CMS releases new survey interpretive guidance, will delay penalties for one year

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Seema Verma
Seema Verma

The Centers for Medicare & Medicaid Services said Friday it “has heard concerns” about requirements for Phase 2 survey guidelines and will be postponing enforcement penalties for another year.

“Specifically, we will not utilize civil money penalties, denial of payment, and/or termination. Should a facility be found to be out of compliance with these new requirements beginning in November of 2017, CMS would use this year-long period to educate facilities about certain new Phase 2 quality standards by requiring a directed plan of correction or additional directed in-service training,” the CMS memo states. “Enforcement for other existing standards (including Phase 1 requirements) would follow the standard process.”

The one-year delay does not change the requirement implementation date of Nov. 28, 2017 — only the monetary penalties. Most facilities should expect to be surveyed for compliance with Phase 2 requirements with the revised survey within a year of that date, the memo says.

In additional good news for providers, CMS said it will keep constant the Nursing Home Five Star Quality Rating system health inspection rating for any surveys after Nov. 28. This will allow nursing homes to catch up with new requirements without potentially losing a star.

“CMS has done this previously where the star ratings are maintained for a period of time as new requirements are phased-in. To address the concern that serious quality concerns will not be known, CMS will separately flag those nursing facilities to ensure public transparency,” the memo states.

In addition to the memo and updated guidance in Appendices P and PP in the State Operations Manual, CMS released the F-Tag Crosswalk. This document (click above to download) provides a reference for old and new F-Tags. For example, new F-Tag 622, Transfer and Discharge Requirements, encompasses the old F-Tag 201 and F-202, encompassing regulations 483.15(c)(1)(i)(ii) and 483.15(c)(2)(i)-(iii).

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