The Centers for Medicare & Medicaid Services (CMS) issued a memo on July 28, 2021, announcing the removal of the July 7, 2017 Memo (S&C 17-37-NH) from its guidance repository. The 2017 memo had instructed CMS Locations to impose civil monetary penalties for prior noncompliance solely on a per-instance basis. However, CMS has now determined that it should retain the discretion to impose a per-day penalty where appropriate to address specific circumstances of prior noncompliance. CMS will work within its operations to apply this discretion, and any final notice of noncompliance will set forth the penalty and the reason(s) for imposing per-instance or per-day penalties. Healthcare facilities, including nursing homes, should be aware of this change in guidance and potential consequences for noncompliance. The memo's effective date was July 16, 2021.

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