US · guidance
CMS Pub. 100-01, ch. 4, § 40.4
Timing of Recertifications for Extended Care Services
The first recertification must be made no later than the l4th day of inpatient extended care
services. A skilled nursing facility can, at its option, provide for the first recertification to
be made earlier, or it can vary the timing of the first recertification within the l4-day
period by diagnostic or clinical categories. Subsequent recertifications must be made at
intervals not exceeding 30 days. Such recertifications may be made at shorter intervals as
established by the utilization review committee and the skilled nursing facility.
At the option of the skilled nursing facility, review of a stay of extended duration,
pursuant to the facility's utilization review plan (if a UR review plan is in place), may
take the place of the second and any subsequent physician recertifications. The skilled
nursing facility should have available in its files a written description of the procedure it
adopts with respect to the timing of recertifications. The procedure should specify the
intervals at which recertifications are required, and whether review of long-stay cases by
the utilization review committee serves as an alternative to recertification by a physician
in the case of the second or subsequent recertifications.
History
(Rev. 1, 09-11-02)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
7ce6c3fda3a0c1c9be6c10ce2278e5d23e0629a1d757f01a13b273328a6d2250
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