§ 19-1402. Imposition of penalties
- (a) Sanctions. — If a deficiency exists, the Secretary may impose sanctions that include:
- (1) A directed plan of correction with corrective measures necessary to protect residents;
- (2) Imposing adequate staffing levels in a nursing home;
- (3) Appointing a State monitor subject to § 19-1405 of this subtitle; and
- (4) Imposing a civil money penalty.
- (b) Standard. — A civil money penalty may be imposed when a deficiency exists or an ongoing pattern of deficiencies exists in a nursing home.
- (c) Factors. — In determining whether a civil money penalty is to be imposed, the Secretary shall consider, pursuant to guidelines set forth in regulations promulgated by the Secretary, the following factors:
- (1) The number, nature, and seriousness of the deficiencies;
- (2) The extent to which the deficiency or deficiencies are part of an ongoing pattern during the preceding 24 months;
- (3) The degree of risk to the health, life, or safety of the residents of the nursing home caused by the deficiency or deficiencies;
- (4) The efforts made by, and the ability of, the nursing home to correct the deficiency or deficiencies; and
- (5) A nursing home’s prior history of compliance.
- (d) Notice. — Upon determination by the Department that a deficiency or deficiencies exist, the Department shall notify the nursing home that:
- (1) Unless corrective action taken pursuant to this section is substantially completed, a civil money penalty will be imposed; or
- (2) An order imposing a civil money penalty will be issued, pursuant to § 19-1403 of this subtitle which shall include a list of all deficiencies and notice that a civil money penalty may be imposed until the time that the cited deficiencies have been rectified.
HISTORY: 1989, ch. 134; 1991, ch. 659, § 1; 1992, ch. 22, § 1; 2000, chs. 217, 218, 219, 488; 2004, ch. 25, § 6.
§19-1403. Order proposing penalty
(a) Contents. — If a civil money penalty is proposed, the Secretary shall issue an order which shall state the basis on which the order is made, the deficiency or deficiencies on which the order is based, the amount of civil money penalties to be imposed, and the manner in which the amount of civil money penalties imposed was calculated.
(b) Validity. — An order issued pursuant to subsection (a) of this section shall be void unless issued within 60 days of the inspection or reinspection at which the deficiency is identified.
HISTORY: 1989, ch. 134; 1991, ch. 659, § 1; 2000, chs. 217, 218, 219, 488.
§ 19-1404. Amount of penalty
(a) Minimal harm deficiencies. — A civil money penalty imposed under this section for potential for more than minimal harm deficiencies:
(1) May not exceed $ 10,000 per instance; or
(2) May not exceed $ 1,000 per day for an ongoing pattern of deficiencies until the nursing home is in compliance.
(b) Actual harm deficiencies. — A civil money penalty imposed under this subtitle for actual harm deficiencies:
(1) May not exceed $ 10,000 per instance; or
(2) May not exceed $ 5,000 per day for an ongoing pattern of deficiencies until the nursing home is in compliance.
(c) Serious and immediate threat. — A civil money penalty imposed under this section for a serious and immediate threat:
(1) May not exceed $ 10,000 per instance; or
(2) May not exceed $ 10,000 per day for an ongoing pattern of deficiencies until the nursing home is in compliance.
(d) Factors. — In setting the amount of a civil money penalty under this section, the Secretary shall consider, pursuant to guidelines set forth in regulations promulgated by the Secretary, the following factors:
(1) The number, nature, and seriousness of the deficiencies;
(2) The degree of risk to the health, life, or safety of the residents of the nursing home caused by the deficiency or deficiencies;
(3) The efforts made by the nursing home to correct the deficiency or deficiencies;
(4) Current federal guidelines for money penalties;
(5) Whether the amount of the proposed civil money penalty will jeopardize the financial ability of the nursing home to continue operating as a nursing home; and
(6) Such other factors as justice may require.
HISTORY: 1989, ch. 134; 1991, ch. 659, § 1; 2000, chs. 217, 218, 219, 488.
§ 19-1405. Independent State monitor
- (a) Appointment. — When the Department determines that there is a deficiency in a nursing home, the Department may appoint an independent monitor to oversee efforts made by the nursing home to achieve compliance with State and federal regulations governing nursing homes that participate in the Medicare and Medicaid programs.
- (b) Intermediate sanction. — The appointment of a State monitor is an intermediate sanction that may be in addition to or in lieu of other sanctions.
- (c) Duties. — The State monitor’s duties may include:
- (1) Periodic inspections of a nursing home for the purpose of assessing the nursing home’s compliance with State and federal regulations; and
- (2) Reporting to the Department and the nursing home its findings.
- (d) Department employees. — The State monitor may not be an employee of the Department.
- (e) Costs. — A nursing home shall be responsible for the costs associated with the appointment of a State monitor to the nursing home.
HISTORY: 2000, chs. 219, 488.
19-1406. Administrative appeal
- (a) Deposit in escrow account. — Within 15 days of the request for an appeal by a nursing home, the nursing home shall deposit the amount of the civil money penalty in an interest bearing escrow account, the nursing home shall bear any cost associated with establishing the escrow account, and the account shall be titled in the name of the nursing home and the Department of Health and Mental Hygiene as joint owners.
- (b) Release of funds in escrow. — When the Secretary issues the final decision of the Department:
- (1) If the decision upholds the imposition of the full civil money penalty, the escrow funds will be released to the Department within 15 days from the date of the decision;
- (2) If the decision upholds the imposition of a civil penalty, but reduces the amount of the civil penalty, the amount due the Department will be released to the Department with accrued interest within 15 days of the date of the decision and the balance will be released to the nursing home within 15 days of the date of the decision; or
- (3) If the decision reverses the imposition of the civil penalty, the escrow funds will be released to the nursing home within 15 days of the decision.
- (c) Hearing. —
- (1) A hearing on the appeal shall be held in accordance with the Administrative Procedure Act, under Title 10, Subtitle 2 of the State Government Article.
- (2) The Secretary shall have the burden of proof with respect to the imposition of civil money penalties under § 19-1404 or § 19-1413.1 of this subtitle.
- (3) A decision shall be rendered by the Office of Administrative Hearings within 10 working days of the hearing.
- (d) Reduction. — A nursing home is entitled to a 40% reduction in the amount of the civil money penalty if it waives its right to a hearing within 30 days of the Department’s order.
HISTORY: 2000, chs. 219, 488; 2002, ch. 47; 2003, ch. 21, § 1.
19-1407. Health Care Quality Account
- (a) Establishment. —
- (1) There is a Health Care Quality Account established in the Department.
- (2) The Health Care Quality Account shall be funded by civil money penalties paid by nursing homes and other penalties that the Office of Health Care Quality may assess.
- (3) The Department shall pay all penalties collected under this title to the Comptroller of the State.
- (4) The Comptroller shall distribute the funds collected under this title to the Health Care Quality Account.
- (5) The Health Care Quality Account is a continuing, nonlapsing fund, not subject to § 7-302 of the State Finance and Procurement Article.
- (6) Any unspent portions of the Health Care Quality Account may not be transferred or reverted to the General Fund of the State, but shall remain in the Health Care Quality Account to be used for the purposes specified in this section.
- (b) Purpose. — The Health Care Quality Account shall be used for training, grant awards, demonstration projects, or other purposes designed to improve the quality of care.
- (c) Regulations. — The Department shall adopt regulations for the distribution of funds from the Health Care Quality Account.
HISTORY: 2000, chs. 219, 488; 2001, ch. 29, § 1; 2010, ch. 72.