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Virginia Health Care Association | Virginia Center for Assisted Living

New Civil Monetary Penalties Take Immediate Effect

New Civil Monetary Penalties Take Immediate Effect

A new interim final rule issued by the U.S. Department of Health and Human Services (HHS) will significantly increase the civil monetary penalty (CMP) amounts to adjust for inflation and provide for continued annual CMP adjustments for inflation.  These changes follow on the heels of the change in CMS policy to require the imposition of a CMP any time IJ is cited in a survey and that CMPs will be levied without permitting a facility to correct deficiencies.

The Bipartisan Budget Act (BBA) of 2015 required the adjustment in the CMPs. The interim final rule is effectively immediately.  Changes to the policy about the imposition of the penalties were announced in Survey & Certification (S&C) Memo 16-31-NH, Memorandum to State Agency Survey Directors: Mandatory Immediate Imposition of Federal Remedies and Assessment Factors Used to Determine the Seriousness of Deficiencies for Nursing Homes

New Penalties (The information below includes only those increases related to skilled nursing facility (SNF) and nursing facility (NF) survey and certification CMPs.)

Penalty for failure of covered individuals to report to the Secretary and one or more law enforcement officials any reasonable suspicion of a crime against a resident or individual receiving care from a long-term care facility:

  • Prior maximum penalty: $200,000 — New maximum penalty: $217,490

Penalty for failure of covered individuals to report to the Secretary and one or more law enforcement officials any reasonable suspicion of a crime against a resident or individual receiving care from a long term care (LTC) facility if such failure exacerbates the harm to the victim of the crime or results in the harm to another individual:

  • Prior maximum penalty: $300,000 — New maximum penalty: $326,235

Penalty for a LTC facility that retaliates against any employee because of lawful acts done by the employee or files a complaint or report with the State professional disciplinary agency against an employee or nurse for lawful acts done by the employee or nurse:

  • Prior maximum penalty: $200,000 — New maximum penalty: $217,490

Penalty per day for a SNF or NF that has a Category 2 violation of certification requirements:

  • Prior minimum penalty: $50 — New minimum penalty: $103
  • Prior maximum penalty: $3,000 — New maximum penalty: $6,188

Penalty per instance of Category 2 noncompliance by a SNF or NF:

  • Prior minimum penalty: $1,000 — New minimum penalty: $2,063
  • Prior maximum penalty: $10,000  — New maximum penalty: $20,628

Penalty per day for a SNF or NF that has a Category 3 violation of certification requirements:

  • Prior minimum penalty: $3,050 — New minimum penalty: $6,291
  • Prior maximum penalty: $10,000 — New maximum penalty: $20,628

Penalty per instance of Category 3 noncompliance by a SNF or NF

  • Prior minimum penalty: $1,000 — New minimum penalty: $2,063
  • Prior maximum penalty: $10,000 — New maximum penalty: $20,628

Penalty per day and per instance for a SNF or NF that has Category 3 noncompliance with Immediate Jeopardy:

  • Prior per day (Minimum): $3,050 — New per day (Minimum): $6,291
  • Prior per day (Maximum): $10,000 — New per day (Maximum): $20,628
  • Prior per instance (Minimum): $1,000 — New per instance (Minimum): $2,063
  • Prior per instance (Maximum): $10,000 — New per instance (Maximum): $20,628

Penalty per day of a SNF or NF that fails to meet certification requirements. These amounts represent the upper range per day:

  • Prior minimum penalty: $3,050 — New minimum penalty: $6,291
  • Prior maximum penalty: $10,000 — New maximum penalty: $20,628

Penalty per day of a SNF or NF that fails to meet certification requirements. These amounts represent the lower range per day:

  • Prior minimum penalty: $50 — New minimum penalty: $103
  • Prior maximum penalty: $3,000 — New maximum penalty: $6,188

Penalty per instance of a SNF or NF that fails to meet certification requirements:

  • Prior minimum penalty: $1,000 — New minimum penalty: $2,063
  • Prior maximum penalty: $10,000 — New maximum penalty: $20,628

Grounds to prohibit approval of Nurse Aide Training Program-if assessed a penalty in 1819(h)(2)(B)(i) or 1919(h)(2)(A)(ii) of ”not less than $5,000” [Not CMP authority, but a specific CMP amount (CMP at this level) that is the triggering condition for disapproval]:

  • Prior penalty amount: $5,000 — New penalty amount: $10,314

Grounds to waive disapproval of nurse aide training program-reference to disapproval based on imposition of CMP ”not less than $5,000” [Not CMP authority but CMP imposition at this level determines eligibility to seek waiver of disapproval of nurse aide training program]:

  • Prior penalty amount: $5,000 — New penalty amount: $10,314

Click here to review the complete text of the interim rule.