CMS SOM App. PP, Tag F836

A facility must be licensed under applicable State and local law.

§483.70(b) Compliance with Federal, State, and Local Laws and Professional

Standards.

The facility must operate and provide services in compliance with all applicable

Federal, State, and local laws, regulations, and codes, and with accepted

professional standards and principles that apply to professionals providing services

in such a facility.

§483.70(c) Relationship to Other HHS Regulations.

In addition to compliance with the regulations set forth in this subpart, facilities are

obliged to meet the applicable provisions of other HHS regulations, including but

not limited to those pertaining to nondiscrimination on the basis of race, color, or

national origin (45 CFR part 80); nondiscrimination on the basis of disability (45

CFR part 84); nondiscrimination on the basis of age (45 CFR part 91);

nondiscrimination on the basis of race, color, national origin, sex, age, or disability

(45 CFR part 92); protection of human subjects of research (45 CFR part 46); and

fraud and abuse (42 CFR part 455) and protection of individually identifiable health

information (45 CFR parts 160 and 164). Violations of such other provisions may

result in a finding of non-compliance with this paragraph.

DEFINITIONS

“Accepted professional standards and principles” means Federal, State and local laws

or professional licensure standards.

An “authority having jurisdiction” is the public agency, i.e., Federal, State or local, or

official(s) having the authority to make a determination of noncompliance, and is

responsible for providing and signing official correspondence notifying the facility or

professional of their final adverse action.

GUIDANCE

This regulation and guidance only applies to actions taken under State licensure authority

or other Federal HHS agencies as defined in the regulation, it does NOT include any

federal CMS enforcement actions as required at 42 CFR Part §488.

PROCEDURES:

Facility licenses, permits, and approvals must be provided upon request if necessary to

determine compliance with these requirements. Surveyors may not interpret or enforce

another agency’s requirements. If surveyors identify a situation indicating that the

facility or any professional providing services may not be in compliance with a State or

local law, regulation, Code and/or standard, refer that information to the authority having

jurisdiction for their follow-up action. The CMS Location will assist you to contact the

appropriate Federal agency to refer your concerns. Do not delay a survey waiting for

confirmation of receipt from another agency or authority having jurisdiction.

If surveyors determined and received confirmation from the authority having jurisdiction

that a final adverse action has been taken, then the facility could be found to not meet the

requirements at §483.70(b) or (c) and a deficiency may be cited here. A final adverse

action includes an action imposed by the authority having jurisdiction and is not under

appeal or litigation by the facility or the professional providing services in the facility.

Do not cite this tag:

• When the authority having jurisdiction has not taken a final adverse action;

• To simply cite non-compliance with State or local licensure requirements unless

final adverse action from the authority having jurisdiction has been confirmed; or

• As past non-compliance if, at the time of the current survey, the facility or

professional is in compliance with the Federal, State or local law, regulation, code

and /or standard but was found not to be in compliance with those requirements

during a time before the current survey. If there is a question, confirm the

facility’s current compliance status with the authority having jurisdiction.

KEY ELEMENTS OF NONCOMPLIANCE

To cite deficient practice at F836, the surveyor’s investigation will generally show that

the facility failed to do any one of the following:

• Hold a current license from the State or other applicable authority to operate as a

nursing home and this information has been verified with the appropriate

authority; or

• Provide services in compliance with all applicable Federal, State, and local laws,

regulations, and codes, and with accepted professional standards and principles

that apply to any professional providing services in the facility, whether

temporary or permanent.