Utah Admin. Code R432-150-28 - Alternative Sanctions for Nursing Facilities
(1) This section applies in addition to the
requirements of Rule R380-600 for certified nursing facility licensees
participating in the Centers for Medicare and Medicaid (CMS) program and
establishes criteria for the imposition of sanctions authorized by
statute.
(2)
(a) As the sole agency of the state
authorized to act as the health care facilities certification agency under
Section 26B-2-217, OL shall conduct
on-site inspections of nursing facilities to determine compliance with federal
nursing home requirements found in 42 CFR 488 (2023).
(b) When OL finds that a nursing facility
licensee is out of compliance with requirements of participation in the CMS
program, OL may recommend to CMS the imposition of sanctions, including federal
civil money penalties (CMP).
(3)
(a) For
a CMS certified nursing facility licensee, OL has authority to apply the
sanctions defined in the federal Omnibus Budget Reconciliation Act (OBRA) of
1987, Pub. L. No. 100 203 and Sections 1819(h) and 1919(h) of the Social
Security Act.
(b) OL may recommend
termination from the Medicare or Medicaid program if a nursing facility
licensee is found in chronic noncompliance with CMS participation
requirements.
(4) In
accordance with 42 CFR 488 (2023), OL may recommend any of the following
sanctions:
(a) closure of the facility and
transfer of a resident;
(b) CMPs
for:
(i) each instance that a facility is not
in substantial compliance in accordance with 42 CFR 488 (2023); or
(ii) the number of days a facility is out of
compliance with one or more participation requirements;
(c) denial of payment for new
admissions;
(d) directed in-service
training;
(e) directed plan of
correction;
(f) state
monitoring;
(g) temporary
management; and
(h) transfer of a
resident.
(5)
(a) OL shall assess interest on the unpaid
balance of any CMP issued and collected by OL on behalf of CMS, beginning on
the due date.
(b) The interest rate
charged is the average of the bond equivalent of the federal standard as
outlined in 42 CFR 488 (2023) during the period when interest is
charged.
(6) OL shall
apply CMPs collected under this section in accordance with Sections 1819 and
1919 of the Social Security Act to the protection of the health and property of
each resident.
Notes
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