Enforcement Action When IJ Exists

10003.5 - Enforcement Action When IJ Exists (Rev. 221; Issued: 05-10-24; Effective: 05-10-24; Implemetation:05-10-24) When there is IJ to patient health or safety, CMS must complete termination procedures within 23 days from the last day of the survey which found the IJ if it is not removed before then (following guidelines in Appendix Q of the State Operations Manual). The procedure must not be postponed or stopped unless the IJ is removed, as verified through onsite verification. If there is a written and timely credible allegation that the IJ has been removed, CMS or the State will conduct a revisit prior to termination, if possible. In addition to termination, one or more alternative sanctions for HHAs or enforcement remedies for hospice programs may be imposed. While the use of alternative sanctions or enforcement remedies in addition to termination is permitted, the Act makes it clear that the enforcement action for noncompliant agencies with IJ deficiencies is intended to be swift. The imposition of alternative sanctions for HHAs or enforcement remedies for hospice programs in addition to termination does not extend the timeframe that the HHA or hospice program has to remove the IJ situation.