SNF Denial Rates Significantly Increase in 2015

May 22, 2017

Rick Gawenda

According to the 2015 Comprehensive Error Rate Testing (CERT) Report, the denial rate for Skilled Nursing Facilities (SNFs) increased from 6.9% in 2014 to 11% in 2015 due to missing or incomplete certification/recertification:

Statement must contain need for skilled services that can only be provided in SNF/swing-bed on a daily basis for a condition patient was treated for in prior hospital stay
Must include physician’s dated signature (printed name if signature is illegible)

In addition, recertifications should include:

Expected length of stay
Explanation if continued need for services is for a condition that arose after SNF admission
Any plans for home care

CMS has several SNF resources available that can be accessed below:

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