When Immediate Jeopardy Exists

7305.1.3 – When Immediate Jeopardy Exists (Rev. 213; Issued: 02-10-23; Effective: 02-10-23; Implementation: 02-10-23) The surveying entity sends the initial notice to the facility of the following: a. The nature of the immediate jeopardy, including regulatory cites or initial assessment of immediate jeopardy findings; b. Requests an allegation of removal of immediate jeopardy, including evidence of steps taken to remove the immediate jeopardy. The plan of correction will usually be deferred until immediate jeopardy has been determined to be removed; c. Consequences of failure to submit an allegation of removal, e.g., provider agreement termination; d. Remedies recommended with effective dates; e. Opportunity for informal dispute resolution; f. Opportunity for independent informal dispute resolution if a civil money penalty subject to being collected and placed in an escrow account is imposed; g. Disapproval of nurse aide training and competency evaluation program and competency evaluation program and appeal rights if the program loss is based on a finding of substandard quality of care; h. When substandard quality of care is determined, the facility must provide the State with a list of the physicians of those residents who were found to be subject to the substandard quality of care. The State must notify each attending physician and refer the administrator to the State’s licensing board; and, i. When no formal notification of remedies is being provided in this initial notice, the following language will be inserted in bold type in the letter to make it clear that the initial notice is not the notice that triggers the imposition of remedies and that any such determination will be provided in a separate notice: “Please note that this notice does not constitute formal notice of imposition of alternative remedies or termination of your provider agreement. If it is determined that termination or any other remedy is warranted, you will be provided with a separate formal notification of that determination.” j. May serve as the formal notice of the imposition of any category 1 remedy, as authorized by CMS or the State Medicaid Agency, to be effective on (date the State expects correction based on the outside correction date on the facility’s approved plan of correction, but no earlier than 2 calendar days from the date of receipt of notice by the facility). Also, if authorized by the CMS Location, the State may provide formal notice to the facility of imposition of denial of payment for new admissions in the initial notice rather than in the first revisit letter, to be effective on (date the State expects correction based on the outside correction date on the facility’s approved plan of correction but no earlier than 2 calendar days from the date of receipt of notice by the facility). (See also §7301, §7313.2, §7314, §7316.2, and §7506.1.)