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Department of Community Health

Department of Community Health. Bureau of Health Systems Enforcement Unit. Purpose of Enforcement. Ensures nursing homes are safe, comfortable and able to provide adequate care based on individual needs and initiates enforcement action when survey results identify citations.

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Department of Community Health

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  1. Department of Community Health Bureau of Health Systems Enforcement Unit

  2. Purpose of Enforcement • Ensures nursing homes are safe, comfortable and able to provide adequate care based on individual needs and initiates enforcement action when survey results identify citations. • Remedies are imposed as applicable to encourage facilities to maintain acceptable levels of care based on state and federal regulations. • Information regarding enforcement history allows public to make informed choices when choosing a nursing home.

  3. Enforcement • An enforcement cycle begins with a survey/inspection that results in a “deficiency”. • 1. Standard – a periodic, resident-centered inspection that gathers information about the quality of service furnished in a facility to determine compliance with the requirements of participation. • 2. Abbreviated Standard – may be conducted due to a complaint received. • 3. Extended – evaluates additional participation requirements subsequent to finding “Substandard Quality of Care” (SQOC) during a standard survey. The standard survey was expanded – a standard that has been increased (or extended) when surveyors expect SQOC. • 4. Partial Extended – finds SQOC at an abbreviated survey • 5. Immediate Jeopardy – caused or is likely to cause serious injury, harm, impairment or death to a resident.

  4. Federal Remedies • Directed Plan of Correction • State Monitor; and/or • Directed In-Service Training • Transfer of Residents • Denial of Payments for New Admissions • Civil Money Penalties 1) $50 - $3,000/day – Non-IJ 2) $3,050 - $10,000/day – IJ 3) $1,000 - $10,000/per instance

  5. Federal Remedies • Temporary Management • Termination

  6. State Enforcement Remedies • Correction Notice Orders: 1) Ban on Admissions 2) Reduced License Capacity 3) Selective Transfer of Residents 4) Receivership 5) Administrative Advisor 6) Clinical Advisor 7) Temporary Manager

  7. State Enforcement Remedies • State Civil Penalty Orders • License Revocation 1) Emergency Order 2) Non-Emergency Revocation

  8. Enforcement • Facilities with a good compliance history and relatively minor violations are normally provided an opportunity to correct areas of concern prior to the imposition of penalties. • Facilities who harm residents or continually have poor surveys have penalties imposed that become progressively more severe. • Facilities who fail to improve may also be inspected more frequently. • Continued noncompliance could result in closure.

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