CMS Changes Compliant Survey Procedure for Deemed Providers and Suppliers
May 28, 2013 03:13 PM
The Centers for Medicare and Medicaid (CMS) Survey and Certification Group issued a letter to the Medicare State Survey Agencies (SAs) announcing a change to its procedures when a complaint survey has been conducted and a condition level deficiency had been found on deemed providers and suppliers.
The SAs will only conduct a full survey if requested by the Region Office (RO).
Current CMS policy requires that all deemed providers and supplies found to have a condition level non compliance on a complaint survey must have a full survey of all the Conditions of Participation (CoPs) or Conditions of Coverage (CoCs).
The regulation at 42 CFR 488.7(d), provides for deemed providers and suppliers found to have condition-level non-compliance (including cases of immediate jeopardy (IJ)) during a complaint survey to be subject to a full survey. However, the regulation does not require that the provider or supplier have a full survey conducted. Therefore, in the interest of improving efficiency and effectiveness, CMS is revising their policy so that the RO will make a case-by-case determination on whether or not to require a full survey of a deemed provider or supplier after a complaint survey with condition-level noncompliance.
If the RO does not require a full survey, the RO takes enforcement action based on the complaint survey. In other words, the deemed provider or supplier is placed on a termination track, either 23-day or 90-day, depending on whether or not there was an IJ that was not removed while the survey team was on-site. The SA will continue to require a plan of correction and conduct revisits to determine substantial compliance, however a full survey of the all the CoPs/CoCs will no longer be automatically conducted.
In determining whether to require a full survey, the RO may consider factors including, but not limited to, the manner and degree of noncompliance identified as a result of the complaint investigation, the provider’s/supplier’s compliance history, recent changes in the provider’s/supplier’s ownership or management, whether the resources required to conduct a full survey are available in the timeframe needed, and/or the length of time since the provider’s/supplier’s last accreditation survey.
Click Here (http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-13-27.pdf) to access the Survey and Certification letter.