Revised Survey Guidelines Give ROs More Discretion In Handling IJs

According to revised guidelines from CMS, regional authorities will now have the authority to decide whether to conduct full surveys of deemed providers that are cited for Immediate Jeopardy. Deemed status is available to certain long-term care providers, including hospices, home health agencies and rehabilitation agencies.

The revised guidelines, which were released on April 19, state that providers are subject to full surveys if a complaint investigation finds that they are exhibiting condition-level noncompliance (that is, care that poses a serious health or safety risk to residents, including Immediate Jeopardy citations). However, full surveys might not be necessary for all instances of condition-level noncompliance. Instead, CMS Regional Offices (ROs) will be tasked with deciding whether a full survey is needed on a case-by-case basis. CMS notes that this policy should improve efficiency and effectiveness. 

ROs will take the following into consideration when deciding whether a full survey is warranted (this list is not all-inclusive):

• The manner and degree of noncompliance (determined by the complaint investigation) 
• The provider's/supplier's complaint history
• Recent changes to ownership or management
• Whether the resources required to conduct a full survey are available in the timeframe needed
• The length of time since the provider's/supplier's last accreditation survey

If the RO determines a full survey is not needed, the provider/supplier will be placed on a 23- or 90-day termination track from the Medicare and Medicaid programs. Facilities that receive an IJ citation that isn't remedied while the surveyor is on-site will be placed on the 23-day track, but the RO will have the the option to conduct a revisit instead of a full survey prior to the 23-day deadline. 

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