March 28, 2014 –S&C-14-18-NH

Important Information in S&C letter

Updates: State Operations Manual Chapter 7; Various Exhibits in SOM

Reminder

The S&C includes a “Reminder Regarding Survey Process Timeframes” and emphasizes the importance of certain requirements when an immediate jeopardy is identified. (pp.2-3)

Updates to State Operations Manual

§7212.3 – Mandatory Elements of Informal Dispute Resolution (pp. 36 – 39)

Provides specific instructions related to what must be noted on the CMS Form 2567 when facility is successful during the informal dispute resolution process.

Specifies the time frame within which a deficiency pending IDR must be entered in the Automated Survey Processing Environment system (ASPEN).

§7213 – Independent Informal Dispute Resolution (Independent IDR) (pp. 39 – 52)

Incorporates into the State Operations Manual (SOM) Independent IDR process that was issued as Interim Advance Guidance in S&C: 12-08-NH dated December 2, 2011.

Modifications are made to the original interim advance guidance toincorporate a later change/update that allows all civil monetary penalties (CMPs) to be subject to escrow (see S&C: 13-57-NH).

Clarifies when an Independent IDR is considered to be “complete.”

Requires the final Independent IDR decision to the facility must contain the result for each deficiency challenged and a brief summary of the rationale for that result.

Provides additional elements for Federal Independent IDR process.

§7516.4 – Reduction of a Civil Money Penalty by 50 Percent for Self-Reporting and Prompt Correction of Noncompliance (p. 125)

Incorporates language into the SOM related to the Affordable Care Act provision permitting a reduction of a CMP by up to 50 percent when the facility has self-reported noncompliance to CMS.

§7529.1 – When a Civil Money Penalty Subject to Being Collected and Placed in an Escrow Account in Imposed (p. 132)

Outlines the process to be used when the Regional Office imposes a CMP that is subject to collection and escrow.

§7534 - §7535 – Disposition of Collected Civil Money Penalty (pp. 135 – 140)

Incorporates into the SOM the process for states’ use of Federally imposed CMPs, which was outlined in S&C – 12-13-NH.

Incorporates into the SOM the process of collection and use of CMPs when held in escrow.

Exhibits Updated

Exhibit 139: Model Letter to Provider (Send with CMS-2567) (IJ Does Not Exist)

Exhibit 141: Model Letter Notifying Provider of Results of Revisit

Exhibit 142: Model Letter to Provider (Imposition of Remedies) (IJ Does Not Exist)

Exhibit 143: Model Letter to Provider (Imposition of Remedies)(IJ Exists)

Exhibit 144: Notice of Imposition of a CMP (Insert to Formal Notice)

Exhibit 147: Notice of Payment Amount Due and Payable

Exhibit 147A: Notice of Payment Amount Due for Placement in Escrow (IIDR Complete or Not Timely Requested – Facility is Filing Formal Appeal)

Exhibit 354 – Model Letter to Involved Resident, Resident Representative and/or State Ombudsman – Opportunity to Provide Written Comment (IIDR Has Been Requested)