6 Colo. Code Regs. § 1011-1-5-31

Current through Register Vol. 47, No. 20, October 25, 2024

Section 6 CCR 1011-1-5-31 - ENFORCEMENT ACTIVITIES

For Nursing Care Facilities Certified to Provide Medicaid Services:

31.1 The Department, as the state agency responsible for certifying nursing care facilities, is authorized under Sections 25-1-107.5(2) and 25.5-6-205(1)(a), C.R.S. to recommend to the Department of Health Care Policy and Financing (HCPF) that remedies be imposed against a nursing care facility that violates federal law for participation in the Medicaid program as enumerated in 42 USC § 1396r(h). The remedies recommended shall include any remedies required under federal law and the imposition of civil money penalties. Assessment, enforcement and collection of any civil money penalty recommended under this section and the denial of Medicaid payments shall be HCPF's responsibility.

31.2 In determining whether to recommend imposition of a civil money penalty, the Department may consider mitigating factors such as change of ownership; circumstances outside the facility's reasonable control; and reasonable, good faith efforts to resolve the violation(s).

31.3 In determining the amount of the penalty to recommend for assessment by HCPF, the Department shall consider, at a minimum, the following items:

A) The period of time over which the violation occurred;

B) The frequency of the violation;

C) The nursing care facility's history concerning the type of violation for which the penalty is assessed;

D) The nursing care facility's intent or reason for the violation;

E) The effect, if any, of the violation on residents' health, safety, security or welfare (i.e., severity);

F) The existence of other violations, in combination with the violation for which the penalty is assessed, which increase the threat to residents' health, safety, security or welfare;

G) The accuracy, thoroughness and availability of records regarding the violation which the nursing care facility is required to maintain; and

H) The number of additional related violations occurring within the same time span as the violation in question.

31.4 In the event the Department determines that a violation is life threatening to one or more residents or creates a direct threat or serious adverse harm to the health, safety, security, rights or welfare of one or more residents, HCPF shall impose a penalty for each day the deficiencies that constitute the violation are found to exist.

31.5 In accordance with Section 25-1-107.5(3), C.R.S., any civil money penalty recommended by the Department shall be not less than $100 or more than $10,000 for each day the facility is found to have been in violation of the federal regulations. Penalties assessed shall include interest at the statutory rate.

31.6 If the Department recommends imposition of a civil money penalty, it shall notify the nursing care facility no later than five days after the last day of the inspection or survey during which the deficiencies that constitute the violation were found. Such notice shall comply with Section 25-1-107.5(3)(c)(II),C.R.S.

31.7 Plans of correction shall comply with 6 CCR 1011-1, Chapter 2, Part 2.10.4(B).

31.8 Nothing in this section precludes the Department from imposing any other remedies allowed by state law including, but not limited to, those described in 6 CCR 1011-1, Chapter 2, Part 2.10 and 2.11.

For Licensed, Non-Certified Nursing Care Facilities:

31.9 The Department may impose any enforcement remedy authorized by state law or regulation.

31.10 Enforcement activities shall be conducted in accordance with 6 CCR 1011-1, Chapter 2.

6 CCR 1011-1-5-31