News, Payment/economy, Skilled Nursing Facility, Survey

CMS releases new information on civil money penalties imposed for a deficiency

On August 30, the Centers for Medicare & Medicaid Services (CMS) released a memo sent to state survey agency directors that states that every civil money penalty (CMP) imposed for a deficiency in a nursing home will be subject to escrow and the nursing home may request an independent informal dispute resolution.

Effective October 1,  CMPs imposed pursuant to all standard or complaint surveys that begin on or after October 1, that initiate an enforcement action in which a CMP is imposed where the highest level of deficiency is less than a “G” level, will also be subject to collection and escrow in accordance with 42 C.F.R. §488.431.

Any revisit survey conducted on or after October 1 that is associated with a standard or complaint survey completed prior to October 1 will not be subject to escrow and the independent informal dispute resolution ( IDR) requirement will not apply to that CMP. CMPs based on surveys in which a deficiency is cited for actual harm or immediate jeopardy (“G” or higher) are already subject to escrow, accounting for about 80-85% of all CMPs.

The escrow of any CMP also creates an opportunity for the facility to request to participate in the independent IDR process. The offer of independent IDR must be included in all CMP imposition notices. The standard IDR process remains available as an alternative.

Previously, CMS phased in the escrow requirement by limiting it to CMPs imposed for actual harm or immediate jeopardy.

Read the memo in full here.