Elimination of
Opportunity to Correct Before Federal Sanctions Are Implemented
PDF Version
of BQA 00-002 (PDF, 9 KB)
Date: January 3, 2000 DSL-BQA-00-002
To: Nursing Homes NH 1
From: La Vern Woodford, Chief, Resident Care Review Section
cc: Susan Schroeder, Director, Bureau of Quality Assurance
Effective with surveys completed on or after January 14, 2000, the
federal Health Care Financing Administration (HCFA) has instructed states to implement, or
recommend to HCFA, immediate sanctions if certain criteria are met. Nursing homes that
will be subject to immediate sanctions and which will not have an opportunity to correct
before we implement or recommend federal sanctions are nursing homes that:
-
have one or more federal deficiencies alleging actual harm (grid level of G or above) at
the present survey; and
-
had one or more federal deficiencies at a grid level of G or above at the last
certification survey or any survey in-between the last certification survey and the
present survey.
In the past, most nursing homes that were in substantial compliance with the federal
nursing home regulations at the start of a survey had an opportunity to correct any
deficiencies that the Bureau of Quality Assurance (BQA) cited. In these cases, BQA, or
HCFA, did not impose a federal sanction unless deficiencies were found at a revisit. The
only exceptions were those rare cases where immediate jeopardy was cited during the survey
or where the facility had consecutive surveys with substandard quality of care. Effective
with this change, any nursing home that has a deficiency at a grid level of G or above at
the present survey and had a prior deficiency at G or above (issued at the last
re-certification survey or later) can expect an immediate federal sanction. In most cases,
this will be a civil money penalty. The sanction will continue until the nursing home
comes into substantial compliance with all federal nursing home regulations.
Federal citations at a level G or higher that are issued prior to the last
recertification survey do not count toward denying a facility an opportunity to correct.
HCFA has implemented this change in response to testimony before the United States
Senate that past enforcement efforts did not go far enough in preventing repeated
non-compliance or in ensuring the health and safety of nursing home residents.
If you have questions, please contact the Regional Field Operations Director assigned
to your facility. Their names and phone numbers are listed below [via the regional
offices].
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