42 CFR §498.90

1. (a)General rule. The Board's decision is binding unless—
   1. (1)The affected party has a right to judicial review and timely files a civil action in a United States District Court or, in the case of a civil money penalty, in a United States Court of Appeals; or
   2. (2)The Board reopens and revises its decision in accordance with § 498.102.
2. (b)Right to judicial review. Section 498.5 specifies the circumstances under which an affected party has a right to seek judicial review.
3. (c)Special rules: Civil money penalty—(1) Finality of Board's decision. When CMS imposes a civil money penalty, notice of the Board's decision (or denial of review) is the final administrative action that initiates the 60-day period for seeking judicial review.
   1. (2)Timing for collection of civil money penalty. For SNFs and NFs, the rules that apply are those set forth in subpart F of part 488 of this chapter.