Reporting Reasonable Suspicion of a Crime in a Long-Term: Section 1150B of the Social Security Act
Section 1150B of the Social Security Act (the Act), as established by section 6703(b)(3) of the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), requires specific individuals in applicable long-term care facilities to report any reasonable suspicion of crimes committed against a resident of that facility. Reports must be submitted to at least one law enforcement agency of jurisdiction and the state survey agency (in fulfillment of the statutory directive to report to the Secretary).
This memorandum discusses applicability of this provision to the following Medicare and Medicaid participating long-term care provider types that are collectively referred to as "facilities" or "LTC facilities" in this memorandum:
- Nursing facilities (NFs),
- Skilled nursing facilities (SNFs),
- Hospices that provide services in LTC facilities, and
- Intermediate Care Facilities for the Mentally Retarded (ICFs/MR).
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