CMS Revision of Civil Money Penalty (CMP) Policies and Analytic Tool

On Friday, July 7th, 2017, The Centers for Medicare and Medicaid (CMS) released the Revision of Civil Money Penalty (CMP) Policies and the Analytic Tool User's Guide.

The Omnibus Budget Reconciliation Act of 1987(OBRA ’87) modernized the long term care survey process and provided a range of remedies CMS could impose to an organization. Among the remedies are civil money penalties(CMPs). CMS imposes two types of CMPs: Per Day and Per Instance.

The S & C Memo from July 7th, outlines that CMS is revising the CMP analytic tool. The revised CMP Analytic Tool instructs the CMS Regional Offices (ROs) how to use Per Day and Per Instance CMPs depending on the timing of noncompliance in relation to the survey, whether residents were harmed or abused, whether the facility has a good compliance history, and whether the noncompliance was an isolated event or persistent deficient practices were identified.

CMS revised the CMP Analytic Tool in the following areas:

  • Past noncompliance will have a per-instance CMP imposed if something occurred before the current survey and has been fully addressed and back in compliance
  • Per Instance CMP is the Default for Noncompliance that existed before the Survey. CMS ROs will generally impose a Per Instance CMP retro actively for noncompliance that still exists at the time of the survey.
  • Per Day CMP is the Default for Noncompliance Existing during the Survey and Beyond - however Per Day will be used for noncompliance that occurred with serious harm at IJ level, abuse or persistent deficient practices. CMS states this is due to the urgent need to promote a swift return to substantial compliance for a sustained period of time, preventing future non-compliance.
  • Revisit Timing for the revisit survey to certify compliance when imposing the final CMP amount.
  • Review of High CMPs of $250,000 or greater by CMS Central Office.

 CMS stated to increase national consistency in imposing the CMPs, the revised CMP analytic tool will be the user guide.