Law. Consulting. Technology.
ROLF assists SNFs nationally in preparing for, responding to and appealing survey citations from state agencies and the Centers for Medicare & Medicaid Services (CMS).
The Survey & Enforcement team includes attorneys and consultants who collectively have over 100 years’ legal experience, 60 years of registered nursing experience and six years of Social Work experience in long-term care. In addition to real-time consulting before and during surveys, our team files hundreds Informal Dispute Resolution (IDR) requests, Independent IDR (IIDR) requests and formal appeals each year, resulting in significant outcomes for clients, including:
IDR & IIDR Results
- Reduction of a dozen Immediate Jeopardy (IJ) level deficiencies in the last two (2) years, resulting in decreased survey points and lowered Civil Monetary Penalties (CMP) (e.g., CMP reduced from $455,545 to $30,462)
- Change in Immediate Jeopardy (IJ) level deficiencies to Past-Noncompliance designation, resulting in reduction in CMPs (e.g., CMP reduced from $100,000 to a per instance CMP of less than $20,000), as well as reduction in survey points for the CMS Five Star rating system (e.g., from 75 – 175 points for an ongoing IJ to 20 points)
- Elimination of numerous Level 2 (“D”, “E” & “F”) and Level 3 (“G”, “H” & “I”) deficiencies at a success rate exceeding the state average, and resulting in the reduction of over 2000 survey points in the last two (2) years, with corresponding positive changes to enforcement remedies, such as reductions or recissions of CMPs and Denial of Payment for New Admissions penalties
- Successful disputes for 30 facilities of new federal regulatory tag F884 – all cited at Level “F” (Required Reporting of COVID-related issues to National Healthcare Safety Network), which includes a mandatory CMP that increases with each citation
Formal Administrative Law Appeals
- Decisions to rescind Denial of Payment for New Admissions remedies (e.g., one case saved the facility nearly $300,000 in Medicaid/Medicare funds)
- Elimination of substandard quality of care (SQC) designation, which allowed the facility to keep its nurse aide training program
- Reduction of scope and severity on Immediate Jeopardy (IJ) level deficiencies, resulting in a significant decrease of survey points
- Deletion of consecutive F884 (reporting) deficiencies and rescission of all associated CMPs, with several cases resulting in a rescission of a civil money penalty totaling more than $47,000 in each case
- Extremely rare, favorable Administrative Appeal Decision by Administrative Law Judge determining “G” level citation was without merit