The Centers for Medicare & Medicaid Services (CMS) released the final version of the revised policies on the immediate imposition of federal remedies. The Quality, Safety & Oversight (QSO) memo 18-18-NH replaces S&C: 16-31-NH, released in July 2016 and S&C: 18-01-NH, published in a draft on October 27, 2017. With this finalized version of the immediate imposition policies, CMS has revised guidance in Chapter 7 of the State Operations Manual (SOM) related to the Immediate Imposition of Federal Remedies as well as other associated sections of Chapter 7, as noted in QSO 18-18-NH. The revised guidance is effective July 15, 2018. It is essential that you read the full revised guidance as CMS has CMS has made substantive revisions to the guidance released in July 2016. Changes include:
- When the current survey identifies Immediate Jeopardy (IJ) that does not result in serious injury, harm, impairment or death, the CMS RO may determine the most appropriate remedy to immediately impose. This may include a civil money penalty (CMP); however, in these instances, CMPs are not required.
- Any deficiency from the current survey at levels "G, H, or I" that constitutes Substandard Quality of Care (SQC) is subject to the immediate imposition of remedies, excluding level "F" SQC deficiencies where there was no actual harm.
- For Special Focus Facilities (SFF), scope/severity level "F" citations under tags F812, F813 or F814 are excluded from the immediate imposition of remedies.
- Past Noncompliance deficiencies (as described in §7510.1 of Ch. 7 of the State Operations Manual, i.e., Determining Citations of Past Noncompliance at the Time of the Current Survey) are not included in the criteria for Immediate Imposition of Remedies.