Daniel McElroy-TX

Document ID: CMS-2010-0211-0005
Document Type: Public Submission
Agency: Centers For Medicare & Medicaid Services
Received Date: July 19 2010, at 12:00 AM Eastern Daylight Time
Date Posted: July 20 2010, at 12:00 AM Eastern Standard Time
Comment Start Date: July 12 2010, at 12:00 AM Eastern Standard Time
Comment Due Date: August 11 2010, at 11:59 PM Eastern Standard Time
Tracking Number: 80b1bcd9
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This is comment on Proposed Rule

Medicare and Medicaid Programs: Civil Money Penalties for Nursing Homes

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Proposed 488.431(a) states "CMS retains ultimate authority for the survey findings..." "Survey findings" is not defined in regulation. If "survey findings" means a determination of substantial compliance or noncompliance, this contradicts other regulations. In non-immediate jeopardy at 488.452 the term "finding of noncompliance" is used. The CMS cannot over-rule a State finding of noncompliance. In immediate jeopardy at 488.410(a), "If there is immediate jeopardy to health or safety, the State must (and CMS does) either terminate ... or appoint a temporary manager. The CMS cannot overrule the State's finding of immediate jeopardy. It appears the intent is for 488.431(a) to say that the State Survey Agency (SNF and SNF/NF), the State Medicaid Aency (NF-only) or CMS, not an independent IDR (or a non-independent IDR) "retains ultimate authority to determine compliance or noncompliance."