Immediate Jeopardy Does Not Exist

7301.2 - Immediate Jeopardy Does Not Exist (Rev. 244; Issued: 06-26-26; Effective: 06-26-26; Implementation: 06-26-26) (See also §7310) When immediate jeopardy does not exist: 1. CMS or the State must determine whether the facility will be given an opportunity to correct its deficiencies before remedies are imposed (see §7304). 2. The CMS Location or State Medicaid Agency should impose another remedy in addition to termination for a facility not being given an opportunity to correct. 3. The CMS Location or State Medicaid Agency terminates the Medicare and/or Medicaid provider agreements that are in effect no later than 6 months from the date of the survey that determined noncompliance if noncompliance still exists (see §7600). Except for State monitoring, which requires no notice, the CMS Location or State Medicaid Agency may impose these remedies 15 calendar days from the date the facility receives notice. 4. When there is an opportunity to correct before remedies are imposed, the State will request an acceptable plan of correction, provide initial notice of recommended remedies (including recommendation for subsequent termination, conduct a revisit if applicable, then provide formal notice of denial of payment for new admissions (if authorized by the CMS Location) and other remedies if noncompliance continues at revisit. While formal notice of imposition of denial of payment for new admissions by the State (if authorized by the CMS Location) is generally provided in the revisit letter, the State may provide such notice in its initial notice to the facility. (See also §7305.1, §7314, §7316.2 and §7506.1.) 5. The CMS Location or State Medicaid Agency must impose denial of payment for new admissions no later than 3 months after the last day of the survey that identified the noncompliance if substantial compliance is not achieved. 6. The CMS Location or State Medicaid Agency (or State, as authorized by CMS) may impose State monitoring without notice. 7. The CMS Location or State Medicaid Agency may impose a per day CMP between $50 and $3,000 per day or a “per instance” civil money penalty between $1,000 and $10,000 for each instance of noncompliance, or both per day and per instance CMPs may be imposed for the same survey not to exceed the maximum daily amount when combined, as adjusted under 45 CFR 102.3. The specific procedures for civil money penalties can be found in §7510-§7536. In cases when multiple per instance civil money penalties are imposed for a survey, the total dollar amount of all civil money penalties for noncompliance on any single day may not exceed the statutory and regulatory maximum amount and may not be less than the statutory and regulatory minimum amount for each day. When multiple per instance civil money penalties are imposed for different days of noncompliance, the total aggregate amount of all civil money penalties imposed for the survey may exceed the statutory and regulatory maximum (the statutory maximum only applies to the civil money penalty amount for any single day). Examples: A) F-tags F686 & F689 were cited on a survey and the noncompliance occurred on the same day. A per instance civil money penalty of $5,000* is imposed for F600 and a per instance civil money penalty of $5,000* is imposed for F607. No civil money penalty could then be imposed for additional deficiencies on that day because the total civil money penalty, consisting of any per instance and/or per day penalties, must not exceed the statutory and regulatory maximum for each day. B) F-tags F684 & F687 were cited on a survey and the noncompliance occurred on different days. A per instance civil money penalty of $10,000* is imposed for F600 and a per instance civil money penalty of $10,000* is imposed for F607. If noncompliance occurs on different days, two (or more if each instance of noncompliance occurs on a different day) per instance civil money penalties at the maximum amount may be imposed on the same survey if the maximum statutory and regulatory amount is not exceeded for each day. C) F-tag F689 was cited on a survey, and the noncompliance began two months prior to the start of the survey. A per instance civil money penalty of $10,000* could be imposed for noncompliance related to F689 that started prior to the survey. A per day civil money penalty could also be imposed for noncompliance related to F689 that exists on the survey start date, and it would continue to accumulate until substantial compliance is achieved. *Note: The regulatory maximum CMP amounts referenced in the examples above are noted as the original statutory maximum amounts per day. However, the current maximum amounts have been are adjusted annually for inflation and published in 45 CFR 102.3 based as required under on the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015. The amounts above are being used for illustrative purposes only. Federal CMPs are imposed in accordance with the instructions in the CMP Analytic Tool. 8. The State is authorized to recommend and impose category 1 remedies. When authorized by the CMS Location, the State may also provide notice of imposition and rescission of the denial of payment for new admissions remedy. (See also §7314 and §7506.1.)