Medicare General Information, Eligibility and Entitlement Manual (Pub. 100-01), Ch. 5 § 10.4.1
Agreement with a SNF
10.4.1 - Agreement with a SNF
(Rev. 1, 09-11-02)
All agreements with SNFs are required to be for a specified term of up to l2 full calendar
months with fixed expiration dates. In appropriate situations, the agreement may also
contain a cancellation clause. Therefore, when it is determined that a SNF is eligible and
that its agreement for participation in the Medicare program will be accepted for filing,
the term of the agreement will be determined in the following manner:
A. No Deficiencies - If a SNF is certified as being in full compliance with all
standards contained in the requirements for participation for SNFs, the term of the
agreement is, as appropriate to the period of certification for it has been approved,
for a term of up to 12 full calendar months.
B. Deficiencies - If a SNF is certified as not being in full compliance, the term of the
agreement is, as appropriate to the period of certification or conditional period of
certification for which it has been approved:
1. For a term which expires no later than the close of the 60th day following
the last day of the time period specified in the written plan providing for
the correction of deficiencies in meeting the requirements for
participation, provided that such term does not exceed 12 full calendar
months or
2. Provide a conditional term of up to 12 full calendar months, subject to a
cancellation clause that the agreement may be canceled on a
predetermined date (no later than the close of the 60th day following the
last day of the time period specified in the written plan providing for the
correction of deficiencies in meeting the requirements for participation),
provided that date will occur within the 12-month term.
If the health and safety of Medicare patients are not jeopardized, the term of an
agreement may be extended for 2 full calendar months when necessary to prevent
irreparable harm to the facility, to prevent hardship to Medicare beneficiaries furnished
care, or if it is impracticable within the term of the agreement to determine whether the
SNF is complying with the provisions of the Act and regulations issued thereunder.