Enforcement Remedies and Scope/Severity Flashcards

Which scope-and-severity levels indicate the facility is in substantial compliance despite a cited deficiency?

Answer: A, B, C

Levels A, B, and C are no actual harm with potential for no more than minimal harm. A facility whose deficiencies are all at these levels is considered in substantial compliance.

If a facility does not achieve substantial compliance within 3 months after the last day of the survey, which remedy is mandatory?

Answer: Denial of payment for new admissions (DPNA)

Under 42 CFR 488.417(b), CMS must deny payment for new admissions when a facility is not in substantial compliance 3 months after the last day of the survey.

Absent Immediate Jeopardy, by when must a facility's provider agreement be terminated if it still has not achieved substantial compliance?

Answer: 6 months from the last day of the survey

Under 42 CFR 488.412(d), a facility not in substantial compliance within 6 months of the last day of the survey faces mandatory termination of its provider agreement.

If Immediate Jeopardy is not removed, how soon must CMS or the State terminate the facility's provider agreement?

Answer: Within 23 calendar days of the last day of the survey

Under 42 CFR 488.410, when IJ is not removed, termination must occur no later than 23 calendar days from the last day of the survey, or temporary management must be imposed to remove the IJ.

For which deficiency level is a Plan of Correction NOT required?

Answer: Level A (isolated, potential for minimal harm)

Isolated deficiencies with no actual harm and only potential for minimal harm (level A) do not require a Plan of Correction. All higher levels do.

A facility wants to challenge cited deficiencies through Informal Dispute Resolution (IDR). When must it request IDR?

Answer: Within the same 10 calendar days it has to submit its Plan of Correction

Under 42 CFR 488.331, the facility must request IDR within the same 10-calendar-day period it has to submit an acceptable Plan of Correction. Asking for IDR does not delay enforcement.