Mandatory Immediate Imposition of Federal Remedies and Assessment Factors
Used to Determine the Seriousness of Deficiencies for Nursing Homes
REVISED 07.29.16 to add temporary management under remedies for termination and correct the
effective date. Revisions to the SOM are in yellow highlight.
•Revisions to Chapter 7 of the State Operations Manual (SOM): This policy memorandum provides advanced guidance relating to
revisions in SOM sections §7304 through 7304.3, 7306.1, 7308.3, 7400.5.1, 7400.6.2 and 7313.2 regarding policies on the Immediate
Imposition of Federal Remedies (previously referred to as Opportunity to Correct or No Opportunity to Correct). Sections 7304.2.1
and 7304.2.2 are being deleted and incorporated into the revised sections noted above.
•Civil Money Penalties (CMPs) for Immediate Jeopardy (IJ): The Centers for Medicare & Medicaid Services (CMS) Regional Office
(RO) must now immediately impose a CMP any time Immediate Jeopardy (IJ) is cited.
•Immediate Imposition of Remedies Required: Irrespective of a state recommendation to impose or not impose a remedy, the CMS
RO must immediately impose, without permitting a facility an opportunity to correct deficiencies, one or more federal remedies
based on the seriousness of the deficiencies or when actual harm or Substandard Quality of Care (SQC) is identified as outlined