by Michael Waserman, MD, CMD

We have an immediate advocacy opportunity available for our members. Reach out to your Congressional representatives and ask them to contact CMS to reverse this mistake, lest we further discourage physicians from practicing in nursing homes.

Based on a mistaken assumption, CMS has created a rule that leads to physician’s billing for services delivered to residents receiving skilled Part A care (POS 31) will be reimbursed at a lower rate than identical services delivered to custodial residents (POS 32).

Two individuals in the same nursing home, even in the same room, receiving the same evaluation and management service from the same clinician, may generate different reimbursement solely because one is classified under Part A and the other is not.

PALTmed has sent a letter to CMS that included the following:

“I work for an independent doctor group, and I have seen many patients in both a SNF (POS 31) and NF (POS 32) and have had to bring the same equipment including my own stethoscope, laptop, and other supplies needed to deliver care. In many cases, the POS designation is not known to the practitioner providing the care as this is handled by the facility”.

This real-world example underscores the core issue: practice expense remains the same whether the clinician sees a patient in POS 31 or POS 32, and the POS designation is handled administratively by the facility and may not even be known to the practitioner at the time of service. The patient may remain in the same bed, under the care of the same physician, with identical equipment, staff support, and documentation requirements. Yet payment changes solely based on certification status. The physician’s overhead and indirect costs do not change. To even determine this can actually significantly increase administrative burden as well and many electronic medical records are not well equipped to manage this in real time to ensure billing accuracy.

We encourage our members to reach out immediately to their congressional representatives, asking them to contact CMS and have this mistaken rule rescinded.

Link(s) for further reading:

• https://www.mcknights.com/blogs/whats-up-wassdoc/cms-unforced-error/
• https://paltmed.org/news-media/paltmed-leads-coalition-effort-overturn-snf-services-payment-reduction
• Sample letter

Updated February 2026.

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FOR IMMEDIATE RELEASE

CALTCM Awarded Accreditation with Commendation by the California Medical Association (CMA) for its CME Program

Los Angeles, CA – August 8, 2025 – The California Association of Long Term Care Medicine (CALTCM) is proud to announce that its continuing medical education (CME) program has been awarded Accreditation with Commendation by the California Medical Association (CMA). This prestigious designation recognizes CALTCM's commitment to providing high-quality, impactful CME activities that improve patient care. 

Accreditation with Commendation recognizes CME providers that go beyond compliance to demonstrate excellence in areas such as learner performance, health care quality improvement, and public health impact. CALTCM programs have shown a measurable commitment to improving clinical care through innovative, team-based, and outcomes-driven education.

CALTCM is committed to continuing to provide high-quality CME activities that meet the evolving needs of the post-acute and long-term care (PALTC) community. Healthcare professionals are encouraged to explore CALTCM’s CME offerings and learn more about how they can benefit from their accredited program.  CALTCM proudly offers several signature events: CALTCM’s annual meeting, the CALTCM Summit for Excellence, Leadership and Management in Geriatrics®, and CALTCM SNF 2.0®. 

Dr. Rebecca Ferrini, Chair of the CALTCM Education Committee, shares: "I’m incredibly proud of the CALTCM Education Committee’s accomplishments. Through forward-thinking programs, we’ve made our in-person meetings more engaging than ever—with focused presentations, exceptional speakers, and personalized learning in our small-group ‘In-The-Trenches’ sessions. These gatherings don’t just share knowledge—they build a vibrant community, offering countless opportunities to connect with fellow PALTC professionals. Join us at our next meeting and experience it for yourself!"

Barbara Hulz, CALTCM Executive Director, adds: “I am grateful to CALTCM’s dedicated volunteers and members—especially our Education Committee and Board of Directors. Their tireless commitment and unwavering pursuit of excellence continually inspire and elevate our work. Our upcoming Annual Meeting is a shining example of this dedication and the exceptional programs we deliver.”

About CALTCM: The California Association of Long Term Care Medicine (CALTCM) is the medical voice of post-acute and long-term care in California. CALTCM values excellent and individualized medical care, a team approach, and the integration of medical science with personalized care. CALTCM is the organization of choice for long term care physicians and other long term care professionals in California. Founded in 1975 as the California Association of Medical Directors (CAMD), CALTCM changed its name to recognize the importance of other disciplines in PALTC, and to better reflect the interdisciplinary team approach needed to carry out its mission: To promote quality patient care across the long-term care continuum through medical leadership and education. CALTCM exists to provide quality education for long term care professionals, promote effective medical leadership, promote ethical delivery of care, and promote the rights of patients.