CDPHE Imposing Discretionary Denial of Payment on Behalf of CMS

 

To: Nursing Facility Administrators  From: Nursing Facilities Section & Federal Enforcement Coordinator   Beginning July 1, 2023 the Colorado Department of Public Health and Environment will begin imposing the discretionary denial of payment remedy for applicable nursing facility surveys with harm, substandard quality of care, and immediate jeopardy findings. During the public health emergency, the Centers for Medicare and Medicaid services required all states to impose discretionary denial of payment for new admissions for applicable surveys, consequently, this practice will be familiar to many of our providers. States in other Centers for Medicare and Medicaid Services location jurisdictions, like Kansas City, have been imposing discretionary denial of payment for new admissions remedy on applicable surveys prior to the public health emergency. The Centers for Medicare and Medicaid Services Denver location has offered Denver location states the opportunity to impose discretionary denial of payment in order to encourage speedier return to compliance through the selection of more prompt completion dates for all deficiencies cited during an applicable survey. In keeping with the State Operations Manual Chapter 7 - Survey and Enforcement Process for Skilled Nursing Facilities and Nursing Facilities, discretionary denial of payment will be imposed 15 days from the date of the state enforcement letter. The Colorado Department of Public Health and Environment will review state imposition of discretionary denial of payment for new admissions with the Centers for Medicare and Medicaid Services to ensure this practice is achieving the intended goal. After the review, adjustments may be made to ensure this enforcement is practicable and operates in the manner intended.   Questions regarding enforcement and enforcement remedies can be directed to the Federal Enforcement Coordinator, Shannon St. Hilaire, at shannon.st.hilaire@state.co.us or 720-477-0191.