C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER G—STANDARDS AND CERTIFICATION › PART 488—SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES › Subpart F—Enforcement of Compliance for Long-Term Care Facilities with Deficiencies

42 C.F.R. § 488.412

Action when there is no immediate jeopardy

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(a) If a facility's deficiencies do not pose immediate jeopardy to residents' health or safety, and the facility is not in substantial compliance, CMS or the State may terminate the facility's provider agreement or may allow the facility to continue to participate for no longer than 6 months from the last day of the survey if—

(1) The State survey agency finds that it is more appropriate to impose alternative remedies than to terminate the facility's provider agreement;

(2) The State has submitted a plan and timetable for corrective action approved by CMS; and

(3) The facility in the case of a Medicare SNF or the State in the case of a Medicaid NF agrees to repay to the Federal government payments received after the last day of the survey that first identified the deficiencies if corrective action is not taken in accordance with the approved plan of correction.

(b) If a facility does not meet the criteria for continuation of payment under paragraph (a) of this section, CMS will and the State must terminate the facility's provider agreement.

(c) CMS does and the State must deny payment for new admissions when a facility is not in substantial compliance 3 months after the last day of the survey.

(d) CMS terminates the provider agreement for SNFs and NFs, and stops FFP to a State for a NF for which participation was continued under paragraph (a) of this section, if the facility is not in substantial compliance within 6 months of the last day of the survey.

[59 FR 56243, Nov. 10, 1994; 60 FR 50118, Sept. 28, 1995]
Notes of Decisions
Cited in 7 cases, 1998–2012 · leading case: Woodruff v. Mason, 542 F.3d 545 (7th Cir. 2008).
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Woodruff v. Mason, 542 F.3d 545 (7th Cir. 2008). · cites it 4× “See 42 C.F.R. § 488.412 . When a deficiency is found, the ISDH schedules a post-review survey to determine whether the deficiency has been corrected.”
Beverly Health & Rehab. Servs., Inc. v. Thompson, 223 F. Supp. 2d 73 (D.D.C. 2002). · cites it 2× “42 C.F.R. § 488.412 (a). Finally, plaintiffs appear to seek reversal of the termination on the grounds that Spring Hill was denied the opportunity to have the sanction reviewed without consideration of the immediate jeopardy findings that were overturned by the ALJ.”
Vencor Nursing Centers, L.P. v. Shalala, 63 F. Supp. 2d 1 (D.D.C. 1999). “” Therefore, Vencor argues, by terminating Village Square in the absence of a finding of “immediate jeopardy” HHS violated the Medicare Act, the Medicaid Act and the *8 Due Process Clause.”
Woodruff v. Wilson, 484 F. Supp. 2d 876 (S.D. Ind. 2007). · cites it 2× “42 CFR § 488.412 (a). In addition to these federal requirements, a facility must be licensed by ISDH to receive Medicare.”
N. Health Facilities, Inc. v. United States, 39 F. Supp. 2d 563 (D. Maryland 1998). · cites it 3× “See 42 C.F.R. § 488.412 , 488.456. *574 The Medicaid provisions mostly parallel Medicare provisions.”
Gos Operator, LLC v. Sebelius, 843 F. Supp. 2d 1218 (S.D. Ala. 2012). “” 42 C.F.R. § 488.412 (a); see also § 488.412(d) (“CMS terminates the provider agreement .”
Woodruff, Randall L. v. Mason, Jo Ann (7th Cir. 2008). · cites it 2× “See 42 C.F.R. § 488.412 . When a deficiency is found, the ISDH schedules a post-review survey to determine whether the deficiency has been corrected.”
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