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.

• Authority: 42 U.S.C 1302 and 1395hh.
• Source: 53 FR 22859, June 17, 1988, unless otherwise noted.

42:5.0.1.1.6.1	SUBPART A	Subpart A - General Provisions
42:5.0.1.1.6.1.21.1	SECTION 488.1	488.1 Definitions.
42:5.0.1.1.6.1.21.2	SECTION 488.2	488.2 Statutory basis.
42:5.0.1.1.6.1.21.3	SECTION 488.3	488.3 Conditions of participation, conditions for coverage, conditions for certification and long term care requirements.
42:5.0.1.1.6.1.21.4	SECTION 488.4	488.4 General rules for a CMS-approved accreditation program for providers and suppliers.
42:5.0.1.1.6.1.21.5	SECTION 488.5	488.5 Application and re-application procedures for national accrediting organizations.
42:5.0.1.1.6.1.21.6	SECTION 488.6	488.6 Providers or suppliers that participate in the Medicaid program under a CMS-approved accreditation program.
42:5.0.1.1.6.1.21.7	SECTION 488.7	488.7 Release and use of accreditation surveys.
42:5.0.1.1.6.1.21.8	SECTION 488.8	488.8 Ongoing review of accrediting organizations.
42:5.0.1.1.6.1.21.9	SECTION 488.9	488.9 Validation surveys.
42:5.0.1.1.6.1.21.10	SECTION 488.10	488.10 State survey agency review: Statutory provisions.
42:5.0.1.1.6.1.21.11	SECTION 488.11	488.11 State survey agency functions.
42:5.0.1.1.6.1.21.12	SECTION 488.12	488.12 Effect of survey agency certification.
42:5.0.1.1.6.1.21.13	SECTION 488.13	488.13 Loss of accreditation.
42:5.0.1.1.6.1.21.14	SECTION 488.14	488.14 Effect of QIO review.
42:5.0.1.1.6.1.21.15	SECTION 488.18	488.18 Documentation of findings.
42:5.0.1.1.6.1.21.16	SECTION 488.20	488.20 Periodic review of compliance and approval.
42:5.0.1.1.6.1.21.17	SECTION 488.24	488.24 Certification of noncompliance.
42:5.0.1.1.6.1.21.18	SECTION 488.26	488.26 Determining compliance.
42:5.0.1.1.6.1.21.19	SECTION 488.28	488.28 Providers or suppliers, other than SNFs, NFs, and HHAs with deficiencies.
42:5.0.1.1.6.1.21.20	SECTION 488.30	488.30 Revisit user fee for revisit surveys.
42:5.0.1.1.6.2	SUBPART B	Subpart B - Special Requirements
42:5.0.1.1.6.2.21.1	SECTION 488.52	488.52 [Reserved]
42:5.0.1.1.6.2.21.2	SECTION 488.54	488.54 Temporary waivers applicable to hospitals.
42:5.0.1.1.6.2.21.3	SECTION 488.56	488.56 Temporary waivers applicable to skilled nursing facilities.
42:5.0.1.1.6.2.21.4	SECTION 488.60	488.60 Special procedures for approving end stage renal disease facilities.
42:5.0.1.1.6.2.21.5	SECTION 488.61	488.61 Special procedures for approval and re-approval of organ transplant programs.
42:5.0.1.1.6.2.21.6	SECTION 488.64	488.64 Remote facility variances for utilization review requirements.
42:5.0.1.1.6.2.21.7	SECTION 488.68	488.68 State Agency responsibilities for OASIS collection and data base requirements.
42:5.0.1.1.6.3	SUBPART C	Subpart C - Survey Forms and Procedures
42:5.0.1.1.6.3.21.1	SECTION 488.100	488.100 Long term care survey forms, Part A.
42:5.0.1.1.6.3.21.2	SECTION 488.105	488.105 Long term care survey forms, Part B.
42:5.0.1.1.6.3.21.3	SECTION 488.110	488.110 Procedural guidelines.
42:5.0.1.1.6.3.21.4	SECTION 488.115	488.115 Care guidelines.
42:5.0.1.1.6.4	SUBPART D	Subpart D - Reconsideration of Adverse Determinations - Deeming Authority for Accreditation Organizations and CLIA Exemption of Laboratories Under State Programs
42:5.0.1.1.6.4.21.1	SECTION 488.201	488.201 Reconsideration.
42:5.0.1.1.6.4.21.2	SECTION 488.203	488.203 Withdrawal of request for reconsideration.
42:5.0.1.1.6.4.21.3	SECTION 488.205	488.205 Right to informal hearing.
42:5.0.1.1.6.4.21.4	SECTION 488.207	488.207 Informal hearing procedures.
42:5.0.1.1.6.4.21.5	SECTION 488.209	488.209 Hearing officer's findings.
42:5.0.1.1.6.4.21.6	SECTION 488.211	488.211 Final reconsideration determination.
42:5.0.1.1.6.5	SUBPART E	Subpart E - Survey and Certification of Long-Term Care Facilities
42:5.0.1.1.6.5.21.1	SECTION 488.300	488.300 Statutory basis.
42:5.0.1.1.6.5.21.2	SECTION 488.301	488.301 Definitions.
42:5.0.1.1.6.5.21.3	SECTION 488.303	488.303 State plan requirement.
42:5.0.1.1.6.5.21.4	SECTION 488.305	488.305 Standard surveys.
42:5.0.1.1.6.5.21.5	SECTION 488.307	488.307 Unannounced surveys.
42:5.0.1.1.6.5.21.6	SECTION 488.308	488.308 Survey frequency.
42:5.0.1.1.6.5.21.7	SECTION 488.310	488.310 Extended survey.
42:5.0.1.1.6.5.21.8	SECTION 488.312	488.312 Consistency of survey results.
42:5.0.1.1.6.5.21.9	SECTION 488.314	488.314 Survey teams.
42:5.0.1.1.6.5.21.10	SECTION 488.318	488.318 Inadequate survey performance.
42:5.0.1.1.6.5.21.11	SECTION 488.320	488.320 Sanctions for inadequate survey performance.
42:5.0.1.1.6.5.21.12	SECTION 488.325	488.325 Disclosure of results of surveys and activities.
42:5.0.1.1.6.5.21.13	SECTION 488.330	488.330 Certification of compliance or noncompliance.
42:5.0.1.1.6.5.21.14	SECTION 488.331	488.331 Informal dispute resolution.
42:5.0.1.1.6.5.21.15	SECTION 488.332	488.332 Investigation of complaints of violations and monitoring of compliance.
42:5.0.1.1.6.5.21.16	SECTION 488.334	488.334 Educational programs.
42:5.0.1.1.6.5.21.17	SECTION 488.335	488.335 Action on complaints of resident neglect and abuse, and misappropriation of resident property.
42:5.0.1.1.6.6	SUBPART F	Subpart F - Enforcement of Compliance for Long-Term Care Facilities with Deficiencies
42:5.0.1.1.6.6.21.1	SECTION 488.400	488.400 Statutory basis.
42:5.0.1.1.6.6.21.2	SECTION 488.401	488.401 Definitions.
42:5.0.1.1.6.6.21.3	SECTION 488.402	488.402 General provisions.
42:5.0.1.1.6.6.21.4	SECTION 488.404	488.404 Factors to be considered in selecting remedies.
42:5.0.1.1.6.6.21.5	SECTION 488.406	488.406 Available remedies.
42:5.0.1.1.6.6.21.6	SECTION 488.408	488.408 Selection of remedies.
42:5.0.1.1.6.6.21.7	SECTION 488.410	488.410 Action when there is immediate jeopardy.
42:5.0.1.1.6.6.21.8	SECTION 488.412	488.412 Action when there is no immediate jeopardy.
42:5.0.1.1.6.6.21.9	SECTION 488.414	488.414 Action when there is repeated substandard quality of care.
42:5.0.1.1.6.6.21.10	SECTION 488.415	488.415 Temporary management.
42:5.0.1.1.6.6.21.11	SECTION 488.417	488.417 Denial of payment for all new admissions.
42:5.0.1.1.6.6.21.12	SECTION 488.418	488.418 Secretarial authority to deny all payments.
42:5.0.1.1.6.6.21.13	SECTION 488.422	488.422 State monitoring.
42:5.0.1.1.6.6.21.14	SECTION 488.424	488.424 Directed plan of correction.
42:5.0.1.1.6.6.21.15	SECTION 488.425	488.425 Directed inservice training.
42:5.0.1.1.6.6.21.16	SECTION 488.426	488.426 Transfer of residents, or closure of the facility and transfer of residents.
42:5.0.1.1.6.6.21.17	SECTION 488.430	488.430 Civil money penalties: Basis for imposing penalty.
42:5.0.1.1.6.6.21.18	SECTION 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.
42:5.0.1.1.6.6.21.19	SECTION 488.432	488.432 Civil money penalties imposed by the State: NF-only.
42:5.0.1.1.6.6.21.20	SECTION 488.433	488.433 Civil money penalties: Uses and approval of civil money penalties imposed by CMS.
42:5.0.1.1.6.6.21.21	SECTION 488.434	488.434 Civil money penalties: Notice of penalty.
42:5.0.1.1.6.6.21.22	SECTION 488.436	488.436 Civil money penalties: Waiver of hearing, reduction of penalty amount.
42:5.0.1.1.6.6.21.23	SECTION 488.438	488.438 Civil money penalties: Amount of penalty.
42:5.0.1.1.6.6.21.24	SECTION 488.440	488.440 Civil money penalties: Effective date and duration of penalty.
42:5.0.1.1.6.6.21.25	SECTION 488.442	488.442 Civil money penalties: Due date for payment of penalty.
42:5.0.1.1.6.6.21.26	SECTION 488.444	488.444 Civil money penalties: Settlement of penalties.
42:5.0.1.1.6.6.21.27	SECTION 488.446	488.446 Administrator sanctions: long-term care facility closures.
42:5.0.1.1.6.6.21.28	SECTION 488.447	488.447 Civil Money Penalties imposed for failure to comply with 42 CFR 483.80(g)(1) and (2).
42:5.0.1.1.6.6.21.29	SECTION 488.450	488.450 Continuation of payments to a facility with deficiencies.
42:5.0.1.1.6.6.21.30	SECTION 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.
42:5.0.1.1.6.6.21.31	SECTION 488.454	488.454 Duration of remedies.
42:5.0.1.1.6.6.21.32	SECTION 488.456	488.456 Termination of provider agreement.
42:5.0.1.1.6.7	SUBPART G	Subpart G [Reserved]
42:5.0.1.1.6.8	SUBPART H	Subpart H - Termination of Medicare Coverage and Alternative Sanctions for End-Stage Renal Disease (ESRD) Facilities
42:5.0.1.1.6.8.21.1	SECTION 488.604	488.604 Termination of Medicare coverage.
42:5.0.1.1.6.8.21.2	SECTION 488.606	488.606 Alternative sanctions.
42:5.0.1.1.6.8.21.3	SECTION 488.608	488.608 Notice of alternative sanction and appeal rights: Termination of coverage.
42:5.0.1.1.6.8.21.4	SECTION 488.610	488.610 Notice of appeal rights: Alternative sanctions.
42:5.0.1.1.6.9	SUBPART I	Subpart I - Survey and Certification of Home Health Agencies
42:5.0.1.1.6.9.21.1	SECTION 488.700	488.700 Basis and scope.
42:5.0.1.1.6.9.21.2	SECTION 488.705	488.705 Definitions.
42:5.0.1.1.6.9.21.3	SECTION 488.710	488.710 Standard surveys.
42:5.0.1.1.6.9.21.4	SECTION 488.715	488.715 Partial extended surveys.
42:5.0.1.1.6.9.21.5	SECTION 488.720	488.720 Extended surveys.
42:5.0.1.1.6.9.21.6	SECTION 488.725	488.725 Unannounced surveys.
42:5.0.1.1.6.9.21.7	SECTION 488.730	488.730 Survey frequency and content.
42:5.0.1.1.6.9.21.8	SECTION 488.735	488.735 Surveyor qualifications.
42:5.0.1.1.6.9.21.9	SECTION 488.740	488.740 Certification of compliance or noncompliance.
42:5.0.1.1.6.9.21.10	SECTION 488.745	488.745 Informal Dispute Resolution (IDR).
42:5.0.1.1.6.10	SUBPART J	Subpart J - Alternative Sanctions for Home Health Agencies With Deficiencies
42:5.0.1.1.6.10.21.1	SECTION 488.800	488.800 Statutory basis.
42:5.0.1.1.6.10.21.2	SECTION 488.805	488.805 Definitions.
42:5.0.1.1.6.10.21.3	SECTION 488.810	488.810 General provisions.
42:5.0.1.1.6.10.21.4	SECTION 488.815	488.815 Factors to be considered in selecting sanctions.
42:5.0.1.1.6.10.21.5	SECTION 488.820	488.820 Available sanctions.
42:5.0.1.1.6.10.21.6	SECTION 488.825	488.825 Action when deficiencies pose immediate jeopardy.
42:5.0.1.1.6.10.21.7	SECTION 488.830	488.830 Action when deficiencies are at the condition-level but do not pose immediate jeopardy.
42:5.0.1.1.6.10.21.8	SECTION 488.835	488.835 Temporary management.
42:5.0.1.1.6.10.21.9	SECTION 488.840	488.840 Suspension of payment for all new patient admissions.
42:5.0.1.1.6.10.21.10	SECTION 488.845	488.845 Civil money penalties.
42:5.0.1.1.6.10.21.11	SECTION 488.850	488.850 Directed plan of correction.
42:5.0.1.1.6.10.21.12	SECTION 488.855	488.855 Directed in-service training.
42:5.0.1.1.6.10.21.13	SECTION 488.860	488.860 Continuation of payments to an HHA with deficiencies.
42:5.0.1.1.6.10.21.14	SECTION 488.865	488.865 Termination of provider agreement.
42:5.0.1.1.6.11	SUBPART K	Subpart K - [Reserved]
42:5.0.1.1.6.12	SUBPART L	Subpart L - Accreditation of Home Infusion Therapy Suppliers
42:5.0.1.1.6.12.21	SUBJGRP 21	General Provisions
42:5.0.1.1.6.12.21.1	SECTION 488.1000	488.1000 Basis and scope.
42:5.0.1.1.6.12.21.2	SECTION 488.1005	488.1005 Definitions.
42:5.0.1.1.6.12.22	SUBJGRP 22	Approval and Oversight of Home Infusion Therapy Supplier Accrediting Organizations
42:5.0.1.1.6.12.22.3	SECTION 488.1010	488.1010 Application and reapplication procedures for national home infusion therapy accrediting organizations.
42:5.0.1.1.6.12.22.4	SECTION 488.1015	488.1015 Resubmitting a request for reapproval.
42:5.0.1.1.6.12.22.5	SECTION 488.1020	488.1020 Public notice and comment.
42:5.0.1.1.6.12.22.6	SECTION 488.1025	488.1025 Release and use of home infusion therapy accreditation surveys.
42:5.0.1.1.6.12.22.7	SECTION 488.1030	488.1030 Ongoing review of home infusion therapy accrediting organizations.
42:5.0.1.1.6.12.22.8	SECTION 488.1035	488.1035 Ongoing responsibilities of a CMS-approved home infusion therapy accrediting organization.
42:5.0.1.1.6.12.22.9	SECTION 488.1040	488.1040 Onsite observations of home infusion therapy accrediting organization operations.
42:5.0.1.1.6.12.22.10	SECTION 488.1045	488.1045 Voluntary and involuntary termination.
42:5.0.1.1.6.12.22.11	SECTION 488.1050	488.1050 Reconsideration.

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