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CMS guidance aims to ease access to nursing home waivers for ACOs

January 10, 2019 / Paige Minemyer

The Centers for Medicare & Medicaid Services is making it easier for accountable care organizations that accept downside risk to obtain waivers for a rule that requires a three-day inpatient stay before a referral to a nursing home. CMS issued guidance (PDF) on the issue earlier this week, and in the document it outlines how Medicare Shared Savings Program (MSSP) ACOs can apply for the waivers. Only ACOs that are participating in or applying for MSSP’s performance-based risk tracks are eligible. To apply, ACOs must submit a list of affiliate skilled nursing facilities it intends to partner with, and these nursing homes must maintain a rating of at least three stars on Nursing Home Compare.