CMS Subcontractors Conducting Unannounced Nursing Home Visits

LeadingAge members reported concerns about subcontractors without proper identification or documentation showing up for unannounced visits to take photos of their nursing home and skilled rehab. The inspector may identify themselves as a subcontractor for the Centers for Medicare & Medicaid Services (CMS) or working for a Medicare Administrative Contractor (MAC).

LeadingAge reported concerns to CMS and received some information for nursing home members on what to expect. According to CMS, the inspector needs to provide a photo ID (they do not have a government employee or contractor identification) and a CMS letter of authorization. This letter has a QR code that links to the MAC contact list for providers to call if they would like to verify the visit. Providers may review but not obtain or copy the identification or letter.

This process may be found online from CMS outreach at Medicare Provider Enrollment MLN (Enrollment tab, step 3). This verifies CMS' authority to conduct visits on all providers and information was also provided in the MLN newsletter, Provider & Supplier Enrollment Site Visits: CMS has Authority to Conduct.