Nursing homes are crying foul over what they call excessive and hurried federal demands for ownership and related-party information that were sent with atypically short notice and relatively little guidance, especially with provider’s eligibility to accept Medicare pay at stake.
Providers on Wednesday asked for a more typical six months to return requested data forms for the off-cycle revalidation, rather than the three months now given.
The request came in a letter the American Health Care Association/National Centers for Assisted Living sent to Health and Human Services Secretary Xavier Becerra (pictured) and Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure.
The nation’s largest nursing home association also told the federal leaders it wants more official guidance issued, answers to questions posed to federal contractors about the new forms, and assurances that personal information such as Social Security Numbers and birthdates for key facility and organizational leaders will be protected and not posted online.
“When final regulations result in substantial changes or new requirements, agencies traditionally provide ample notice, guidance, and communication prior to implementation,” wrote Martin Allen, senior vice president of reimbursement policy for AHCA/NCAL in his letter to the officials.
Providers were given less than two weeks’ notification, instead of the more standard six months, that requests for information would be going out Oct. 1, Allen pointed out. Brief guidance was issued about a week out. In addition, the Additional Disclosable Party (ADP) portion of the reporting requirements has expanded to 70 pages, which includes 18 new and specific pages to skilled nursing facilities.
The ADP information request is “far beyond” what is required of any other Medicare provider or supplier, Allen noted.
The ownership transparency rule requiring more expansive reporting received mixed reviews when it was issued in November of 2023.
About 5,000 SNFs are receiving the revalidation letters each month from October to December. Each will have 90 days to respond, a window that providers want doubled.
‘Frustrating,’ ‘tricky’ reporting
Allen said the “profession stands ready to comply” with accurate information but simply needs more time.
There were similar vows of cooperation and indignation Wednesday out of LeadingAge, the association of nonprofit providers of aging services, including nursing homes.
The complexity of information requested on short notice “will present challenges,” said Jon Lips, vice president of legal affairs for LeadingAge in an email to McKnight’s. He also reiterated objections he sent to officials back in April.
Covenant Living Communities’ General Counsel Cory Kallheim told McKnight’s Wednesday that the company had received notice to file its forms by January and that he and colleagues would be meeting to discuss plans. Earlier this month he said he was anticipating that his organization’s finance team would need additional time and resources to complete them. Covenant operates 17 CCRCs in 11 states.
“The transparency efforts are interesting,” Kallheim said. “We all want more transparency, but I think the frustration on the nonprofit side is we’ve got volunteer board members and now their information is everywhere. They don’t have any financial stake, so it’s tricky trying to report on their roles.”
In addition, he noted, all nonprofits providers are already required to capture extensive ownership and management information in their annual “very long” IRS form 990 submissions. Those forms are all publicly available already.
That duplication of effort is one reason Hooper Lundy Bookman partners David J. Vernon and Catherine Srithong Wicker last week called the new forms “onerous and demanding on SNF providers” in a client alert. Another is the quick turnaround for the initial forms.
“They are expansive and will prove difficult to comply with, but failure to do so can be fatal for a SNF’s Medicare certification,” Vernon and Wicker wrote.
