serious deficiency: it’s not a joke serious deficiencies for providers

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Serious Deficiency: It’s Not a Joke Serious Deficiencies for Providers

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Page 1: Serious Deficiency: It’s Not a Joke Serious Deficiencies for Providers

Serious Deficiency:It’s Not a Joke

Serious Deficiencies for Providers

Page 2: Serious Deficiency: It’s Not a Joke Serious Deficiencies for Providers

What is Seriously Deficient?

“The status of an institution or day care home that has been determined to be

non-compliant in one or more aspects of its

operation of the Program.”

Page 3: Serious Deficiency: It’s Not a Joke Serious Deficiencies for Providers

What is a Serious Deficiency?

• Submission of false information on the application

• Submission of false claims for reimbursement

• Simultaneous participation under more than one sponsoring organization

• Non-compliance with the Program meal pattern

• Failure to keep required records (i.e. meal counts, menus, etc.)

Page 4: Serious Deficiency: It’s Not a Joke Serious Deficiencies for Providers

What is a Serious Deficiency?

• Conduct or conditions that threaten the health or safety of a child(ren) in care or the public health or safety

• A determination that the day care home has been convicted of any activity in the past seven years that indicated a lack of business integrity

• Failure to participate in training

Page 5: Serious Deficiency: It’s Not a Joke Serious Deficiencies for Providers

What is a Serious Deficiency?

• Any other circumstance related to non-performance under the sponsoring organization-day care home agreement as specified by the sponsoring organization or the State Agency.

Page 6: Serious Deficiency: It’s Not a Joke Serious Deficiencies for Providers

What Happens if a FDCH is “SD”?

The Sponsor must…

• Notify the FDCH and the State Agency of the serious deficiencies

• Inform FDCH of the required actions to correct deficiencies and the time frame allotted to do so (30 days max)

• Inform FDCH that the seriously deficient determination is not subject to administrative review

• Inform FDCH that failure to fully and permanently correct the deficiencies will result in termination from the Program

Page 7: Serious Deficiency: It’s Not a Joke Serious Deficiencies for Providers

Additional Information

• Continue to pay any claims for reimbursement for eligible meals served until the serious deficiency is corrected, or the day the FDCH’s agreement is terminated, including the period of any administrative review.

Page 8: Serious Deficiency: It’s Not a Joke Serious Deficiencies for Providers

Deficiencies are fully and permanently corrected

Deficiencies are not fully and permanently corrected

• Resume normal CACFP operations

• SD status is temporarily deferred

• The Sponsor initiates action to terminate the Provider from the CACFP

• The Sponsor initiates action to disqualify the Provider by adding the Provider to the National Disqualified List (NDL)

What Happens if a FDCH is “SD”?

Page 10: Serious Deficiency: It’s Not a Joke Serious Deficiencies for Providers

Following suspension, the Sponsor must…

• Notify the FDCH and the State Agency of the suspension and serious deficiency(ies) found

• State that participation and payments WILL remain suspended until the administrative review is concluded

• Inform FDCH that if the official overturns the suspension the FDCH may claim reimbursement for eligible meals during suspension period

• Inform FDCH that termination of their agreement with the state (voluntary or not) will result in placement on the NDL

What Happens if a FDCH is “SD”?

Page 11: Serious Deficiency: It’s Not a Joke Serious Deficiencies for Providers

Questions