In a conference call with the Office of Inspector General, KAHCF was informed that another change is immediately in effect for the survey enforcement process. Sanctions have previously been issued when facilities had surveys with the noncompliance scope & severity of G level (actual harm) or higher on a current survey as well as on the previous standard survey (standard, revisit, complaint). Please see 7304.2.1 in the CMS State Operations Manual (SOM) for information on no opportunity to correct. Now CMS, per SOM 7304.3 which gives CMS or the State discretion to impose immediate sanctions, has given direction that, effective immediately, noncompliance at a scope & severity of level G or higher, in any survey, will be a no opportunity to correct. All G level deficiencies will be referred to CMS for review and enforcement decisions.

Previously in Members Only we shared the following information based on the CMS  Survey & Certification Letter: 16-11-ALL which addressed the procedures for  Medicare & Medicaid participating survey exit conferences:  Exit conferences are not guaranteed and are considered a courtesy to promote timely remediation of quality of care or safety problems. Tag numbers may be shared if it can help the provider gain more insight into the issues through the interpretive guidelines. If the team is still in deliberation which tag is most pertinent, tag numbers will not be shared. States may not require surveyors to always provide certain information during the exit conference. Surveyors cannot, under any circumstances, provide the Scope & Severity of a given deficiency finding (unless it is an immediate jeopardy) as it should await supervisory review but surveyors should relay the seriousness of the noncompliance as it affects the well-being of residents.