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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