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Tip of the week: Understand immediate jeopardy violations

Contemporary Long-Term Care Weekly, October 1, 2009

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Immediate jeopardy is defined by CMS as, “a situation in which the provider’s non-compliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident.” It is the highest-level citation a facility can receive and must be relieved within 23 days of being cited or participation in Medicare and Medicaid will be discontinued. CMS’ State Operations Manual states that three components have to exist for immediate jeopardy to be cited:

1. Harm – Harm can either be actual or potential and will result if the provider’s noncompliance likely will cause serious injury, harm, impairment, or death to the individual.
2. Immediacy – For immediate jeopardy to exist there has to be an immediacy of harm. In other words, is the risk of harm so severe that this individual, or others in the facility, likely will be harmed, injured, impaired, or die in the near future?
3. Culpability – The State Operations Manual looks to five key questions involving culpability:

• Did the facility know about the situation, and if so, when did it first become aware of it?
• Should the facility have known about the situation?
• Did the facility conduct a thorough investigation of the circumstances surrounding the incident?
• Did the facility implement corrective actions?
• Did the facility continue to look at the corrective actions and measures that were put in place to make sure they were working and the situation was corrected?

This is an excerpt from HCPro’s book, The Long-Term Care Administrator’s Field Guide, by Brian Garavaglia, PhD.

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