70th AHCA/NCAL Convention and Expo
Civil money penalties (CMPs) remain one of the most frequently cited, and dreaded, sanctions in the arsenal of enforcement remedies available to the Centers for Medicaid and Medicare Services (CMS) under federal statutes and regulations governing skilled nursing facility surveys and enforcement. However, under CMS’s current State Operations Manual and guidance to State Survey Agencies, providers have a real opportunity to shorten periods of noncompliance and avoid large CMPs, even in cases of immediate jeopardy, by finding and fixing potential deficient practices and events before a survey. By doing so, providers can achieve “past noncompliance” and turn large, daily CMPs into a one-time CMP covering all days of alleged noncompliance for a given outcome or event.
The presenters will review the required elements for an “acceptable” Allegation of Compliance (AOC) Plan of Correction (POC) for jeopardy-level deficiencies, and CMS' changing interpretations of these requirements. Attendees will learn how to develop and document, before survey, acceptable POCs to show corrected past noncompliance, and avoid large daily CMPs that can span weeks or months. The session will also focus on creating an acceptable AOC for immediate jeopardy citations during a survey to obtain past noncompliance, based upon CMS's revised Appendix Q. The presenters will discuss the elements that surveyors will look for to cite corrected past noncompliance, strategize about what constitutes “sufficient evidence to support that the facility corrected the noncompliance,” and walk through development of actual POCs that have been accepted as sufficient and led to past noncompliance determinations. Short of not being cited at all, accomplishing past noncompliance through early development of an acceptable POC is the single most effective way to limit the harm from deficient practices , correct and sustain compliance, mitigate risk management challenges, and limit exponential CMPs.