Immediate Jeopardy: How “Likely” Is It?
November 3, 2017 | Aging Services Risk Management
Immediate jeopardy is defined as “a situation in which the provider's noncompliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident," according to regulations. Organizations have 23 calendar days to rectify the situation. If violations are not rectified, organizations risk termination as Medicare providers and are subject to removal from the program, and they face hefty civil money penalties if found noncompliant. Although it may be obvious or quick to determine whether a deficiency caused actual harm or serious injury, some organizations may be able to challenge the determination that immediate jeopardy existed for several months yet no actual harm occurred, notes an article published in iAdvance Senior Care's 2017 Innovation Issue. According to the Centers for Medicare and Medicaid Services (CMS) Guidelines for Determining Immediate Jeopardy(Appendix Q of the State Operations Manual), if an immediate jeopardy deficiency has yet to cause harm, then it must be likely to occur “in the very near future." However, the author of the article states that CMS may consider the meaning of “likely" in the context of “risk" rather than “probability.