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Nursing Home Citations for Past Noncompliance

Recently, LeadingAge Minnesota received more questions about citations for past noncompliance actions and how those citations impact the five-star rating, calculating fines, and appeals.

Background

Surveyors from the Minnesota Department of Health may cite providers for past noncompliance on any F-Tag or K-Tag if all criteria are met, including:

  • The facility was not in compliance at the time the situation causing the citation occurred
  • The noncompliance occurred after the exit date of the last standard recertification survey and before the current survey entrance date.
  • There is sufficient evidence the facility corrected the noncompliance and is in substantial compliance at the time of the current survey.

Organizations can appeal to citations of past noncompliance just as we appeal other citations.

What is the impact on the Five-Star Rating?

Citations issued as past noncompliance do have an impact on the organization's five-star rating, although the impact is slightly different for immediate jeopardy citations. If the citation is issued at an immediate jeopardy level but is labeled past noncompliance, the points assigned for the health inspection score would be the points associated with a G-Level. For example, a non-quality of care citation at a J level is traditionally 50 points; however, if cited as past noncompliance, the points associated would be 20 points.

How are fines calculated for past noncompliance?

Nursing homes may receive fines for tags associated with past noncompliance. Before 2021, past noncompliance fines were solely per instance fines; in 2021, there was a change that allows regulatory agencies to opt for a per day fine in situations the agency assesses as appropriate. It may be challenging to determine the actual noncompliance date and when the organization became compliant. For this reason, fines continue to be per instance in most cases.

If you have additional questions, please contact Kari Everson.

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