Reporting Suspicion of a Crime

Section 1150 B of the Social Security Act, as established by Section 6703 (b)(3) of the Patient Protection and Affordable Care Act of 2010 requires specific individuals in applicable long term care facilities to report any reasonable suspicion of crimes committed against a resident of that facility. In accordance with Centers for Medicare & Medicaid Services (CMS) memorandum dated June 17, 2011, S&C: 11-30-NH, reports must be submitted to at least one law enforcement agency of jurisdiction and to the State Survey Agency (In fulfillment of the statutory directive to report to the Secretary). The requirement to report, as detailed in the attached memo, is effective immediately.

At the present time there are no Centers for Medicare and Medicaid Services (CMS) regulations that apply specifically to Section 1150B pertaining to responsibilities of covered individuals or facilities. Consequently, the State Survey Agency has been instructed to focus on (a) the events giving rise to reports made under this requirement and (b) the facility's responsibilities under existing CMS Conditions of Participation and requirements to report incidents, prevent abuse or neglect, provide quality care and a safe environment, train staff, and similar duties of direct relevance to safety and quality of care.

As more information and guidance is made available by CMS, the Bureau of Health Care Services web site (www.michigan.gov/bhs) will be updated. In accordance with the attached CMS memorandum, surveyors of the Bureau of Health Care Services will make determinations of compliance based on existing requirements and existing procedures for reporting incidents. Facilities and covered individuals should continue to use existing procedures for reporting complaints and Facility Reported Incidents to the state agency (via the Complaint Hotline Number 1-800-882-6006, Fax Number (517) 241-0093 or www.michigan.gov/bhs under Facilities Complaint and Investigation). Single reports can include multiple names of covered individuals with first-hand knowledge of suspicion of a crime. In evaluating compliance with reporting requirements, the State Survey Agency will consider the fact that a report of a reasonable suspicion of a crime was reported of paramount importance.

Related Documents
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