CMS Issues Guidance to Surveyors on Alternative Sanctions for Home Health Agencies
March 21, 2014 08:45 AM
The Centers for Medicare & Medicaid Services (CMS) has issued guidance to State Survey Agency Directors on the implementation of new alternative sanctions for home health agencies that was finalized in the November 8, 2012 Federal Register notice. Alternatives sanctions provide CMS with alternatives to program termination for agencies found to be not in “substantial compliance” with the conditions of participation.
CMS now has the authority to impose alternative sanctions of civil money penalties (CMPs), directed in-service training, directed plans of correction, suspension of payment for new admissions, and temporary management on HHAs that are found to have condition level deficiencies. The guide instructs on the implementation, basis for, and notification requirements for the individual sanctions, in addition to, the process for an informal dispute resolution (IDR), and the formal appeals process for when CMPs sanctions are imposed.
The guidance provides instructions on enforcement actions for deficiencies that pose either immediate jeopardy or no immediate jeopardy situations. In cases where deficiencies pose immediate jeopardy to patient safety, CMS will terminate an agency’s provider agreement no later than 23 days from the last day of the survey, unless immediate jeopardy is removed. CMS may also impose sanctions in cases of immediate jeopardy. In non-jeopardy cases, agencies that are noncompliant with conditions of participation and repeat noncompliance with condition and standard-level deficiencies may also be subject to termination and/or imposition of sanctions.
The effective dates for the sanctions began July 1, 2013 for directed plan of correction, directed in-service training, and temporary management. CMPs, suspension of new admissions, and the IDR process will become effective July 1, 2014.
The guidance on alternative sanctions for home health agencies will be included as a new chapter, titled Survey and Enforcement Process for Home Health Agencies,as part of the State Operation Manual (SOM).
CMS has also updated the Interpretive Guidelines to Surveyors for Home Health Agencies and Chapter 2, Sections 2182-2202 of the SOM, which had not been revised since 2005, to reflect policy and other minor changes.
Click here to view the Survey & Certification letter.