Penalty process explained

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A long-term care facility that has been slapped with a civil monetary penalty has 10 days to file for an independent informal dispute resolution process, according to a recent manual update from the Centers for Medicare & Medicaid Services.

The manual update also covers matters such as when an operator must put a monetary penalty in an escrow account and conditions under which CMS might reduce a penalty. For instance, penalties might be reduced when a facility self-reports and promptly corrects noncompliance. Reductions are not available if the penalty relates to Immediate Jeopardy or other issues related to resident harm.

The update to Chapter 7 of the State Operations Manual incorporates changes from a final rule published in the Federal Register in March 2011, “Medicare and Medicaid: Civil Monetary Penalties for Nursing Homes.”

Providers also are urged to examine Chapter 7 items related to Immediate Jeopardy enforcement actions, CMS stated in its memorandum announcing the manual revision.

In particular, the chapter describes “very specific time frames for the survey enforcement process” when Immediate Jeopardy exists, according to the memo. For example, surveyors must furnish a notice of Immediate Jeopardy within two days of survey completion.