Accrual and Duration of Per Instance Penalty

10005.15 – Accrual and Duration of Per Instance Penalty (Rev. 221; Issued: 05-10-24; Effective: 05-10-24; Implemetation:05-10-24) As set forth in §488.845(b)(6) for HHA and §488.1245(b)(6) for hospice programs, a per instance CMP is imposed for each instance of noncompliance based on a deficiency(ies) during a specific survey. It is applied to as many instances as is deemed appropriate and in a specific amount for that deficiency(ies). The current adjusted range for per instance CMPs, as well as the maximum adjusted amount per day, is posted on the CMS website on the Quality, Safety & Oversight Group webpage. NOTE: The per day and per instance CMP would not be imposed simultaneously for the same CoPs in a survey. In no instance will the period of noncompliance be allowed to extend beyond 6 months from the last day of the original survey that determined the HHA’s or hospice program’s noncompliance. If the HHA or hospice program has not achieved substantial compliance with all the participation requirements within those 6 months, CMS will terminate the HHA or hospice program. The accrual of the per day CMP stops on the day the HHA’s or hospice program’s provider agreement is terminated or the HHA or hospice program achieves substantial compliance, whichever is earlier. Example: When the per instance CMP is used on the original survey, the revisit survey is used to determine compliance. If noncompliance is identified at the revisit survey and a CMP is selected as the enforcement remedy/sanction, either the per instance or per day remedy may be selected.