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Enforcement
When survey findings indicate that a nursing home has significant deficiencies (or regulatory requirements not met), which seriously limit its ability to provide quality care, the Department initiates enforcement action. An enforcement action (or remedy) is initiated when there is a finding of jeopardy or substandard quality of care, or when a home fails to correct deficiencies within six months of the survey. All nursing homes are required to submit a plan of correction when requirements are found not met and most are given an opportunity to correct problems before an enforcement action is taken.
In most cases, homes make the necessary corrections and achieve substantial compliance (a requirement for continued certification in the Medicare and Medicaid programs). However, there are some situations in which the Department must impose remedies because a nursing home has a poor history of compliance with the regulatory requirements, has failed to correct identified deficiencies, or has very serious deficiencies which jeopardize the health and safety of residents in the home. The remedies, which can be imposed by the Department of Public Health for Medicaid certified homes and by the Health Care Financing Administration for Medicare/Medicaid certified homes, include but are not limited to the following:
- termination from the Medicare and/or Medicaid program(s)
- denial of Medicare and Medicaid payment for new admissions
- a freeze on all admissions to the nursing home
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