CMS Spells Out New Standards For State Surveyors On Immediate Jeopardy Citations

The Centers for Medicare & Medicaid Services (CMS) recently revised its guidance to states on standards for citing "immediate jeopardy" during surveys of all provider and supplier types and laboratories, including health, emergency preparedness, and life safety code surveys. CMS Administrator Seema Verma observed in a blog post that the changes were made in response to stakeholders who "have voiced concerns that the guidance needs to be clearer and more consistent to identify serious quality concerns across states." Administrator Verma added that the updated policy "is just the beginning of upcoming efforts to strengthen oversight of healthcare settings."

Under the new policy, which is set forth in an update to Appendix Q to the State Operations Manual (SOM), surveyors must identify the following "key components" in order to cite immediate jeopardy:

Noncompliance: An entity has failed to meet one or more federal health, safety, and/or quality regulations. CMS removed a previous requirement of culpability to cite immediate jeopardy.

AND

Serious Adverse Outcome or Likely Serious Adverse Outcome: As a result of the identified noncompliance, serious injury, serious harm, serious impairment or death has occurred, is occurring, or is likely to occur to one or more identified recipients at risk. In its guidance to state survey agency directors, CMS points out that the potential for that level of harm does...