Articles and Blogs

On June 16, 2017, CMS issued transmittal S&C: 17-35-ALL. This transmittal clarified CMS policy by stating a reasonable assurance period will apply if a provider or supplier voluntarily terminates its Medicare certification when an enforcement action has been initiated by the State Survey Agency. Section 2016 of the State Operations Manual allows a provider... READ MORE

On May 16, 2014, CMS issued a Survey and Certification Transmittal (“Transmittal”) to the state survey agency directors providing infomation on how Medicare and Medicaid certifed long-term care facilities may obtain an extension of time for the installation of automatic sprinkler sytems.  The Transmittal sets forth the procedures on how a nursing home may seek an... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) issued a Survey & Certification Memo (“S&C Letter”) to state agencies detailing the result of the governmental shutdown on long-term care providers as it relates to surveys.  As of this writing, the S&C Letter has not been published or otherwise made publicly available, and the below... READ MORE

Beginning October 1, 2013, a skilled nursing facility (“SNF”), a nursing facility (“NF”) or a dually-certified SNF/NF will be permitted to request an independent informal dispute resolution (“IIDR”) for all federal deficiencies cited on its standard or complaint survey (CMS-2567) that are subject to the imposition, collection and escrow of civil money penalties (“CMPs”)... READ MORE

On August 13, 2013, all nursing facilities participating in the Medicare and Medicaid programs were required to be in compliance with the automatic sprinkler systems’ regulation that was published in a final rule on August 13, 2008. The regulation provided a five-year phase-in program to allow long-term care facilities (“Facilities”) to achieve compliance by... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) recently released a Survey and Certification Letter updating the State Operations Manual (“SOM”) guidelines  on surveys of deemed status long-term care (“LTC”) providers when the provider has been found to have a condition level instance of noncompliance, including immediate jeopardy (“IJ”), in a complaint survey.  This change... READ MORE

In a transmittal issued on April 5, 2013, CMS provided guidance on survey activities that will be affected by the sequestration cuts.  The transmittal provides guidance on several areas that will have an immediate and potentially negative effect on nursing homes and post-acute care providers.  These changes will affect the survey process as conducted by the state survey... READ MORE

Based on additional feedback, the Centers for Medicare & Medicaid Services (CMS) has revised the surveyor guidance issued in September 2012 on Naso-Gastric Tubes (NG Tubes) for F-Tag F322.  Since the NG Tube regulation, §483.25(g), was published, the use of NG Tubes has become increasingly rare in favor of other forms of enteral feeding... READ MORE

The Office of the Inspector General (OIG) has published their annual Work Plan for 2013. The Work Plan continues to identify compliance risk areas that subject Medicare and Medicaid providers to audit and enforcement initiatives. The Work Plan specifically targets skilled nursing facilities (SNFs), hospices, and home health agencies (HHAs). For all types of... READ MORE

On September 27, 2012, CMS issued an advance copy of the State Operations Manual (“SOM”) revisions to Appendix P of the SOM, which addresses Long-Term Care Facility survey protocol. The SOM guidance also makes changes to various survey forms resulting from the new quality measures reports. READ MORE