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Long Term Care & Senior Living Blog

We offer updates on national on regional issues such as malpractice defense, regulatory compliance, labor and employment issues and estate planning.

Long Term Care & Senior Living Blog
March 16, 2017

CMS Update - Sharp Rise in Denials for SNF Claims

CMS issued an update regarding what appears to be a sharp increase in the denial rate for Skilled Nursing Facilities (SNFs) as reported in the 2015 Comprehensive Error Rate Testing (CERT) Report. The CERT Report showed denials increasing from 6.9% reported in 2014 to 11% in 2015. What did CMS attribute as the cause of this significant increase? DOCUMENTATION Here are some documentation requirements that CMS reported for the increase in denials resulting from missing or incomplete certification/recertification including: