Perfect compliance is not a realistic expectation. Facilities are, however, expected to achieve substantial, continued compliance and take an active stance in quality assurance and improvement, with ongoing efforts at internal quality control. The enforcement process, including definitions of scope and severity, was developed in partnership with provider and beneficiary groups. HCFA recognizes that one enforcement response is not appropriate for all deficiencies. The new regulation provides alternatives to termination and denial of payment for addressing noncompliance.
Sanctions are commensurate with the level and pervasiveness of harm.
HCFA has four goals in implementing the final rule. Motivate facilities to remain in compliance . Enforcement process can result in remedies for noncompliance. A facility cannot wait for a state to act as its quality assurance program by identifying deficiencies on the survey, then fix it without a remedy. Promote survey and enforcement consistency .