For Immediate Release:
July 7, 2011

CMS Survey and Certification Issues “Reporting Reasonable Suspicion of a Crime in a LTC Facility”

A CMS memorandum, issued on June 17, 2011, informs Survey Agencies of the new section 1150B of the Affordable Care Act, “Reporting to Law Enforcement of Crimes Occurring in Federally Funded Long-Term Care Facilities” (originally established by section 6703(b)(3)).  Per the Medicare Hospice CoPs section §418.112(c)(8), a hospice provider is required to “report all alleged violations involving mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown source, and misappropriation of patient property by anyone unrelated to the hospice to the SNF/NF or ICF/MR administrator within 24 hours of the hospice becoming aware of the alleged violation.”  Non-compliance could yield deficiency citations for a hospice provider during a survey. 

Hospice providers should ensure that:

• All alleged violations involving mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown source, and misappropriation of patient property by anyone furnishing services on behalf of the hospice, are reported immediately by hospice employees and contracted staff to the hospice administrator.

• Hospice and SNF/NF or ICF/MR must have a written agreement that includes a provision stating that the hospice must report all alleged violations involving mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown source, and misappropriation of patient property by anyone unrelated to the hospice to the SNF/NF or ICF/MR administrator within 24 hours of the hospice becoming aware of the alleged violation.

Read the CMS  S&C11-30-NH memo (PDF) online.