Reed Smith Client Alerts

Introduction On July 16, 2015, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule comprehensively updating and extensively revising the requirements for participation for long term care (“LTC”) facilities participating in the Medicare and Medicaid programs (the “Proposed Rule”).1 Signifying the considerable potential impact of the Proposed Rule, CMS estimates that the total projected cost of implementing the proposed requirements would be $729 million in the first year (or an estimated $46,491 per facility) and would cost approximately $638 million in the second and subsequent years (or $40,685 per facility). CMS explains in the preamble discussion that while the LTC facility requirements for participation have been periodically reviewed and updated due to legislative mandates or specific issues, the agency has not thoroughly reviewed and updated the LTC facility requirements for participation since 1991.

Comments to the Proposed Rule were originally due to CMS by September 14, 2015. In response to inquiries from hospital associations and other industry stakeholders regarding the 60-day comment period, CMS revisited the length of the comment period. Specifically, given the scope and complexity of the Proposed Rule, on September 9, 2015, CMS determined to extend the comment period an additional 30 days.2 Comments are now due to CMS by October 14, 2015.

  1. Centers for Medicare & Medicaid Services, Reform of Requirements for Long-Term Care Facilities, 80 Fed. Reg. 42,168 (July 16, 2015), available at
  2. 80 Fed. Reg. 55,284 (Sept. 15, 2015), available at


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