CMS To Issue Guidance for Implementation of Reporting Requirements of the EJA

A letter dated March 11, 2011 from the Director of The Center for Medicare and Medicaid Services (CMS) establishes that CMS will issue further guidance on necessary procedures for implementation of reporting requirements contained in the Elder Justice Act of 2009 (EJA). The EJA, as part of the PPACA, adds new provisions and specific Federal nursing home requirements by amending various sections of the Social Security Act (SSA). The primary objective of the EJA is to detect, prevent and prosecute elder abuse, neglect, and exploitation.

The reporting crimes requirement of the EJA requires each individual owner, operator, employee, manager, agent, or contractor of long term nursing homes receiving at least $10,000 in annual federal long term care funding, to report to the Secretary of HHS and local law enforcement entities any reasonable suspicion of crimes occurring in such facility. Reports of reasonable suspicion of a crime must be made to the Secretary and at least one local law enforcement entity within two hours of suspicion if there is serious bodily injury, and within twenty-four hours of suspicion if no serious bodily injury has occurred.

The EJA also requires compliance with enhanced prohibitions against retaliation for reporting suspected criminal acts. A facility is prohibited from retaliating, discriminating, or filing a complaint or a report against an employee who makes a report, causes a report to be made or takes steps in furtherance of making a report according to the EJA’s requirements. Failure of a covered individual to report a suspected crime results in a civil money penalty of up to $200,000, and may cause exclusion from participation in any Federal health care program. If failure to report results in further injury to a victim of the crime, the civil money penalty increases to $300,000.