November 17, 2023
Last week, the Centers for Medicare & Medicaid Services (CMS) released its final rule that will implement portions of section 6101 of the Patient Protection and Affordable Care Act (Affordable Care Act), which requires the disclosure of certain ownership, managerial, and other information regarding Medicare skilled nursing facilities (SNFs) and Medicaid nursing facilities.
CMS is finalizing proposals that nursing homes must disclose the following information to CMS or, for Medicaid nursing facilities, the applicable state Medicaid agency (hereafter occasionally referenced as “state” or “state agency”):
- Each member of the facility's governing body, including the name, title, and period of service of each member
- Each person or entity who is an officer, director, member, partner, trustee, or managing employee of the facility, including the name, title, and period of service of each such person or entity
- Each person or entity who is an additional disclosable party of the facility.
- The organizational structure of each additional disclosable party of the facility and a description of the relationship of each such additional disclosable party to the facility and to one another
In the final rule, CMS updated the definition of “managing employee” to explicitly include SNF medical directors:
“Managing employee means— (1) A general manager, business manager, administrator, director, or other individual that exercises operational or managerial control over, or who directly or indirectly conducts, the day-to-day operation of the provider or supplier, either under contract or through some other arrangement, whether or not the individual is a W–2 employee of the provider or supplier. For purposes of this definition, this includes, but is not limited to, a hospice or skilled nursing facility administrator and a hospice or skilled nursing facility medical director.”
The update to this definition now means that facilities must report who their medical directors are, and CMS will publicly report them. The mechanism for public reporting was not finalized and will be decided through sub-regulatory guidance.
The Society has advocated for a publicly available database of nursing home medical directors for more than a decade, and Society leaders are thrilled with CMS’ actions in this final rule.