South Carolina Code of Regulations
Chapter 126 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
Article 8 - INTERMEDIATE SANCTIONS FOR MEDICAID CERTIFIED NURSING FACILITIES
Section 126-840 - Schedule of Sanctions
Universal Citation: SC Code Regs 126-840
Current through Register Vol. 48, No. 3, March 22, 2024
CLASS I DEFICIENCY:
A. Violation of requirements which present an indirect relationship to resident health, safety or welfare, and which does not create a substantial and/or immediate risk to health and safety.
B. Remedies/Sanctions:
1. Deny payment under the Medicaid program
for any new admissions from the date of issuance of a certified notice to the
facility when the facility has failed to correct deficiencies within this class
within 90 days of the annual standard survey exit date.
2. Assess and collect monetary penalties up
to $500 per day retroactive to the exit date of the standard annual survey for
deficiencies in this class which remain uncorrected at the time of the first
survey revisit.
3. Assess and
collect monetary penalties up to $990 per day retroactive to the exit date of
the first survey revisit for deficiencies in this class which remain
uncorrected at the time of a second survey revisit.
4. Assess and collect monetary penalties up
to $1485 per day retroactive to the exit date of the second survey revisit for
deficiencies which remain uncorrected at the time of the third survey
revisit.
5. Deny payment under the
Medicaid program 30 days from decertification date imposed by the State Survey
Agency.
CLASS II DEFICIENCY:
A. Violation of requirements which presents a direct relationship to the health, safety or welfare, of residents but which does not create a substantial and/or immediate risk to health and safety.
B. Remedies/Sanctions:
1. Deny payment under the Medicaid program
for any new admissions from the date of issuance of a certified notice to the
facility when the facility has failed to correct deficiencies within this class
within 90 days of the annual standard survey exit date.
2. Assess and collect monetary penalties up
to $750 per day retroactive to the exit date of the standard annual survey for
deficiencies in this class which remain uncorrected at the time of the first
survey revisit.
3. Assess and
collect monetary penalties up to $1500 per day retroactive to the exit date of
the first survey revisit for deficiencies in this class which remain
uncorrected at the time of a second survey revisit.
4. Assess and collect monetary penalties up
to $2250 per day retroactive to the exit date of the second survey revisit for
deficiencies which remain uncorrected at the time of the third survey
revisit.
5. Deny payment under the
Medicaid program 30 days from decertification date imposed by the State Survey
Agency.
CLASS III DEFICIENCY:
A. Violation of requirements which poses a substantial risk to the health and safety of residents.
B. Remedies/Sanctions:
1. Deny Payment under the Medicaid program
for any new admissions from the date of issuance of a certified notice to the
facility when conditions exist that pose substantial risk to the health and
safety of residents or when the facility has failed to correct deficiencies
within 30 days of any survey by the State Survey Agency or the Centers for
Medicare and Medicaid Services, United States Department of Health and Human
Services.
2. Assess and collect
monetary penalties up to $900 per day retroactive to the exit date of the
standard annual survey for deficiencies in this class which remain uncorrected
at the time of the first survey revisit.
3. Assess and collect monetary penalties up
to $1800 per day retroactive to the exit date of the first survey revisit for
deficiencies in this class which remain uncorrected at the time of a second
survey revisit.
4. Assess and
collect monetary penalties up to $2400 per day retroactive to the exit date of
the second survey revisit for deficiencies which remain uncorrected at the time
of the third survey revisit.
5.
Seek circuit court appointment of temporary management to effect an orderly
closure when facility management is judged unable or unwilling to correct the
deficiencies in this class by the dates stipulated in an accepted plan of
correction or in an accepted credible allegation.
6. Deny payment under the Medicaid program 30
days from decertification date imposed by the State Survey Agency.
CLASS IV DEFICIENCY:
A. Violation of requirements which immediately jeopardizes the health and safety of residents.
B. Remedies/Sanctions:
1. Deny payment under the Medicaid program
for any new admissions from the date of issuance of a certified notice to the
facility when conditions exist that pose immediate jeopardy to health and
safety.
2. Assess and collect
monetary penalties up to $1200 per day retroactive to the exit date of the
standard annual survey for deficiencies in this class which remain uncorrected
at the time of the first survey revisit.
3. Assess and collect monetary penalties up
to $2250 per day retroactive to the exit date of the first survey revisit for
deficiencies in this class which remain uncorrected at the time of a second
survey revisit.
4. Assess and
collect monetary penalties up to $2500 per day retroactive to the exit date of
the second survey revisit for deficiencies which remain uncorrected at the time
of the third survey revisit.
5.
Initiate emergency action in a court of competent jurisdiction to appoint a
receiver to effect an orderly closure.
6. Deny payment under the Medicaid program 30
days from decertification date imposed by the State Survey Agency.
Disclaimer: These regulations may not be the most recent version. South Carolina may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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