New Chapter Added to the State Operations Manual that Guides Surveyors on Imposing Alternate Sanctions
April 30, 2014 09:23 AM
The Centers for Medicare & Medicaid Services (CMS) has issued Transmittal 114, which includes in the State Operations Manual (SOM) a new chapter, chapter 10, to guide State Survey Agencies and Regional Offices on the implementation of new alternative sanctions for home health agencies. CMS initially issued the guidance in March, 2014 through their Survey and Certification Policy and Memo web page with the intention of adding the guidance to the SOM. The authority to impose alternative sanctions was finalized in the November 8, 2012 Federal Register notice.
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.