As Attachment 1 compliance requirements continue to take shape and change, maintaining direct and consistent communication with the individual MAC analysts assigned to a CHOW or other CMS application is critical. MAC analysts remain the most reliable and accessible resources for understanding the evolving CMS compliance landscape. However, these interpersonal resources must be balanced with a proactive effort to maintain a thorough understanding of the governing CMS rules, regulations and official guidance, which, as evidenced by the most recent indefinite suspension, are ever-changing.
Next Steps
Industry observers should watch for subsequent actions from CMS. Holland & Knight is closely monitoring for more definitive public policy guidance that may clarify the agency's long-term intentions. It remains to be seen whether the indefinite suspension is a precursor to a broader effort by CMS to reconsider the compliance landscape, last altered extensively in 2024. For now, providers can utilize the suspension to shift a degree of focus to other compliance matters while remaining vigilant for future updates.
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