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Phase 2 RoPs – Temporary Enforcement Delays for Certain Ftags

As you are aware, Phase 2 of the Requirements of Participation is effective tomorrow, November 28, 2017. The Centers for Medicare and Medicaid Services (CMS) issued a new S&C memo on November 24, 2017 that outlines information regarding the imposition of a temporary moratorium on imposing certain enforcement remedies for specific Phase 2 requirements and Ftags.

CMS had previously noted that it may use a 12-month period beginning November 28th to delay the enforcement of certain Phase 2 requirements. This S&C memo now states that an 18-month moratorium on the imposition of civil monetary penalties (CMPs), discretionary denials of payment for new admissions (DPNAs) and discretionary termination when a remedy is based on one of the following deficiencies:

  • F655 Baseline Care Plan
  • F740 Behavioral Health Services
  • F741 Sufficient/ Competent Staff – Behavioral Health Needs
  • F758 Free from Unnecessary Psychotropic Meds/ PRN Use – related to PRN usage
  • F838 Facility Assessment
  • F881 Antibiotic Stewardship Program
  • F865 QAPI Program/ Plan, Disclosure/ Good Faith Attempt – related to development of the QAPI Plan
  • F926 Smoking Policies

So, does this mean that providers are off the hook for more of the “big ticket” Phase 2 RoPs? No. CMS will use the 18-month moratorium to educate providers and surveyors about compliance expectations. The Ftags that are part of the moratorium on remedies will still be cited as appropriate by State Agencies and sent to the Regional Office as normal. Deficiencies cited under all other F-tags will follow the standard enforcement procedures.

Here’s a quick overview on how enforcement will be conducted beginning November 28. 2017:

  • Phase 1 Tags only
    • Normal enforcement policies apply
  • Both Phase 1 and Phase 2 Tags
    • Normal enforcement policies in place for Phase 1 tags
    • Directed Plan of Correction (DPOC) or Directed Inservice Training (DIST) only may be imposed for Phase 2 tags
  • Phase 2 Tags only
    • 18-month moratorium enforcement policies apply for DPOC/DIST

That’s not all that’s included in the November 24, 2017 CMS S&C memo “Temporary Enforcement Delays for Certain Phase 2 F-tags and Changes to Nursing Home Compare” (Ref: S&C 18-04-NH). Check back on the CMSCG Blog shortly for a post on upcoming changes to Nursing Home Compare.

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