10- 144 C.M.R. ch. 110, § 22
For the purposes of this Chapter, the following words have the following meanings:
Each nursing facility will be inspected prior to being issued its initial license and annually thereafter prior to renewal of a license. The Division may also inspect at any other time to determine compliance with State licensing regulations. For nursing facilities providing both nursing home and assisted living services, the Division will ensure that a single coordinated licensing and life safety code inspection is performed.
After any inspection, a Statement of Deficiencies will be sent to the facility if the inspection discloses any failure to comply with State licensing regulations. A Statement of Deficiencies will be accompanied by either a Plan of Correction form or a Directed Plan of Correction.
If mailed a Plan of Correction form, the provider must complete it by indicating how and when any deficiency will be or has been corrected, and submit it to the Division within ten working days of receipt of any Statement of Deficiencies. The Division will have ten (10) days after receipt to determine whether it accepts the Plan of Correction.
The failure to correct any deficiency or deficiencies or to file a Plan of Correction with the Division may lead to the imposition of sanctions or penalties as described in this Chapter.
The Division is authorized to impose one or more of the following intermediate sanctions when any of the circumstances listed in Section 22.D., below, are present and the Division determines that a sanction is necessary and appropriate to ensure compliance with State licensing regulations or to protect the residents of a nursing facility or the general public.
The following circumstances shall be grounds for the imposition of intermediate sanctions:
Upon review or inspection of a nursing facility, the Division of Licensing and Certification will compile a list of deficiencies found (if any) and send out a Statement of Deficiencies. The Division will also review the deficiencies to ascertain whether there are any grounds for assessment of financial penalties in accordance with Sections 22. C., 22. D., and 22.F. of this Section. If the Division determines it is appropriate to assess financial penalties against a nursing facility, based on a Statement of Deficiencies, the Division shall issue to that facility an Assessment of Financial Penalties. That Assessment shall describe the grounds for the imposition of the penalty, the regulation or law that has been violated, and the scheduled amount of the fine corresponding to that violation.
Penalties shall accrue with interest for each day that grounds for imposition of the penalty exist, after the date upon which an Assessment of Financial Penalties is issued. The burden of demonstrating correction of the grounds that support any penalty rests with the facility.
In any instance where the Division imposes a penalty or penalties for conduct described in Section 22.D.7., penalties will not be imposed pursuant to Sections 22.D.5. or 22.D.6. for that same conduct.
If the nursing facility does not contest the imposition or amount of a penalty assessed by the Division, the facility must pay the Department the amount of that penalty within thirty (30) days of receipt of the Assessment of Penalties. The Department may offset against any reimbursement due the facility the amount of any penalties that are outstanding after this time period.
If a nursing facility disagrees with the imposition or amount of any penalty assessed by the Division, the facility must notify the Division in writing, stating the nature of the disagreement, within ten (10) working days of a receipt of an Assessment of Penalties. Upon receipt of this request, the Director of the Division of Licensing and Certification or his/her designee shall schedule an informal conference for the purpose of trying to resolve the dispute. The Division Director or his/her designee shall inform the facility of the result of the informal conference in writing. A facility which desires to appeal the result of an affirmed or modified assessment of penalties following an informal conference must request an administrative hearing, pursuant to Section 22.G.6. The Department will stay the collection of any fiscal penalties until final action is taken on an appeal. Penalties shall accrue with interest for each day until final resolution and implementation.
A request for an informal conference or for an administrative review of the results of an informal conference shall not affect any nursing facility's obligation to comply with State licensing laws and regulations.
The Division will determine the amount of any penalty to be imposed against a nursing facility according to the following classification system, or as most recently determined by statute or regulation:
| Class | Grounds for Penalty | Amount | Repeat |
| Class I | Any failure to comply with State licensing laws, gulations, or 42 USC, Section 1396 r (b), (c), or (d) that poses an immediate threat of death to a resident or residents; or impeding, interfering, or giving false information in connection with the enforcement of laws or regulations governing nursing facility licensure. | $9.00 per bed per occurrence | $10.00 |
| Class II | Any failure to comply with State licensing laws, regulations or 42 USC Section 1396 r (b), (c), or or (d) or any regulations imposed pursuant to these laws that poses a substantial probability of serious mental or physical harm to a resident or residents | $8.00 per bed per occurrence | $9.00 |
| failure to submit a plan of correction within ten (10) working days after receipt of a statement of deficiencies; or | |||
| failure to take timely corrective action in accordance with a plan of correction or directed plan of correction. | |||
| Class III | The occurrence of a repeated deficiency that poses a substantial risk to a resident's or residents' health or safety | $6.00 per bed per occurrence | |
| Any failure to comply with 42 USC Section 1396 r (b), (c) or (d) which is not included either as a Class I or Class II violation. | $10.00 per bed |
* "$9.00 per bed per occurrence" means, for example, that a facility with 50 (fifty) beds would be assessed a penalty of $450 ($9.00 per resident x 50 beds) for a single instance of a Class I violation.
The minimum penalty for operating a nursing facility without a license is $500 per day.
The maximum penalty the Division may impose in any instance in which it issues an Assessment of Financial Penalties subsequent to issuance of a Statement of Deficiencies to a nursing facility shall be $10,000.
Nursing facilities which are unable to immediately pay a penalty may apply to the Division of Licensing and Certification to have payment of that penalty delayed, paid in installments, or, in certain circumstances, reduced.
In order to have the payment of a fine delayed or paid in installments, a nursing facility must provide sufficient information, on forms provided by the Division of Licensing and Certification, to demonstrate that immediate full payment of the total amount due would result in the interruption of the provision of necessary services to residents.
In order to have a fine reduced, a nursing facility must, on forms provided by the Division of Licensing and Certification, demonstrate that payment of the full amount of the penalty would result in a permanent interruption in the provision of necessary services to residents even if paid in installments or delayed.
When an applicant fails to demonstrate consistent compliance with applicable laws and regulations, the Department may refuse to issue or renew a license to operate a nursing facility.
If, at the expiration of a full or provisional license, or during the term of a full license, the facility fails to comply with applicable laws and regulations, and, in the judgment of the Division, the best interest of the public would be served, the Division may issue a conditional license, or change a full license to a conditional license. Failure by the conditional licensee to meet the conditions specified by the Department shall permit the Division to void the conditional license or refuse to issue a full license. The conditional license shall be void when the Division has delivered in hand or by certified mail a written notice to the licensee, or, if the licensee cannot be reached for service in-hand or by certified mail, has left written notice thereof at the agency or facility. For the purposes of this subsection, the term "licensee" means the person, firm, corporation or association to whom a conditional license has been issued.
Whenever, upon investigation, conditions are found which, in the opinion of the Department, immediately endanger the health or safety of the persons living in or attending a facility, the Department may take action for an emergency suspension or temporary revocation of the license pursuant to either 10004, 1153 Section . If the Department acts pursuant to 5 M.R.S.A., Section10004, it shall give written notice of such emergency suspension by delivering notice in hand to the licensee. If the licensee cannot be reached for personal service, the notice may be left at the licensed premises. Whenever a license is suspended by the Department under this emergency provision, the Department shall file a complaint with the Administrative Court within thirty (30) days if the Department determines that a longer period of suspension or revocation is required.
Any license issued under these regulations may be suspended or revoked for violation of applicable laws and regulations, committing, permitting, aiding or abetting any illegal practices in the operation of the facility or conduct or practices detrimental to the welfare of persons living in or attending a facility. When the Division believes a license should be suspended or revoked, it shall file a complaint with the Administrative Court as provided in the Maine Administrative Procedures Act, Title V, Chapter 375.
Pursuant to 22 M.R.S.A. Section7931et seq., the Department may petition the Superior Court to appoint a receiver to operate a nursing facility in the following circumstances:
Any nursing facility aggrieved by the Department's decision to take any of the following actions, or to impose any of the following sanctions, may request an administrative hearing to refute the basis of the Department's decision, as provided by the Maine Administrative Procedures Act, 5 M.R.S.A. Section1001et seq. or the Department's Administrative Hearing Manual. Administrative hearings will be held in conformity with the Department's Administrative Hearing Manual. A request for a hearing must be made in writing to the Director of the Division of Licensing and Certification, and must specify the reason for the appeal. Any request must be mailed within ten (10) days from receipt of the Department's decision to:
The Department will maintain an up-to-date listing of all sanctioned facilities. Upon final action on the imposition of a sanction, the Department will add the sanctioned facility to its listing. This information will be available to the public.
10- 144 C.M.R. ch. 110, § 22