INARF
​​Home | login | contact us
  • About Us
    • About Us
    • Board of Directors
    • Staff
    • Corporate Committees
    • Professional Interest Sections
    • Awards & Recognition
  • Membership
    • Member Login
    • Membership
    • Member Benefits & Inquiries
    • Organizational Member Directory
    • Associate Member Directory
    • Member Job Postings
  • Events
    • Upcoming Events
    • INARF 2023 Annual Conference >
      • Artisan Opportunities
      • Sponsor Opportunities
      • Exhibit Opportunities
    • INARF 2023 Pre-Conference
  • Professional Development
    • Professional Development
    • INARF DSP Series
    • INARF Leadership Academy
  • Technical Assistance
    • Technical Assistance
    • News & Information
  • Governmental Affairs
    • Governmental Affairs
    • INARF PAC
    • Bills Being Watched
    • Statehouse News
    • Take Action Now With VoterVoice!
  • About Us
    • About Us
    • Board of Directors
    • Staff
    • Corporate Committees
    • Professional Interest Sections
    • Awards & Recognition
  • Membership
    • Member Login
    • Membership
    • Member Benefits & Inquiries
    • Organizational Member Directory
    • Associate Member Directory
    • Member Job Postings
  • Events
    • Upcoming Events
    • INARF 2023 Annual Conference >
      • Artisan Opportunities
      • Sponsor Opportunities
      • Exhibit Opportunities
    • INARF 2023 Pre-Conference
  • Professional Development
    • Professional Development
    • INARF DSP Series
    • INARF Leadership Academy
  • Technical Assistance
    • Technical Assistance
    • News & Information
  • Governmental Affairs
    • Governmental Affairs
    • INARF PAC
    • Bills Being Watched
    • Statehouse News
    • Take Action Now With VoterVoice!

CMS Revised Immediate Jeopardy Guidance

3/18/2019

 
The Centers for Medicare & Medicaid Services (CMS) has issued guidance addressing immediate jeopardy, or violations of health and safety regulations that cause serious harm or death to a patient and require immediate action to prevent further serious harm. The guidance in the revised Appendix Q of the State Operations Manual clarifies what information is needed to identify immediate jeopardy cases and includes an administrative tool that helps surveyors make sure they have the evidence needed to meet criteria for immediate jeopardy. CMS has also posted online training on this new guidance, available here.
​


Key Changes in the Core Appendix Q include:
  • Likelihood instead of potential – The previous version of Appendix Q suggested that a potential for serious harm might constitute immediate jeopardy. Core Appendix Q makes it clear that in order to cite immediate jeopardy in situations where recipients have not already suffered serious injury, harm, impairment or death, the nature and/or extent of the identified noncompliance creates a likelihood (reasonable expectation) that such harm will occur if not corrected, not simply the potential for that level of harm to occur.
  • Culpability has been removed – The previous version of Appendix Q made culpability a required component to cite immediate jeopardy. Because the regulatory definitions of immediate jeopardy do not require a finding of culpability, that requirement has been removed and has been replaced with the key component of noncompliance, since the definitions of immediate jeopardy require noncompliance to be the cause of the serious injury, harm, impairment or death, or the likelihood thereof.
  • Psychosocial harm – Core Appendix Q includes a section instructing surveyors to consider whether noncompliance has caused or made likely serious mental or psychosocial harm to recipients. In situations where the psychosocial outcome to the recipient may be difficult to determine or incongruent with what would be expected, the guidance instructs surveyors to use the reasonable person concept to make that determination. The reasonable person approach considers how a reasonable person in the recipient’s position would be impacted by the noncompliance (i.e. consider if a reasonable person in a similar situation could be expected to experience a serious psychosocial adverse outcome as a result of the same noncompliance).
  • ​No automatic immediate jeopardy citations – Core Appendix Q makes it clear that each immediate jeopardy citation must be decided independently and there are no automatic immediate jeopardy citations.

If you have questions or need additional information, contact Sarah Chestnut at sarah@inarf.org.


Comments are closed.

    RSS Feed

    Archives

    September 2022
    August 2022
    July 2022
    June 2022
    May 2022
    April 2022
    March 2022
    February 2022
    January 2022
    December 2021
    November 2021
    October 2021
    September 2021
    August 2021
    July 2021
    June 2021
    May 2021
    April 2021
    March 2021
    February 2021
    January 2021
    December 2020
    November 2020
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    November 2019
    October 2019
    September 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016
    February 2016
    January 2016
    December 2015
    November 2015
    October 2015
    September 2015
    August 2015
    July 2015
    June 2015
    May 2015
    April 2015
    March 2015
    February 2015
    January 2015
    December 2014
    November 2014
    October 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    December 2013
    November 2013
    October 2013
    September 2013
    August 2013
    July 2013
    June 2013
    May 2013
    April 2013
    March 2013
    February 2013
    January 2013
    January 2011
    September 2009
    December 2007

© Indiana Association of Rehabilitation Facilities, Inc. (INARF)
    615 North Alabama Street, Suite 410, Indianapolis, IN 46204
    (t) 317-634-4957 / (f) 317-634-3221 / Contact us by email
ANCOR Proud Member Small