Nursing Home Survey Tool

Enforcement

	When survey findings indicate that a nursing home has significant deficiencies (or regulatory requirements not met) which seriously limit its ability to provide quality care, the Department of Public Health initiates enforcement action based on state licensure requirements or based on federal certification requirements on behalf of the Centers for Medicare and Medicaid Services (CMS). An enforcement action (or remedy) is initiated when there is a finding of substandard quality of care or jeopardy, or when a nursing home fails to correct deficiencies within six months of the survey. All nursing homes are required to submit a plan of correction when requirements are found not met, and most are given an opportunity to correct problems before an enforcement action is taken. In most cases, nursing homes make the necessary corrections and achieve substantial compliance (a requirement for continued certification in the federal Medicare and Medicaid programs). However, there are rare situations in which the Department of Public Health must impose remedies because a nursing home has a weak history of compliance with the regulatory requirements, has failed to correct identified deficiencies, or has very serious deficiencies which jeopardize the health and safety of residents in the home. The remedies, which can be imposed by the Department of Public Health or the Centers for Medicare and Medicaid Services (CMS) for Medicaid certified homes and by MassHealth for Medicare/Medicaid certified homes, include but are not limited to the following: - termination from the federal Medicare and/or Medicaid program(s) - denial of Medicare and Medicaid payment for new admissions - a freeze on all admissions to the nursing home

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Enforcement