An Alabama nursing home that did not properly handle a resident with pressure sores on her feet is on the hook for Immediate Jeopardy fines of nearly $135,000, a federal appeals court recently affirmed.

The case involves Bibb Medical Center Nursing Home in Centreville, AL. For not properly reporting, treating or preventing pressure sores on a female resident’s feet, the Centers for Medicare & Medicaid Services fined the facility $3,550 per day for a 38-day period during the autumn of 2010. The nursing home appealed, arguing its noncompliance with CMS regulations did not lead to Immediate Jeopardy.

A CMS appeals board and an administrative law judge upheld the determination before the case reached the U.S. Court of Appeals for the Eleventh Circuit. The appeals court denied Bibb’s petition for review on Feb. 26, saying the nursing home’s noncompliance did create Immediate Jeopardy.

“Immediate jeopardy exists if the nursing home’s noncompliance has caused or is likely to cause ‘serious injury, harm, impairment or death to a resident,’” the appeals court stated. “Actual harm is not a prerequisite for an immediate jeopardy finding.”

This case demonstrates the high stakes of Immediate Jeopardy, which will be covered in a McKnight’s Online Expo webcast featuring Joan Redden, vice president of Regulatory and Consumer Affairs at Skilled Healthcare. Redden’s session will be one of five webcasts offered March 20-21 as part of the seventh annual Online Expo. Continuing education credits are available for attending these sessions. Registration is ongoing at