Skip to content Accessibility tools
Virginia Health Care Association | Virginia Center for Assisted Living

New Penalties for Deficiencies to Take Effect September 1

New Penalties for Deficiencies to Take Effect September 1

The Centers for Medicare and Medicaid Services released a revision to its Survey & Certification (S&C) Memo 16-31-NH updating Chapter 7 of the State Operations Manual.  The revision is dated July 29, 2016.  (The most recent changes to the memo are highlighted in yellow.)  With this new memo, CMS is instituting a policy that requires the imposition of federal enforcement remedies when one or more residents suffer significant harm.

A change from the version we notified you about last week is a shift in the effective date from the previously announced August 1 to September 1, 2016.  The new penalties will take effect for any surveys completed on or after September 1, 2016. The revision also adds “temporary management” to the list of possible remedies under Category 2 remedies.

This change in policy represents a marked expansion of the punitive enforcement process associated with survey citations.  The memo summarizes the revisions noting that:

Civil Money Penalties (CMPs) for Immediate Jeopardy (IJ): The CMS Regional Office (RO) must now immediately impose a CMP any time IJ is cited.

Immediate Imposition of Remedies Required: Irrespective of a state recommendation to impose or not impose a remedy, the CMS RO must immediately impose, without permitting a facility an opportunity to correct deficiencies, one or more federal remedies based on the seriousness of the deficiencies or when actual harm or Substandard Quality of Care (SQC) is identified as outlined in §7304.1.

Preliminary analysis of survey data from Virginia from SMART (VHCA’s Survey Management and Analysis Resource Tool), indicates that there has been an increase in the number of facilities and the number of deficiencies being cited at actual harm and immediate jeopardy. We will provide more specific information on Virginia’s survey trends in the near future.

AHCA expressed grave concerns to CMS about this new policy prior to the issuance of the new memo; however, there have been no signals that CMS will consider altering this new approach to penalties.

Follow the link below to read the memo in its entirety: