South Carolina Code of Regulations › Chapter 126 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › Article 8 - INTERMEDIATE SANCTIONS FOR MEDICAID CERTIFIED NURSING FACILITIES › Section 126-800 - Definitions

Current through Register Vol. 48, No. 6, June 28, 2024
A. Administrator of
			 the State Medicaid Agency means the Executive Director of South Carolina
			 Department of Health and Human Services.
B. Annual Standard Survey means an annual
			 standard survey conducted on each nursing facility, without prior notice to the
			 facility. The survey may occur as early as nine months, but shall not be later
			 than fifteen months after the date of the nursing facility's previous standard
			 survey. The statewide average interval between standard surveys shall not
			 exceed twelve months.
C.
			 Certification means the State Survey Agency's determination that a nursing
			 facility meets the requirements for participation in the Medicaid
			 program.
D. Credible allegation
			 means a statement or documentation which must be submitted to the Centers for
			 Medicare and Medicaid Services (CMS) of the United States Department of Health
			 and Human Services (USDHHS) when a nursing facility has had serious
			 deficiencies resulting in imminent action to terminate the provider's
			 certification. The statement must indicate how deficiencies will be corrected
			 and problems resolved and be realistic in terms of the possibility of
			 correction by specified deadlines.
E. Credible Certified Notice of Correction
			 means a certification letter from the Nursing Facility to the State Survey
			 Agency and the Medicaid Agency, stipulating that deficiencies noted in the most
			 recent survey and due to be corrected by the last date in an accepted credible
			 allegation or in an accepted plan of correction, have been corrected as of the
			 date of the certification letter. Credibility shall be validated upon the next
			 Survey Agency revisit, and penalties shall cease or escalate from the date of
			 the certified notice in accordance with procedures in Section
			 126-840.
			 The statement, "I certify that" must precede the statement of
			 correction.
F. Deficiency means
			 non-compliance with requirements of participation for nursing facilities as
			 mandated by Federal Regulations.
G.
			 Immediately Jeopardizes the Health or Safety of Residents means that conditions
			 exist which pose a high probability that serious harm or injury to patients
			 could occur at any time, or already has occurred and may well occur again if
			 patients are not protected effectively from the harm (An immediate and serious
			 threat need not result in actual harm to the resident. The threat of probable
			 harm is perceived as being as serious or significant).
The only acceptable corrective action is the immediate
				elimination of the conditions which immediately jeopardize the resident's
				health and safety.
H.
			 Medicaid is the common name for Title XIX of the Social Security Act.
I. Nursing Facility means a facility with an
			 organized nursing staff to maintain and operate organized facilities and
			 services to accommodate two or more non-related persons over a period exceeding
			 twenty-four hours, which is operated either in connection with a hospital or as
			 a free standing facility for the express or implied purpose of providing
			 nursing care for persons who are not in need of hospital care, and in which all
			 nursing care is prescribed by or performed under the direction of persons
			 currently licensed to practice medicine in the State of South Carolina. Nursing
			 care consists of nursing services requiring knowledge, judgment, and skill in
			 caring for the sick.
J. Recurring
			 Deficiency means a deficiency, cited by the State Survey Agency during a
			 current survey, that has the exact same tag number but a different reason from
			 the one cited during the previous survey.
K. Repeat Deficiency means a deficiency,
			 cited by the State Survey Agency during a current survey, that has the exact
			 same tag number as cited for the exact same reason in a previous
			 survey.
L. Requirements of
			 Participation means the requirements a nursing facility must meet in order to
			 receive payment under the state's Medicaid program.
M. Substantial Risk to Health and Safety of
			 Residents means conditions exist which over time if not corrected, will likely
			 result in harm or injury to patients.
N. State Medicaid Agency means Department of
			 Health and Human Services (SCDHHS).
O. State Survey Agency means the Department
			 of Health and Environmental Control (DHEC).
P. Tag Number means a reference number which
			 identifies a particular Code of Federal Regulation regulatory
			 statement.
Q. Temporary
			 Management/Receivership means the appointment of a substitute manager or
			 administrator, with powers, as enumerated in the statute, by the
			 court.