CMS Emphasizes CMPs and Immediate Jeopardies in New S&C Letter

The Centers for Medicare & Medicaid Services (CMS) issued an S&C letter, “Advance Copy: Update of State Operations Manual (SOM) Chapter 7 and Survey Process Timeframe Reminder” on March 28th. The memo emphasizes changes to Civil Monetary Penalties that are related to provisions of the Affordable Care Act (ACA).

Last August, CMS issued an S&C letter, “Escrow and Independent Informal Dispute Resolution (Independent IDR) Process for Nursing Homes – Applicable to All Civil Monetary Penalties” that provided updates to the imposition of CMPs on standard and complaint surveys. That letter outlined the implementation and noted that guidance and instructions would be made in an upcoming Chapter 7 SOM revision. The entire updated SOM Chapter 7 can be viewed with the memo. The advance copy issued on March 28th provides information on:

  • Independent IDR opportunity guidelines
  • Use of escrow in Independent IDRs
  • Reduction of CMPs in specific cases where facilities have self-reported and promptly corrected noncompliance and waived their rights to a hearing

CMS also issues some strong reminders to surveyors in this S&C letter, specifically around immediate jeopardy situations and the timeframes for enforcement actions. CMS Compliance Group put together a 4-part, comprehensive article on nursing home immediate jeopardy situations that includes this information, which can be viewed on our blog. The S&C letter issues the following reminders:

  • When an immediate jeopardy is identified, the facility must submit an allegation that the immediate jeopardy has been removed. This allegation must include a plan of sufficient detail to demonstrate how and when the immediate jeopardy has been removed. The plan of correction for the deficiencies should be deferred until a revisit to verify that the removal of the immediate jeopardy has been completed.
  • It is essential to remove the risk as soon as possible. Notice of Immediate Jeopardy to a facility must be delivered no more than two days after the end of survey. If there are additional deficiencies, the 2567 must be delivered by the tenth working day.

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