You Can ’t Always Get What You Want: Appealing CMS Enforcement Actions

Many of the country ’s 15,400 skilled nursing facilities live in almost mortal fear of a survey that results in enforcement actions by the Centers for Medicare& Medicaid Services. When surveyors determine that noncompliance exists, CMS has a veritable quiver of arrows at its disposal to target the allegedly offending SNF. CMS is authorized by the statute (the Social Security Act) and its implementing regulations at 42 CFR Part 498 to impose one or more “sanctions” (euphemistically referred to as “remedies” but more accurately described as “enforcement actions”) when a SNF is not in “substantial compliance” with Medicare’s Requirements for Participation (ROP) found at 42 CFR Part 483.
Source: Caring for the Ages - Category: Health Management Authors: Source Type: news