Civil money penalties

1. The department may impose a civil money penalty for the number of days a provider is not in substantial compliance with one or more participation requirements. 2. The department may impose a civil money penalty for the number of days of past noncompliance since the last standard survey. 3. A minimum of fifty dollars per day and a maximum of three thousand dollars per day in penalties may be imposed when immediate jeopardy does not exist, but deficiencies either caused actual harm or caused no acutal harm, but have the potential for more than minimal harm. 4. A minimum of three thousand fifty dollars per day and a maximum of ten thousand dollars per day in penalties may be imposed when immediate jeopardy exists or when immediate jeopardy does not exist if a penalty in the lower range of penalty identified in subsection 3 was previously imposed and deficiencies are repeated. 5. A civil money penalty imposed under subsection 4 must be decreased to the range of penalties provided in subsection 3 when the penalty was imposed for a situation of immediate jeopardy and the immediate jeopardy is removed, but noncompliance continues. 6. The following factors must be considered in determining the amount of a civil money penalty to impose. a. The seriousness of the deficiency determined by: (1) Severity measured as: (a) No actual harm with a potential for minimal harm; (b) No actual harm with a potential for more than minimal harm, but not immediate jeopardy; (c) Actual harm that is not immediate jeopardy; or (d) Immediate jeopardy to residents' health or safety; and (2) Scope measured as: (a) Isolated; (b) Patterned; or (c) Widespread; b. The relationship of one deficiency to another; c. History of noncompliance: (1) For all deficiencies; and (2) For deficiencies specifically related to deficiencies currently cited; d. The provider's financial condition; and e. The likelihood the civil money penalty may achieve correction and continued compliance. 7. A civil money penalty may be increased when continued noncompliance by a provider becomes sufficiently serious to pose immediate jeopardy. 8. The department shall increase a civil money penalty by twenty-five percent if the provider has repeated deficiencies. The increased civil money penalty may exceed the maximum amount per day established in this section. 9. A civil money penalty is collectible for the number of days of noncompliance from the date the penalty starts until the date the provider achieves substantial compliance or, if applicable, the date of termination. 10. The provider may, in accordance with 42 CFR part 431, appeal the decision that resulted in imposition of a civil money penalty. a. The collection of the civil money penalty must be delayed if a hearing is requested. b. The civil money penalty must be reduced by thirty-five percent if the provider, in writing, waives the right to appeal no later than sixty days from the date of the notice of the imposition of the civil money penalty. 11. Payment of a civil money penalty is due: a. Fifteen days after a provider comes into substantial compliance or the provider agreement is terminated; b. Fifteen days after a final administrative decision is made upholding the imposition of the civil money penalty if the provider has achieved substantial compliance or was terminated prior to the final administrative decision; or c. Fifteen days after the time period for requesting a hearing has expired and the provider has achieved substantial compliance or was terminated prior to the final day the hearing request was due. 12. Interest is payable on the unpaid civil money penalty balance beginning on the due date. Interest will accrue at three times the legal rate. 13. Civil money penalties and applicable interest, if any, not paid within thirty days after the due date must be deducted from any payment owing to the provider. 14. Civil money penalties collected must be used for the protection of the health or property of residents of facilities found deficient.