DEPARTMENT OF HEALTH AND HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, MD 21244-1850 
 
Center for Medicaid, CHIP, and Survey & Certification 
 
CMCS Informational Bulletin 
  
 
DATE:  September 28, 2011 
 
FROM:  Cindy Mann, Director 
  Center for Medicaid, CHIP and Survey and & Certification (CMCS) 
 
SUBJECT:  Affordable Care Act Section 6103: Guidance for State Consumer-   
    Oriented Websites 
 
 
This bulletin provides information for States on funding availability and implementation of 
section 6103(d)(2) of the Affordable Care Act.  This provision amends section 1902(a)(9) of the 
Social Security Act to require that the State maintain a consumer-oriented website containing 
information to consumers on all skilled nursing facilities and all nursing facilities in the State.  
The provision requires States to post Form 2567 State inspection reports (or a successor form), 
complaint investigation reports, the facilitys plan of correction, and such other information that 
the State or the Secretary considers useful in assisting the public to assess the quality of long 
term care options and the quality of care provided by individual facilities. 
 
A. Key Elements of a State Website  
 
Federal funds are available to meet the requirements of this legislation in accordance with 
normal cost-allocation principles (described in section B).  The statute sets out basic 
requirements for the website, which are noted above.  CMS funding is available to support States 
in their efforts to develop the websites.  Websites developed by a State under their state plan to 
satisfy the new requirement of section 1902(a)(9)(D) of the Act should include these 
characteristics: 
 
(1) Inclusive: Include all skilled nursing facilities (SNFs) and nursing facilities (NFs) in 
the State. 
(2) Accessible:  Be easily accessible from the main page of the website of both the State 
Medicaid agency and the State Survey Agency. 
(3) Consumer Friendly: Be written and conveyed in a manner that is welcoming and 
readily understandable to consumers and the public. 
   
  Page 2- Cindy Mann, Director  
 
(4) Searchable: Provide search capabilities that allow a consumer to identify any SNF 
and NF in the State by name and geographic location. 
(5) Comprehensive: The CMS Form 2567 survey results for each recertification survey 
and each complaint survey performed in the last three years should be available in 
viewable and downloadable form for each SNF and NF, in a manner consistent with 
industry standards (such as those developed by the National Institute of Standards and 
Technology), including portable document file (.pdf) or hyper text markup language 
(HTML) format. 
(6) Include Plans of Correction: For each recertification and complaint survey 
completed, provide the nursing facility or skilled nursing facilitys plan of correction 
when available. 
(7) Link to Federal Websites: Link to CMSs Nursing Home Compare website.  See 
also paragraph (c) of the enclosure for a discussion of Federal plans for making CMS 
Form 2567 data available. 
(8) Link to State Websites: Link to the State Long Term Care Ombudsman Program 
and, if applicable, a State Aging and Disability Resource Center (ARDC). 
(9) Include Information about Alternative Services: Provide links and information 
about alternative long term care services available in the State, including services 
provided under Home- and Community-based Service programs. 
(10) Privacy Safeguards: Must not contain any identifying information about the 
resident or complainant(s) in the text of the CMS 2567.  
 
States should provide CMS with the universal resource locator (URL) for the relevant state 
websites so that CMS may include a link to the states web site on the Nursing Home Compare 
website. 
 
B. Financing 
 
The costs for development and operation of the State websites to meet section 1902(a)(9)(D) of 
the Act are allowable expenses for reimbursement through a combination of Medicaid, Medicare 
survey and certification, and State-only funds under standard cost-allocation procedures.   
 
In those States in which a State law or regulation requires public posting of CMS Form 2567 
survey results for nursing homes, the cost-allocation proportions in effect for surveys of facilities 
dually certified in Medicare and Medicaid in the State should be used (i.e., costs shared between 
Medicare, Medicaid, and State-only).   
 
For other States (that do not have a State law or regulation requiring the posting of CMS Form 
2567 for nursing homes), costs should be apportioned between Medicare and Medicaid using 
each programs share of survey costs for dually-certified facilities, but adjusted to account for the 
absence of a State-only share.   
   
   
Page 3- Cindy Mann, Director  
 
Upon CMS approval, the Medicare portion of costs for a website that meets the criteria in this 
bulletin may be expensed through the survey and certification operational budget for each State.  
The Medicaid share of costs for a website that meets the criteria in this bulletin qualifies as an 
administrative expense.  The Medicaid share may also be eligible for enhanced Federal Financial 
Participation (FFP) if it meets certain conditions.  Any State interested in exploring the 
possibility of enhanced Medicaid FFP should consult with the appropriate Medicaid 
representative in the CMS regional office.  
 
CMCS Contact 
 
If you have any questions regarding the requirements for posting 2567s as described in this 
bulletin, please contact the appropriate survey & certification contact for your State in the CMS 
regional office.  The RO contacts will be supported by Ed Mortimore in the CMS central office 
(Edward.Mortimore@cms.hhs.gov).    
 
For questions related to Medicaid financing, please consult with the appropriate Medicaid 
representative in your CMS regional office.      
   
Enclosure 
Options for States and Potential Availability of CMS Form 2567 Data Files 
 
This enclosure describes three general options for States to pursue in obtaining CMS 2567 data to 
fulfill their responsibilities under section 6103 of the Patient Protection and Affordable Care Act of 
2010.  Option 1 describes a general method that States may use to post data to which the States have 
direct access.  Options two and three describe methods to use data that CMS is planning to make 
available in 2012.   
 
1. State Server Option 
 
Under this option, States would use Form 2567 data maintained on their State Servers.  This option 
would allow States to link plans of correction to the Form 2567 data, if the Plans of Correction data 
are available on the server.  If Plan of Correction data are not available electronically, States have the 
option of designing an electronic system to capture Plans of Correction, or scanning Plans of 
Correction and posting the scanned files on the Web site.  This option would provide the most up-to-
date array of survey findings, as recorded in the Form 2567s, and the optimum method of linking 
Form 2567s and the corresponding Plans of Correction.  
 
2. Download Option 
 
States may be able to download CMS Form 2567 data from data.medicare.gov.  Our hope is that by 
Spring 2012, we may be able to make available the source data files for CMS Form 2567 on 
data.medicare.gov for download to interested parties.  These data sets would contain the entire text of 
the 2567 form for standard and complaint surveys that have been uploaded to the CASPER database, 
and would be available in an electronic format suitable for loading into databases.  The data sets will 
not, however, contain Plans of Correction.   
 
Detailed specification on the structures of the CMS Form 2567 datasets will be forthcoming.  These 
data will be suitable for use in a database that provides information to consumers, but will need to be 
formatted for printing.   They would be suitable for use in State consumer Web sites.   The 
information would be updated monthly.  Plans of Correction data, however, will continue to exist only 
in State databases.  Please also note that this option will involve some delay in the appearance of the 
Form 2567s, since there is a time lag inherent in the uploading of the Form 2567s from State servers 
to the national CASPER database, from which the downloadable data are derived. 
 
3. Link Option   
 
In this method, States would provide a link to Nursing Home Compare, which would display the 
actual contents of the Form 2567.  CMS is working to make detailed survey information contained on 
the Form 2567 available as .pdf files on the Nursing Home Compare Web site by the summer of 2012.  
CMS does not know at this time if States will be able to link directly to individual nursing homes or 
surveys on the Web site.  CMS will make this information available as soon as it is able.  Another 
limitation of this option is that Nursing Home Compare will not display the Plans of Correction.