Title 42

PART 488

Part 488 - Survey, Certification, And Enforcement Procedures

PART 488 - SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES Authority:42 U.S.C 1302 and 1395hh. Source:53 FR 22859, June 17, 1988, unless otherwise noted.

42:5.0.1.1.6.1SUBPART A
Subpart A - General Provisions
42:5.0.1.1.6.1.21.1SECTION 488.1
   488.1 Definitions.
42:5.0.1.1.6.1.21.2SECTION 488.2
   488.2 Statutory basis.
42:5.0.1.1.6.1.21.3SECTION 488.3
   488.3 Conditions of participation, conditions for coverage, conditions for certification and long term care requirements.
42:5.0.1.1.6.1.21.4SECTION 488.4
   488.4 General rules for a CMS-approved accreditation program for providers and suppliers.
42:5.0.1.1.6.1.21.5SECTION 488.5
   488.5 Application and re-application procedures for national accrediting organizations.
42:5.0.1.1.6.1.21.6SECTION 488.6
   488.6 Providers or suppliers that participate in the Medicaid program under a CMS-approved accreditation program.
42:5.0.1.1.6.1.21.7SECTION 488.7
   488.7 Release and use of accreditation surveys.
42:5.0.1.1.6.1.21.8SECTION 488.8
   488.8 Ongoing review of accrediting organizations.
42:5.0.1.1.6.1.21.9SECTION 488.9
   488.9 Validation surveys.
42:5.0.1.1.6.1.21.10SECTION 488.10
   488.10 State survey agency review: Statutory provisions.
42:5.0.1.1.6.1.21.11SECTION 488.11
   488.11 State survey agency functions.
42:5.0.1.1.6.1.21.12SECTION 488.12
   488.12 Effect of survey agency certification.
42:5.0.1.1.6.1.21.13SECTION 488.13
   488.13 Loss of accreditation.
42:5.0.1.1.6.1.21.14SECTION 488.14
   488.14 Effect of QIO review.
42:5.0.1.1.6.1.21.15SECTION 488.18
   488.18 Documentation of findings.
42:5.0.1.1.6.1.21.16SECTION 488.20
   488.20 Periodic review of compliance and approval.
42:5.0.1.1.6.1.21.17SECTION 488.24
   488.24 Certification of noncompliance.
42:5.0.1.1.6.1.21.18SECTION 488.26
   488.26 Determining compliance.
42:5.0.1.1.6.1.21.19SECTION 488.28
   488.28 Providers or suppliers, other than SNFs, NFs, and HHAs with deficiencies.
42:5.0.1.1.6.1.21.20SECTION 488.30
   488.30 Revisit user fee for revisit surveys.
42:5.0.1.1.6.2SUBPART B
Subpart B - Special Requirements
42:5.0.1.1.6.2.21.1SECTION 488.52
   488.52 [Reserved]
42:5.0.1.1.6.2.21.2SECTION 488.54
   488.54 Temporary waivers applicable to hospitals.
42:5.0.1.1.6.2.21.3SECTION 488.56
   488.56 Temporary waivers applicable to skilled nursing facilities.
42:5.0.1.1.6.2.21.4SECTION 488.60
   488.60 Special procedures for approving end stage renal disease facilities.
42:5.0.1.1.6.2.21.5SECTION 488.61
   488.61 Special procedures for approval and re-approval of organ transplant programs.
42:5.0.1.1.6.2.21.6SECTION 488.64
   488.64 Remote facility variances for utilization review requirements.
42:5.0.1.1.6.2.21.7SECTION 488.68
   488.68 State Agency responsibilities for OASIS collection and data base requirements.
42:5.0.1.1.6.3SUBPART C
Subpart C - Survey Forms and Procedures
42:5.0.1.1.6.3.21.1SECTION 488.100
   488.100 Long term care survey forms, Part A.
42:5.0.1.1.6.3.21.2SECTION 488.105
   488.105 Long term care survey forms, Part B.
42:5.0.1.1.6.3.21.3SECTION 488.110
   488.110 Procedural guidelines.
42:5.0.1.1.6.3.21.4SECTION 488.115
   488.115 Care guidelines.
42:5.0.1.1.6.4SUBPART D
Subpart D - Reconsideration of Adverse Determinations - Deeming Authority for Accreditation Organizations and CLIA Exemption of Laboratories Under State Programs
42:5.0.1.1.6.4.21.1SECTION 488.201
   488.201 Reconsideration.
42:5.0.1.1.6.4.21.2SECTION 488.203
   488.203 Withdrawal of request for reconsideration.
42:5.0.1.1.6.4.21.3SECTION 488.205
   488.205 Right to informal hearing.
42:5.0.1.1.6.4.21.4SECTION 488.207
   488.207 Informal hearing procedures.
42:5.0.1.1.6.4.21.5SECTION 488.209
   488.209 Hearing officer's findings.
42:5.0.1.1.6.4.21.6SECTION 488.211
   488.211 Final reconsideration determination.
42:5.0.1.1.6.5SUBPART E
Subpart E - Survey and Certification of Long-Term Care Facilities
42:5.0.1.1.6.5.21.1SECTION 488.300
   488.300 Statutory basis.
42:5.0.1.1.6.5.21.2SECTION 488.301
   488.301 Definitions.
42:5.0.1.1.6.5.21.3SECTION 488.303
   488.303 State plan requirement.
42:5.0.1.1.6.5.21.4SECTION 488.305
   488.305 Standard surveys.
42:5.0.1.1.6.5.21.5SECTION 488.307
   488.307 Unannounced surveys.
42:5.0.1.1.6.5.21.6SECTION 488.308
   488.308 Survey frequency.
42:5.0.1.1.6.5.21.7SECTION 488.310
   488.310 Extended survey.
42:5.0.1.1.6.5.21.8SECTION 488.312
   488.312 Consistency of survey results.
42:5.0.1.1.6.5.21.9SECTION 488.314
   488.314 Survey teams.
42:5.0.1.1.6.5.21.10SECTION 488.318
   488.318 Inadequate survey performance.
42:5.0.1.1.6.5.21.11SECTION 488.320
   488.320 Sanctions for inadequate survey performance.
42:5.0.1.1.6.5.21.12SECTION 488.325
   488.325 Disclosure of results of surveys and activities.
42:5.0.1.1.6.5.21.13SECTION 488.330
   488.330 Certification of compliance or noncompliance.
42:5.0.1.1.6.5.21.14SECTION 488.331
   488.331 Informal dispute resolution.
42:5.0.1.1.6.5.21.15SECTION 488.332
   488.332 Investigation of complaints of violations and monitoring of compliance.
42:5.0.1.1.6.5.21.16SECTION 488.334
   488.334 Educational programs.
42:5.0.1.1.6.5.21.17SECTION 488.335
   488.335 Action on complaints of resident neglect and abuse, and misappropriation of resident property.
42:5.0.1.1.6.6SUBPART F
Subpart F - Enforcement of Compliance for Long-Term Care Facilities with Deficiencies
42:5.0.1.1.6.6.21.1SECTION 488.400
   488.400 Statutory basis.
42:5.0.1.1.6.6.21.2SECTION 488.401
   488.401 Definitions.
42:5.0.1.1.6.6.21.3SECTION 488.402
   488.402 General provisions.
42:5.0.1.1.6.6.21.4SECTION 488.404
   488.404 Factors to be considered in selecting remedies.
42:5.0.1.1.6.6.21.5SECTION 488.406
   488.406 Available remedies.
42:5.0.1.1.6.6.21.6SECTION 488.408
   488.408 Selection of remedies.
42:5.0.1.1.6.6.21.7SECTION 488.410
   488.410 Action when there is immediate jeopardy.
42:5.0.1.1.6.6.21.8SECTION 488.412
   488.412 Action when there is no immediate jeopardy.
42:5.0.1.1.6.6.21.9SECTION 488.414
   488.414 Action when there is repeated substandard quality of care.
42:5.0.1.1.6.6.21.10SECTION 488.415
   488.415 Temporary management.
42:5.0.1.1.6.6.21.11SECTION 488.417
   488.417 Denial of payment for all new admissions.
42:5.0.1.1.6.6.21.12SECTION 488.418
   488.418 Secretarial authority to deny all payments.
42:5.0.1.1.6.6.21.13SECTION 488.422
   488.422 State monitoring.
42:5.0.1.1.6.6.21.14SECTION 488.424
   488.424 Directed plan of correction.
42:5.0.1.1.6.6.21.15SECTION 488.425
   488.425 Directed inservice training.
42:5.0.1.1.6.6.21.16SECTION 488.426
   488.426 Transfer of residents, or closure of the facility and transfer of residents.
42:5.0.1.1.6.6.21.17SECTION 488.430
   488.430 Civil money penalties: Basis for imposing penalty.
42:5.0.1.1.6.6.21.18SECTION 488.431
   488.431 Civil money penalties imposed by CMS and independent informal dispute resolution: for SNFS, dually-participating SNF/NFs, and NF-only facilities.
42:5.0.1.1.6.6.21.19SECTION 488.432
   488.432 Civil money penalties imposed by the State: NF-only.
42:5.0.1.1.6.6.21.20SECTION 488.433
   488.433 Civil money penalties: Uses and approval of civil money penalties imposed by CMS.
42:5.0.1.1.6.6.21.21SECTION 488.434
   488.434 Civil money penalties: Notice of penalty.
42:5.0.1.1.6.6.21.22SECTION 488.436
   488.436 Civil money penalties: Waiver of hearing, reduction of penalty amount.
42:5.0.1.1.6.6.21.23SECTION 488.438
   488.438 Civil money penalties: Amount of penalty.
42:5.0.1.1.6.6.21.24SECTION 488.440
   488.440 Civil money penalties: Effective date and duration of penalty.
42:5.0.1.1.6.6.21.25SECTION 488.442
   488.442 Civil money penalties: Due date for payment of penalty.
42:5.0.1.1.6.6.21.26SECTION 488.444
   488.444 Civil money penalties: Settlement of penalties.
42:5.0.1.1.6.6.21.27SECTION 488.446
   488.446 Administrator sanctions: long-term care facility closures.
42:5.0.1.1.6.6.21.28SECTION 488.450
   488.450 Continuation of payments to a facility with deficiencies.
42:5.0.1.1.6.6.21.29SECTION 488.452
   488.452 State and Federal disagreements involving findings not in agreement in non-State operated NFs and dually participating facilities when there is no immediate jeopardy.
42:5.0.1.1.6.6.21.30SECTION 488.454
   488.454 Duration of remedies.
42:5.0.1.1.6.6.21.31SECTION 488.456
   488.456 Termination of provider agreement.
42:5.0.1.1.6.7SUBPART G
Subpart G [Reserved]
42:5.0.1.1.6.8SUBPART H
Subpart H - Termination of Medicare Coverage and Alternative Sanctions for End-Stage Renal Disease (ESRD) Facilities
42:5.0.1.1.6.8.21.1SECTION 488.604
   488.604 Termination of Medicare coverage.
42:5.0.1.1.6.8.21.2SECTION 488.606
   488.606 Alternative sanctions.
42:5.0.1.1.6.8.21.3SECTION 488.608
   488.608 Notice of alternative sanction and appeal rights: Termination of coverage.
42:5.0.1.1.6.8.21.4SECTION 488.610
   488.610 Notice of appeal rights: Alternative sanctions.
42:5.0.1.1.6.9SUBPART I
Subpart I - Survey and Certification of Home Health Agencies
42:5.0.1.1.6.9.21.1SECTION 488.700
   488.700 Basis and scope.
42:5.0.1.1.6.9.21.2SECTION 488.705
   488.705 Definitions.
42:5.0.1.1.6.9.21.3SECTION 488.710
   488.710 Standard surveys.
42:5.0.1.1.6.9.21.4SECTION 488.715
   488.715 Partial extended surveys.
42:5.0.1.1.6.9.21.5SECTION 488.720
   488.720 Extended surveys.
42:5.0.1.1.6.9.21.6SECTION 488.725
   488.725 Unannounced surveys.
42:5.0.1.1.6.9.21.7SECTION 488.730
   488.730 Survey frequency and content.
42:5.0.1.1.6.9.21.8SECTION 488.735
   488.735 Surveyor qualifications.
42:5.0.1.1.6.9.21.9SECTION 488.740
   488.740 Certification of compliance or noncompliance.
42:5.0.1.1.6.9.21.10SECTION 488.745
   488.745 Informal Dispute Resolution (IDR).
42:5.0.1.1.6.10SUBPART J
Subpart J - Alternative Sanctions for Home Health Agencies With Deficiencies
42:5.0.1.1.6.10.21.1SECTION 488.800
   488.800 Statutory basis.
42:5.0.1.1.6.10.21.2SECTION 488.805
   488.805 Definitions.
42:5.0.1.1.6.10.21.3SECTION 488.810
   488.810 General provisions.
42:5.0.1.1.6.10.21.4SECTION 488.815
   488.815 Factors to be considered in selecting sanctions.
42:5.0.1.1.6.10.21.5SECTION 488.820
   488.820 Available sanctions.
42:5.0.1.1.6.10.21.6SECTION 488.825
   488.825 Action when deficiencies pose immediate jeopardy.
42:5.0.1.1.6.10.21.7SECTION 488.830
   488.830 Action when deficiencies are at the condition-level but do not pose immediate jeopardy.
42:5.0.1.1.6.10.21.8SECTION 488.835
   488.835 Temporary management.
42:5.0.1.1.6.10.21.9SECTION 488.840
   488.840 Suspension of payment for all new patient admissions.
42:5.0.1.1.6.10.21.10SECTION 488.845
   488.845 Civil money penalties.
42:5.0.1.1.6.10.21.11SECTION 488.850
   488.850 Directed plan of correction.
42:5.0.1.1.6.10.21.12SECTION 488.855
   488.855 Directed in-service training.
42:5.0.1.1.6.10.21.13SECTION 488.860
   488.860 Continuation of payments to an HHA with deficiencies.
42:5.0.1.1.6.10.21.14SECTION 488.865
   488.865 Termination of provider agreement.
42:5.0.1.1.6.11SUBPART K
Subpart K - [Reserved]
42:5.0.1.1.6.12SUBPART L
Subpart L - Accreditation of Home Infusion Therapy Suppliers
42:5.0.1.1.6.12.21SUBJGRP 21
   General Provisions
42:5.0.1.1.6.12.21.1SECTION 488.1000
   488.1000 Basis and scope.
42:5.0.1.1.6.12.21.2SECTION 488.1005
   488.1005 Definitions.
42:5.0.1.1.6.12.22SUBJGRP 22
   Approval and Oversight of Home Infusion Therapy Supplier Accrediting Organizations
42:5.0.1.1.6.12.22.3SECTION 488.1010
   488.1010 Application and reapplication procedures for national home infusion therapy accrediting organizations.
42:5.0.1.1.6.12.22.4SECTION 488.1015
   488.1015 Resubmitting a request for reapproval.
42:5.0.1.1.6.12.22.5SECTION 488.1020
   488.1020 Public notice and comment.
42:5.0.1.1.6.12.22.6SECTION 488.1025
   488.1025 Release and use of home infusion therapy accreditation surveys.
42:5.0.1.1.6.12.22.7SECTION 488.1030
   488.1030 Ongoing review of home infusion therapy accrediting organizations.
42:5.0.1.1.6.12.22.8SECTION 488.1035
   488.1035 Ongoing responsibilities of a CMS-approved home infusion therapy accrediting organization.
42:5.0.1.1.6.12.22.9SECTION 488.1040
   488.1040 Onsite observations of home infusion therapy accrediting organization operations.
42:5.0.1.1.6.12.22.10SECTION 488.1045
   488.1045 Voluntary and involuntary termination.
42:5.0.1.1.6.12.22.11SECTION 488.1050
   488.1050 Reconsideration.