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. § 488.454

Duration of remedies

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(a) Except as specified in paragraphs (b) and (d) of this section, alternative remedies continue until—

(1) The facility has achieved substantial compliance, as determined by CMS or the State based upon a revisit or after an examination of credible written evidence that it can verify without an on-site visit; or

(2) CMS or the State terminates the provider agreement.

(b) In the cases of State monitoring and denial of payment imposed for repeated substandard quality of care, remedies continue until—

(1) CMS or the State determines that the facility has achieved substantial compliance and is capable of remaining in substantial compliance; or

(2) CMS or the State terminates the provider agreement.

(c) In the case of temporary management, the remedy continues until—

(1) CMS or the State determines that the facility has achieved substantial compliance and is capable of remaining in substantial compliance;

(2) CMS or the State terminates the provider agreement; or

(3) The facility which has not achieved substantial compliance reassumes management control. In this case, CMS or the State initiates termination of the provider agreement and may impose additional remedies.

(d) In the case of a civil money penalty imposed for an instance of noncompliance, the remedy is the specific amount of the civil money penalty imposed for the particular deficiency.

(e) If the facility can supply documentation acceptable to CMS or the State survey agency that it was in substantial compliance and was capable of remaining in substantial compliance, if necessary, on a date preceding that of the revisit, the remedies terminate on the date that CMS or the State can verify as the date that substantial compliance was achieved and the facility demonstrated that it could maintain substantial compliance, if necessary.

[59 FR 56243, Nov. 10, 1994; 60 FR 50119, Sept. 28, 1995, as amended at 64 FR 13361, Mar. 18, 1999]
Notes of Decisions
Cited in 5 cases (1 in the last 5 years), 2006–2025 · leading case: In re Bayou Shores SNF, LLC, 525 B.R. 160 (Bankr. M.D. Fla. 2014).
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In re Bayou Shores SNF, LLC, 525 B.R. 160 (Bankr. M.D. Fla. 2014). · cites it 3× “The Debtor relies on 42 C.F.R. § 488.454 , entitled “Duration of Remedies,” in support of its argument.”
Universal Healthcare/King v. Kathleen Sebelius, 499 F. App'x 299 (4th Cir. 2012). “]” 42 C.F.R. § 488.454 (a)(1). On the other hand, per instance CMPs are limited to a cap of $10,000 per survey.”
Delta Health Grp., Inc. v. United States Dep't of Health & Human Servs., 459 F. Supp. 2d 1207 (N.D. Fla. 2006). “See, 42 CFR section 488.454(d). In this case, the State Agency’s revisit of September 20, 1998, is the date compliance was verified.”
Elevate Care Country Club Hills, LLC v. Kennedy, Sec'y of United States Dep't of Health & Human Servs., in his Off. capacity (N.D. Ill. 2025). · cites it 2× “§ 2201 that 42 C.F.R. § 488.454 (a) and its related regulations regarding revisit timing .”
Libertywood Nursing Ctr. v. Kathleen Sebelius, 512 F. App'x 285 (4th Cir. 2013). · cites it 2× “See 42 C.F.R. § 488.454 (a)(1). Although 42 C.”
— 42 C.F.R. § 488.454(d) — 1 case
Delta Health Grp., Inc. v. United States Dep't of Health & Human Servs., 459 F. Supp. 2d 1207 (N.D. Fla. 2006). “See, 42 CFR section 488.454(d). In this case, the State Agency’s revisit of September 20, 1998, is the date compliance was verified.”
— 42 C.F.R. § 488.454(e) — 1 case
Libertywood Nursing Ctr. v. Kathleen Sebelius, 512 F. App'x 285 (4th Cir. 2013). “See 42 C.F.R. § 488.454 (a)(1). Although 42 C.”
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