United States Sixth Circuit

The Appellate Division of the Departmental Appeals Board's (DAB) affirmance of the United States Centers for Medicare and Medicaid Services' imposition of a civil money penalty upon, as well as a denial of payment for new admissions for, a skilled nursing facility, for noncompliance with a number of standards of care required by the U.S. Department of Health and Human Services, is affirmed where: 1) it was clear that the facility failed to achieve substantial compliance with 42 C.F.R. section 483.10(b)(11) as the DAB correctly noted that a sharp decline in food intake persisting for over three weeks should have brought a resident's significant change in status to the facility's attention; 2) DAB's immediate jeopardy determination was not in clear error; 3) substantial evidence existed in the record as a whole to demonstrate that the facility had failed to substantially comply with the requirement that it provide each resident with sufficient fluid intake to maintain proper hydration and health under section 483.25(j); and 4) the ALJ was free not to continue making additional rulings once he determined that the deficiencies concerning the two residents sufficed to support imposition of sanctions.

Appellate Information

• Decided 06/25/2010
• Published 06/25/2010

Judges

Court

• United States Sixth Circuit

Counsel