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US · guidance

CMS Pub. 100-01, ch. 4, § 40.4

Timing of Recertifications for Extended Care Services

activein force · 2026-08-25 – presentas-observed

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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