{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/32.1-27.3.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/32.1-27.3.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/32.1-27.3.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/32.1-27.3.html"}],"law_id":77478,"edition_id":1,"section_id":77478,"structure_id":14107,"section_number":"32.1-27.3","catch_line":"Sanctions; civil penalty","history":"2025, cc. 166, 180.","full_text":"A\n\nNotwithstanding any other provision of law, the Commissioner may impose sanctions in accordance with this section on any nursing home that is licensed pursuant to Chapter 5 (\u00a7 32.1-123 et seq.) in response to findings made during a state licensure inspection conducted within the previous 24 months and for which such findings have been communicated to the nursing home within 14 business days of the survey end date for:1\n\nViolating any order of or refusing, failing, or neglecting to comply with any order of the Board or Commissioner, or violating any provision of Chapter 5 (&#xA7; 32.1-123 et seq.) or of any applicable regulation promulgated pursuant to Chapter 5 (&#xA7; 32.1-123 et seq.); or2\n\nPermitting, aiding, or abetting the commission of any illegal act during the provision of health care services delivered by such nursing home.B\n\nNo sanctions under this section shall be imposed for violations deemed more severe than a level 2 deficiency under the Centers for Medicare and Medicaid Services deficiency severity definitions under federal law.C\n\nThe sanctions that the Commissioner may impose pursuant to subsection A shall include the following:1\n\nPlacing on probation any license issued pursuant to Chapter 5 (&#xA7; 32.1-123 et seq.); and2\n\nImposing a civil penalty not to exceed $500 per violation per day, capped at $10,000 for a series of related incidents of noncompliance. Any civil penalties collected by the Commissioner pursuant to this subdivision shall be paid to the Nursing Scholarship and Loan Repayment Fund established pursuant to &#xA7; 54.1-3011.2 to be used for the nursing scholarship and loan repayment program for nurses who agree to perform a period of service in a Commonwealth long-term care facility established pursuant to subsection B of &#xA7; 32.1-122.6:01.D\n\nA nursing home sanctioned by the Commissioner pursuant to subsection C shall retain responsibility for the health, safety, and welfare of any person under such nursing home&#8217;s care, including the timely transfer or relocation of any persons under such nursing home&#8217;s care as may be deemed necessary by the Commissioner.1\n\nPrior to imposing sanctions pursuant to subsection C, the Commissioner shall first require the submission of and compliance with a plan of correction. Such plan of correction shall include mandated training for the nursing home&#8217;s employees, with all costs borne by the facility, when the Commissioner concludes that the lack of training has led directly to noncompliance.2\n\nUpon expiration of the initial plan of correction, the Commissioner may extend the time period for the plan of correction or may impose sanctions pursuant to subsection C.E\n\nThe Commissioner shall impose a sanction pursuant to subsection C only after the person subject to such disciplinary action is provided reasonable notice and an opportunity to be heard within no fewer than 30 days from the day of such notice by the Commissioner&#8217;s presiding officer in accordance with \u00a7 2.2-4019. Such sanction may be in addition to any penalty imposed by law for the violation for which such sanction is imposed.1\n\nAll requests for an opportunity to be heard following a notice of the imposition of such sanction shall be received in writing within 15 days of the date of receipt of such notice.2\n\nAll administrative proceedings under this section shall be separate from the regulatory office of the Department that conducted the inspection, investigation, examination, or review.3\n\nThe adjudication officer shall provide a recommendation to the Commissioner, including findings of fact, conclusions, and appropriate disciplinary action.4\n\nThe Commissioner may affirm, modify, or reverse such recommendation and shall issue a final case decision.5\n\nAny person aggrieved by the final case decision of the Commissioner to impose disciplinary action is entitled to judicial review in accordance with the provisions of the Administrative Process Act (&#xA7; 2.2-4000 et seq.).F\n\nIf a nursing home has been sanctioned by the Centers for Medicare and Medicaid Services for conduct that also subjects the nursing home to sanctions pursuant to subsection A, the Commissioner shall not issue a sanction under this section. If the Centers for Medicare and Medicaid Services fail to issue a sanction to a nursing home in the Commonwealth for conduct described in subsection A within 60 days, the Commissioner may issue a sanction under this section if he determines that issuing such sanction is necessary to protect the public health and welfare or the health and safety of the nursing home&#8217;s clients. In the event the Centers for Medicare and Medicaid Services issue a sanction on a violation for which the Commissioner has issued a sanction pursuant to this section, the sanction issued by the Commissioner shall be nullified with any civil penalty imposed refunded to the nursing home within 60 days.G\n\nIf a license of any nursing home issued pursuant to Chapter 5 (\u00a7 32.1-123 et seq.) is revoked, a new license may be issued by the Commissioner after:1\n\nSatisfactory evidence is submitted to him that the conditions upon which revocation was based have been corrected; and2\n\nProper inspection has been made and compliance with all provisions of Chapter 5 (&#xA7; 32.1-123 et seq.) and applicable state and federal laws and regulations hereunder has been obtained.H\n\nThe Board shall promulgate regulations to implement the provisions of this section that include:1\n\nCriteria for when the imposition of sanctions or initiation of court proceedings as specified in &#xA7; 32.1-27, 32.1-27.1, or a combination thereof are appropriate in order to ensure prompt correction of violations involving noncompliance with requirements of any order of the Board or Commissioner or any provision of or regulation promulgated pursuant to Chapter 5 (&#xA7; 32.1-123 et seq.);2\n\nCriteria for the imposition of sanctions;3\n\nA schedule of civil penalties, which shall be uniform for each type of specific violation;4\n\nProcedures for the imposition of sanctions consistent with the Administrative Process Act (&#xA7; 2.2-4000 et seq.); and5\n\nProvisions for the prompt notification of the Department of Medical Assistance Services whenever any license is revoked or suspended for the purpose of terminating or suspending the applicable Medicaid provider agreement.","order_by":null,"text":{"0":{"id":277901,"text":"Notwithstanding any other provision of law, the Commissioner may impose sanctions in accordance with this section on any nursing home that is licensed pursuant to Chapter 5 (\u00a7 32.1-123 et seq.) in response to findings made during a state licensure inspection conducted within the previous 24 months and for which such findings have been communicated to the nursing home within 14 business days of the survey end date for:","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"A1"},"1":{"id":277902,"text":"Violating any order of or refusing, failing, or neglecting to comply with any order of the Board or Commissioner, or violating any provision of Chapter 5 (&#xA7; 32.1-123 et seq.) or of any applicable regulation promulgated pursuant to Chapter 5 (&#xA7; 32.1-123 et seq.); or","type":"section","prefixes":["A","1"],"prefix":"1","entire_prefix":"A1","prefix_anchor":"A1","level":2,"prior_prefix":"A","next_prefix":"A2"},"2":{"id":277903,"text":"Permitting, aiding, or abetting the commission of any illegal act during the provision of health care services delivered by such nursing home.","type":"section","prefixes":["A","2"],"prefix":"2","entire_prefix":"A2","prefix_anchor":"A2","level":2,"prior_prefix":"A1","next_prefix":"B"},"3":{"id":277904,"text":"No sanctions under this section shall be imposed for violations deemed more severe than a level 2 deficiency under the Centers for Medicare and Medicaid Services deficiency severity definitions under federal law.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A2","next_prefix":"C"},"4":{"id":277905,"text":"The sanctions that the Commissioner may impose pursuant to subsection A shall include the following:","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"C1"},"5":{"id":277906,"text":"Placing on probation any license issued pursuant to Chapter 5 (&#xA7; 32.1-123 et seq.); and","type":"section","prefixes":["C","1"],"prefix":"1","entire_prefix":"C1","prefix_anchor":"C1","level":2,"prior_prefix":"C","next_prefix":"C2"},"6":{"id":277907,"text":"Imposing a civil penalty not to exceed $500 per violation per day, capped at $10,000 for a series of related incidents of noncompliance. Any civil penalties collected by the Commissioner pursuant to this subdivision shall be paid to the Nursing Scholarship and Loan Repayment Fund established pursuant to &#xA7; 54.1-3011.2 to be used for the nursing scholarship and loan repayment program for nurses who agree to perform a period of service in a Commonwealth long-term care facility established pursuant to subsection B of &#xA7; 32.1-122.6:01.","type":"section","prefixes":["C","2"],"prefix":"2","entire_prefix":"C2","prefix_anchor":"C2","level":2,"prior_prefix":"C1","next_prefix":"D"},"7":{"id":277908,"text":"A nursing home sanctioned by the Commissioner pursuant to subsection C shall retain responsibility for the health, safety, and welfare of any person under such nursing home&#8217;s care, including the timely transfer or relocation of any persons under such nursing home&#8217;s care as may be deemed necessary by the Commissioner.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C2","next_prefix":"D1"},"8":{"id":277909,"text":"Prior to imposing sanctions pursuant to subsection C, the Commissioner shall first require the submission of and compliance with a plan of correction. Such plan of correction shall include mandated training for the nursing home&#8217;s employees, with all costs borne by the facility, when the Commissioner concludes that the lack of training has led directly to noncompliance.","type":"section","prefixes":["D","1"],"prefix":"1","entire_prefix":"D1","prefix_anchor":"D1","level":2,"prior_prefix":"D","next_prefix":"D2"},"9":{"id":277910,"text":"Upon expiration of the initial plan of correction, the Commissioner may extend the time period for the plan of correction or may impose sanctions pursuant to subsection C.","type":"section","prefixes":["D","2"],"prefix":"2","entire_prefix":"D2","prefix_anchor":"D2","level":2,"prior_prefix":"D1","next_prefix":"E"},"10":{"id":277911,"text":"The Commissioner shall impose a sanction pursuant to subsection C only after the person subject to such disciplinary action is provided reasonable notice and an opportunity to be heard within no fewer than 30 days from the day of such notice by the Commissioner&#8217;s presiding officer in accordance with \u00a7 2.2-4019. Such sanction may be in addition to any penalty imposed by law for the violation for which such sanction is imposed.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D2","next_prefix":"E1"},"11":{"id":277912,"text":"All requests for an opportunity to be heard following a notice of the imposition of such sanction shall be received in writing within 15 days of the date of receipt of such notice.","type":"section","prefixes":["E","1"],"prefix":"1","entire_prefix":"E1","prefix_anchor":"E1","level":2,"prior_prefix":"E","next_prefix":"E2"},"12":{"id":277913,"text":"All administrative proceedings under this section shall be separate from the regulatory office of the Department that conducted the inspection, investigation, examination, or review.","type":"section","prefixes":["E","2"],"prefix":"2","entire_prefix":"E2","prefix_anchor":"E2","level":2,"prior_prefix":"E1","next_prefix":"E3"},"13":{"id":277914,"text":"The adjudication officer shall provide a recommendation to the Commissioner, including findings of fact, conclusions, and appropriate disciplinary action.","type":"section","prefixes":["E","3"],"prefix":"3","entire_prefix":"E3","prefix_anchor":"E3","level":2,"prior_prefix":"E2","next_prefix":"E4"},"14":{"id":277915,"text":"The Commissioner may affirm, modify, or reverse such recommendation and shall issue a final case decision.","type":"section","prefixes":["E","4"],"prefix":"4","entire_prefix":"E4","prefix_anchor":"E4","level":2,"prior_prefix":"E3","next_prefix":"E5"},"15":{"id":277916,"text":"Any person aggrieved by the final case decision of the Commissioner to impose disciplinary action is entitled to judicial review in accordance with the provisions of the Administrative Process Act (&#xA7; 2.2-4000 et seq.).","type":"section","prefixes":["E","5"],"prefix":"5","entire_prefix":"E5","prefix_anchor":"E5","level":2,"prior_prefix":"E4","next_prefix":"F"},"16":{"id":277917,"text":"If a nursing home has been sanctioned by the Centers for Medicare and Medicaid Services for conduct that also subjects the nursing home to sanctions pursuant to subsection A, the Commissioner shall not issue a sanction under this section. If the Centers for Medicare and Medicaid Services fail to issue a sanction to a nursing home in the Commonwealth for conduct described in subsection A within 60 days, the Commissioner may issue a sanction under this section if he determines that issuing such sanction is necessary to protect the public health and welfare or the health and safety of the nursing home&#8217;s clients. In the event the Centers for Medicare and Medicaid Services issue a sanction on a violation for which the Commissioner has issued a sanction pursuant to this section, the sanction issued by the Commissioner shall be nullified with any civil penalty imposed refunded to the nursing home within 60 days.","type":"section","prefixes":["F"],"prefix":"F","entire_prefix":"F","prefix_anchor":"F","level":1,"prior_prefix":"E5","next_prefix":"G"},"17":{"id":277918,"text":"If a license of any nursing home issued pursuant to Chapter 5 (\u00a7 32.1-123 et seq.) is revoked, a new license may be issued by the Commissioner after:","type":"section","prefixes":["G"],"prefix":"G","entire_prefix":"G","prefix_anchor":"G","level":1,"prior_prefix":"F","next_prefix":"G1"},"18":{"id":277919,"text":"Satisfactory evidence is submitted to him that the conditions upon which revocation was based have been corrected; and","type":"section","prefixes":["G","1"],"prefix":"1","entire_prefix":"G1","prefix_anchor":"G1","level":2,"prior_prefix":"G","next_prefix":"G2"},"19":{"id":277920,"text":"Proper inspection has been made and compliance with all provisions of Chapter 5 (&#xA7; 32.1-123 et seq.) and applicable state and federal laws and regulations hereunder has been obtained.","type":"section","prefixes":["G","2"],"prefix":"2","entire_prefix":"G2","prefix_anchor":"G2","level":2,"prior_prefix":"G1","next_prefix":"H"},"20":{"id":277921,"text":"The Board shall promulgate regulations to implement the provisions of this section that include:","type":"section","prefixes":["H"],"prefix":"H","entire_prefix":"H","prefix_anchor":"H","level":1,"prior_prefix":"G2","next_prefix":"H1"},"21":{"id":277922,"text":"Criteria for when the imposition of sanctions or initiation of court proceedings as specified in &#xA7; 32.1-27, 32.1-27.1, or a combination thereof are appropriate in order to ensure prompt correction of violations involving noncompliance with requirements of any order of the Board or Commissioner or any provision of or regulation promulgated pursuant to Chapter 5 (&#xA7; 32.1-123 et seq.);","type":"section","prefixes":["H","1"],"prefix":"1","entire_prefix":"H1","prefix_anchor":"H1","level":2,"prior_prefix":"H","next_prefix":"H2"},"22":{"id":277923,"text":"Criteria for the imposition of sanctions;","type":"section","prefixes":["H","2"],"prefix":"2","entire_prefix":"H2","prefix_anchor":"H2","level":2,"prior_prefix":"H1","next_prefix":"H3"},"23":{"id":277924,"text":"A schedule of civil penalties, which shall be uniform for each type of specific violation;","type":"section","prefixes":["H","3"],"prefix":"3","entire_prefix":"H3","prefix_anchor":"H3","level":2,"prior_prefix":"H2","next_prefix":"H4"},"24":{"id":277925,"text":"Procedures for the imposition of sanctions consistent with the Administrative Process Act (&#xA7; 2.2-4000 et seq.); and","type":"section","prefixes":["H","4"],"prefix":"4","entire_prefix":"H4","prefix_anchor":"H4","level":2,"prior_prefix":"H3","next_prefix":"H5"},"25":{"id":277926,"text":"Provisions for the prompt notification of the Department of Medical Assistance Services whenever any license is revoked or suspended for the purpose of terminating or suspending the applicable Medicaid provider agreement.","type":"section","prefixes":["H","5"],"prefix":"5","entire_prefix":"H5","prefix_anchor":"H5","level":2,"prior_prefix":"H4"}},"ancestry":[{"id":14107,"edition_id":1,"name":"Procedures; Inspections; Orders; Penalties; Representation by Attorney General","identifier":"4","label":"article","depth":3,"order_by":1,"parent_id":13065,"metadata":{},"date_created":"2026-06-26 03:46:53","date_modified":"2026-06-26 03:46:53","permalink":{"id":201281,"object_type":"structure","relational_id":14107,"identifier":"4","token":"32.1\/1\/4","url":"\/32.1\/1\/4\/","edition_id":1,"permalink":0,"preferred":1}},{"id":13065,"edition_id":1,"name":"Administration Generally","identifier":"1","label":"chapter","depth":2,"order_by":1,"parent_id":12727,"metadata":{},"date_created":"2026-06-26 03:44:12","date_modified":"2026-06-26 03:44:12","permalink":{"id":201101,"object_type":"structure","relational_id":13065,"identifier":"1","token":"32.1\/1","url":"\/32.1\/1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12727,"edition_id":1,"name":"Health","identifier":"32.1","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:50","date_modified":"2026-06-26 03:43:50","permalink":{"id":201099,"object_type":"structure","relational_id":12727,"identifier":"32.1","token":"32.1","url":"\/32.1\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":82400,"structure_id":14107,"section_number":"32.1-24","catch_line":"Applicability of Administrative Process Act","url":"\/32.1-24\/","token":"32.1\/1\/4\/32.1-24","metadata":false},{"id":86774,"structure_id":14107,"section_number":"32.1-25","catch_line":"Right of entry to inspect, etc.; warrants","url":"\/32.1-25\/","token":"32.1\/1\/4\/32.1-25","metadata":false},{"id":68435,"structure_id":14107,"section_number":"32.1-26","catch_line":"Orders; hearing and notice","url":"\/32.1-26\/","token":"32.1\/1\/4\/32.1-26","metadata":false},{"id":59474,"structure_id":14107,"section_number":"32.1-27","catch_line":"Penalties, injunctions, civil penalties and charges for violations","url":"\/32.1-27\/","token":"32.1\/1\/4\/32.1-27","metadata":false},{"id":84466,"structure_id":14107,"section_number":"32.1-27.1","catch_line":"Additional civil penalty or appointment of a receiver","url":"\/32.1-27.1\/","token":"32.1\/1\/4\/32.1-27.1","metadata":false},{"id":56823,"structure_id":14107,"section_number":"32.1-27.2","catch_line":"Administrative sanctions","url":"\/32.1-27.2\/","token":"32.1\/1\/4\/32.1-27.2","metadata":false},{"id":77478,"structure_id":14107,"section_number":"32.1-27.3","catch_line":"Sanctions; civil penalty","url":"\/32.1-27.3\/","token":"32.1\/1\/4\/32.1-27.3","metadata":false},{"id":64525,"structure_id":14107,"section_number":"32.1-28","catch_line":"When Attorney General to represent Board; special counsel","url":"\/32.1-28\/","token":"32.1\/1\/4\/32.1-28","metadata":false},{"id":55238,"structure_id":14107,"section_number":"32.1-29","catch_line":"Employment of attorney to defend Board members, employee, etc","url":"\/32.1-29\/","token":"32.1\/1\/4\/32.1-29","metadata":false}],"previous_section":{"id":56823,"structure_id":14107,"section_number":"32.1-27.2","catch_line":"Administrative sanctions","url":"\/32.1-27.2\/","token":"32.1\/1\/4\/32.1-27.2","metadata":false},"next_section":{"id":64525,"structure_id":14107,"section_number":"32.1-28","catch_line":"When Attorney General to represent Board; special counsel","url":"\/32.1-28\/","token":"32.1\/1\/4\/32.1-28","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/32.1-27.3\/","history_text":"<p>This law was first created in 2025. The record of its establishment is cataloged in chapters <a href=\"https:\/\/legacylis.virginia.gov\/cgi-bin\/legp604.exe?251+ful+CHAP0166\">166<\/a> and <a href=\"https:\/\/legacylis.virginia.gov\/cgi-bin\/legp604.exe?251+ful+CHAP0180\">180<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year.<\/p>","references":[{"id":63277,"section_number":"32.1-127.01","catch_line":"Regulations to authorize certain disciplinary actions and guidelines","order_by":null,"url":"\/32.1-127.01\/"},{"id":65119,"section_number":"32.1-134.1","catch_line":"When denial, etc., to duly licensed physician of staff membership or professional privileges improper","order_by":null,"url":"\/32.1-134.1\/"},{"id":55369,"section_number":"32.1-134.4","catch_line":"Right of podiatrists or advanced practice registered nurses to injunction","order_by":null,"url":"\/32.1-134.4\/"}],"refers_to":[{"id":86911,"section_number":"2.2-4000","catch_line":"Short title; purpose","order_by":null,"url":"\/2.2-4000\/"},{"id":85983,"section_number":"2.2-4019","catch_line":"Informal fact finding proceedings","order_by":null,"url":"\/2.2-4019\/"},{"id":80727,"section_number":"32.1-123","catch_line":"(Effective January 1, 2026) Definitions","order_by":null,"url":"\/32.1-123\/"},{"id":59474,"section_number":"32.1-27","catch_line":"Penalties, injunctions, civil penalties and charges for violations","order_by":null,"url":"\/32.1-27\/"},{"id":84466,"section_number":"32.1-27.1","catch_line":"Additional civil penalty or appointment of a receiver","order_by":null,"url":"\/32.1-27.1\/"},{"id":58847,"section_number":"54.1-3011.2","catch_line":"Nursing Scholarship and Loan Repayment Fund","order_by":null,"url":"\/54.1-3011.2\/"}],"permalink":{"id":201307,"object_type":"law","relational_id":77478,"identifier":"32.1-27.3","token":"32.1\/1\/4\/32.1-27.3","url":"\/32.1-27.3\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/32.1-27.3\/","token":"32.1\/1\/4\/32.1-27.3","dublin_core":{"Title":"Sanctions; civil penalty","Type":"Text","Format":"text\/html","Identifier":"\u00a7 32.1-27.3","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t<section id=\"A\"><p><span class=\"prefix-number\">A.<\/span> Notwithstanding any other provision of <span class=\"dictionary\">law<\/span>, the <span class=\"dictionary\">Commissioner<\/span> may impose <span class=\"dictionary\">sanctions<\/span> in accordance with this section on any nursing home that is licensed pursuant to Chapter 5 (\u00a7&nbsp;<a class=\"law\" title=\"(Effective January 1, 2026) Definitions\" href=\"\/32.1-123\/\">32.1-123<\/a> et seq.) in response to <span class=\"dictionary\">findings<\/span> made during a state licensure inspection conducted within the previous 24 months and for which such <span class=\"dictionary\">findings<\/span> have been communicated to the nursing home within 14 business days of the survey end date for: <a id=\"paragraph-277901\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#A\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"A1\" class=\"indent-1\"><p><span class=\"prefix-number\">1.<\/span> Violating any <span class=\"dictionary\">order<\/span> of or refusing, failing, or neglecting to comply with any <span class=\"dictionary\">order<\/span> of the <span class=\"dictionary\">Board<\/span> or <span class=\"dictionary\">Commissioner<\/span>, or violating any provision of Chapter 5 (&#xA7; <a class=\"law\" title=\"(Effective January 1, 2026) Definitions\" href=\"\/32.1-123\/\">32.1-123<\/a> et seq.) or of any applicable regulation promulgated pursuant to Chapter 5 (&#xA7; <a class=\"law\" title=\"(Effective January 1, 2026) Definitions\" href=\"\/32.1-123\/\">32.1-123<\/a> et seq.); or <a id=\"paragraph-277902\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#A1\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"A2\" class=\"indent-1\"><p><span class=\"prefix-number\">2.<\/span> Permitting, aiding, or abetting the commission of any illegal act during the provision of health care services delivered by such nursing home. <a id=\"paragraph-277903\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#A2\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"B\"><p><span class=\"prefix-number\">B.<\/span> No <span class=\"dictionary\">sanctions<\/span> under this section shall be imposed for violations deemed more severe than a level 2 deficiency under the Centers for Medicare and Medicaid Services deficiency severity definitions under federal <span class=\"dictionary\">law<\/span>. <a id=\"paragraph-277904\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#B\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"C\"><p><span class=\"prefix-number\">C.<\/span> The <span class=\"dictionary\">sanctions<\/span> that the <span class=\"dictionary\">Commissioner<\/span> may impose pursuant to subsection A shall include the following: <a id=\"paragraph-277905\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#C\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"C1\" class=\"indent-1\"><p><span class=\"prefix-number\">1.<\/span> Placing on <span class=\"dictionary\">probation<\/span> any license issued pursuant to Chapter 5 (&#xA7; <a class=\"law\" title=\"(Effective January 1, 2026) Definitions\" href=\"\/32.1-123\/\">32.1-123<\/a> et seq.); and <a id=\"paragraph-277906\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#C1\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"C2\" class=\"indent-1\"><p><span class=\"prefix-number\">2.<\/span> Imposing a civil <span class=\"dictionary\">penalty<\/span> not to exceed $500 per violation per day, capped at $10,000 for a series of related incidents of noncompliance. Any civil penalties collected by the <span class=\"dictionary\">Commissioner<\/span> pursuant to this subdivision shall be paid to the Nursing Scholarship and Loan Repayment Fund established pursuant to &#xA7; <a class=\"law\" title=\"Nursing Scholarship and Loan Repayment Fund\" href=\"\/54.1-3011.2\/\">54.1-3011.2<\/a> to be used for the nursing scholarship and loan repayment program for nurses who agree to perform a period of service in a Commonwealth long-term care facility established pursuant to subsection B of &#xA7; <a class=\"law\" title=\"Board of Health to award certain scholarships and loan repayment funds\" href=\"\/32.1-122.6_01\/\">32.1-122.6:01<\/a>. <a id=\"paragraph-277907\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#C2\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"D\"><p><span class=\"prefix-number\">D.<\/span> A nursing home sanctioned by the <span class=\"dictionary\">Commissioner<\/span> pursuant to subsection C shall retain responsibility for the health, safety, and welfare of any <span class=\"dictionary\">person<\/span> under such nursing home&#8217;s care, including the timely transfer or relocation of any <span class=\"dictionary\">persons<\/span> under such nursing home&#8217;s care as may be deemed necessary by the <span class=\"dictionary\">Commissioner<\/span>. <a id=\"paragraph-277908\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#D\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"D1\" class=\"indent-1\"><p><span class=\"prefix-number\">1.<\/span> Prior to imposing <span class=\"dictionary\">sanctions<\/span> pursuant to subsection C, the <span class=\"dictionary\">Commissioner<\/span> shall first require the submission of and compliance with a plan of correction. Such plan of correction shall include mandated training for the nursing home&#8217;s employees, with all costs borne by the facility, when the <span class=\"dictionary\">Commissioner<\/span> concludes that the lack of training has led directly to noncompliance. <a id=\"paragraph-277909\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#D1\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"D2\" class=\"indent-1\"><p><span class=\"prefix-number\">2.<\/span> Upon expiration of the initial plan of correction, the <span class=\"dictionary\">Commissioner<\/span> may extend the time period for the plan of correction or may impose <span class=\"dictionary\">sanctions<\/span> pursuant to subsection C. <a id=\"paragraph-277910\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#D2\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"E\"><p><span class=\"prefix-number\">E.<\/span> The <span class=\"dictionary\">Commissioner<\/span> shall impose a <span class=\"dictionary\">sanction<\/span> pursuant to subsection C only after the <span class=\"dictionary\">person<\/span> subject to such disciplinary action is provided reasonable notice and an opportunity to be heard within no fewer than 30 days from the day of such notice by the <span class=\"dictionary\">Commissioner<\/span>&#8217;s presiding officer in accordance with \u00a7&nbsp;<a class=\"law\" title=\"Informal fact finding proceedings\" href=\"\/2.2-4019\/\">2.2-4019<\/a>. Such <span class=\"dictionary\">sanction<\/span> may be in addition to any <span class=\"dictionary\">penalty<\/span> imposed by <span class=\"dictionary\">law<\/span> for the violation for which such <span class=\"dictionary\">sanction<\/span> is imposed. <a id=\"paragraph-277911\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#E\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"E1\" class=\"indent-1\"><p><span class=\"prefix-number\">1.<\/span> All requests for an opportunity to be heard following a notice of the imposition of such <span class=\"dictionary\">sanction<\/span> shall be received in writing within 15 days of the date of receipt of such notice. <a id=\"paragraph-277912\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#E1\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"E2\" class=\"indent-1\"><p><span class=\"prefix-number\">2.<\/span> All administrative proceedings under this section shall be separate from the regulatory office of the <span class=\"dictionary\">Department<\/span> that conducted the inspection, investigation, examination, or review. <a id=\"paragraph-277913\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#E2\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"E3\" class=\"indent-1\"><p><span class=\"prefix-number\">3.<\/span> The adjudication officer shall provide a recommendation to the <span class=\"dictionary\">Commissioner<\/span>, including <span class=\"dictionary\">findings<\/span> of <span class=\"dictionary\">fact<\/span>, conclusions, and appropriate disciplinary action. <a id=\"paragraph-277914\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#E3\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"E4\" class=\"indent-1\"><p><span class=\"prefix-number\">4.<\/span> The <span class=\"dictionary\">Commissioner<\/span> may <span class=\"dictionary\">affirm<\/span>, modify, or <span class=\"dictionary\">reverse<\/span> such recommendation and shall <span class=\"dictionary\">issue<\/span> a final case decision. <a id=\"paragraph-277915\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#E4\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"E5\" class=\"indent-1\"><p><span class=\"prefix-number\">5.<\/span> Any <span class=\"dictionary\">person<\/span> aggrieved by the final case decision of the <span class=\"dictionary\">Commissioner<\/span> to impose disciplinary action is entitled to judicial review in accordance with the provisions of the Administrative Process Act (&#xA7; <a class=\"law\" title=\"Short title; purpose\" href=\"\/2.2-4000\/\">2.2-4000<\/a> et seq.). <a id=\"paragraph-277916\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#E5\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"F\"><p><span class=\"prefix-number\">F.<\/span> If a nursing home has been sanctioned by the Centers for Medicare and Medicaid Services for conduct that also subjects the nursing home to <span class=\"dictionary\">sanctions<\/span> pursuant to subsection A, the <span class=\"dictionary\">Commissioner<\/span> shall not <span class=\"dictionary\">issue<\/span> a <span class=\"dictionary\">sanction<\/span> under this section. If the Centers for Medicare and Medicaid Services fail to <span class=\"dictionary\">issue<\/span> a <span class=\"dictionary\">sanction<\/span> to a nursing home in the Commonwealth for conduct described in subsection A within 60 days, the <span class=\"dictionary\">Commissioner<\/span> may <span class=\"dictionary\">issue<\/span> a <span class=\"dictionary\">sanction<\/span> under this section if he determines that issuing such <span class=\"dictionary\">sanction<\/span> is necessary to protect the public health and welfare or the health and safety of the nursing home&#8217;s clients. In the event the Centers for Medicare and Medicaid Services <span class=\"dictionary\">issue<\/span> a <span class=\"dictionary\">sanction<\/span> on a violation for which the <span class=\"dictionary\">Commissioner<\/span> has issued a <span class=\"dictionary\">sanction<\/span> pursuant to this section, the <span class=\"dictionary\">sanction<\/span> issued by the <span class=\"dictionary\">Commissioner<\/span> shall be nullified with any civil <span class=\"dictionary\">penalty<\/span> imposed refunded to the nursing home within 60 days. <a id=\"paragraph-277917\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#F\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"G\"><p><span class=\"prefix-number\">G.<\/span> If a license of any nursing home issued pursuant to Chapter 5 (\u00a7&nbsp;<a class=\"law\" title=\"(Effective January 1, 2026) Definitions\" href=\"\/32.1-123\/\">32.1-123<\/a> et seq.) is revoked, a new license may be issued by the <span class=\"dictionary\">Commissioner<\/span> after: <a id=\"paragraph-277918\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#G\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"G1\" class=\"indent-1\"><p><span class=\"prefix-number\">1.<\/span> Satisfactory <span class=\"dictionary\">evidence<\/span> is submitted to him that the conditions upon which <span class=\"dictionary\">revocation<\/span> was based have been corrected; and <a id=\"paragraph-277919\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#G1\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"G2\" class=\"indent-1\"><p><span class=\"prefix-number\">2.<\/span> Proper inspection has been made and compliance with all provisions of Chapter 5 (&#xA7; <a class=\"law\" title=\"(Effective January 1, 2026) Definitions\" href=\"\/32.1-123\/\">32.1-123<\/a> et seq.) and applicable state and federal <span class=\"dictionary\">laws<\/span> and regulations hereunder has been obtained. <a id=\"paragraph-277920\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#G2\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"H\"><p><span class=\"prefix-number\">H.<\/span> The <span class=\"dictionary\">Board<\/span> shall promulgate regulations to implement the provisions of this section that include: <a id=\"paragraph-277921\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#H\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"H1\" class=\"indent-1\"><p><span class=\"prefix-number\">1.<\/span> Criteria for when the imposition of <span class=\"dictionary\">sanctions<\/span> or initiation of <span class=\"dictionary\">court<\/span> proceedings as specified in &#xA7; <a class=\"law\" title=\"Penalties, injunctions, civil penalties and charges for violations\" href=\"\/32.1-27\/\">32.1-27<\/a>, <a class=\"law\" title=\"Additional civil penalty or appointment of a receiver\" href=\"\/32.1-27.1\/\">32.1-27.1<\/a>, or a combination thereof are appropriate in <span class=\"dictionary\">order<\/span> to ensure prompt correction of violations involving noncompliance with requirements of any <span class=\"dictionary\">order<\/span> of the <span class=\"dictionary\">Board<\/span> or <span class=\"dictionary\">Commissioner<\/span> or any provision of or regulation promulgated pursuant to Chapter 5 (&#xA7; <a class=\"law\" title=\"(Effective January 1, 2026) Definitions\" href=\"\/32.1-123\/\">32.1-123<\/a> et seq.); <a id=\"paragraph-277922\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#H1\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"H2\" class=\"indent-1\"><p><span class=\"prefix-number\">2.<\/span> Criteria for the imposition of <span class=\"dictionary\">sanctions<\/span>; <a id=\"paragraph-277923\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#H2\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"H3\" class=\"indent-1\"><p><span class=\"prefix-number\">3.<\/span> A schedule of civil penalties, which shall be uniform for each type of specific violation; <a id=\"paragraph-277924\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#H3\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"H4\" class=\"indent-1\"><p><span class=\"prefix-number\">4.<\/span> Procedures for the imposition of <span class=\"dictionary\">sanctions<\/span> consistent with the Administrative Process Act (&#xA7; <a class=\"law\" title=\"Short title; purpose\" href=\"\/2.2-4000\/\">2.2-4000<\/a> et seq.); and <a id=\"paragraph-277925\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#H4\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"H5\" class=\"indent-1\"><p><span class=\"prefix-number\">5.<\/span> Provisions for the prompt notification of the <span class=\"dictionary\">Department<\/span> of Medical Assistance Services whenever any license is revoked or suspended for the purpose of terminating or suspending the applicable Medicaid provider agreement. <a id=\"paragraph-277926\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-27.3\/#H5\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>","plain_text":"                                 CODE OF VIRGINIA\n\nSANCTIONS; CIVIL PENALTY (\u00a7 32.1-27.3)\n\nA. Notwithstanding any other provision of law, the Commissioner may impose\nsanctions in accordance with this section on any nursing home that is licensed\npursuant to Chapter 5 (\u00a7 32.1-123 et seq.) in response to findings made during\na state licensure inspection conducted within the previous 24 months and for\nwhich such findings have been communicated to the nursing home within 14\nbusiness days of the survey end date for:\n\n   1. Violating any order of or refusing, failing, or neglecting to comply with\n   any order of the Board or Commissioner, or violating any provision of Chapter\n   5 (&#xA7; 32.1-123 et seq.) or of any applicable regulation promulgated\n   pursuant to Chapter 5 (&#xA7; 32.1-123 et seq.); or\n\n   2. Permitting, aiding, or abetting the commission of any illegal act during\n   the provision of health care services delivered by such nursing home.\n\nB. No sanctions under this section shall be imposed for violations deemed more\nsevere than a level 2 deficiency under the Centers for Medicare and Medicaid\nServices deficiency severity definitions under federal law.\n\nC. The sanctions that the Commissioner may impose pursuant to subsection A shall\ninclude the following:\n\n   1. Placing on probation any license issued pursuant to Chapter 5 (&#xA7;\n   32.1-123 et seq.); and\n\n   2. Imposing a civil penalty not to exceed $500 per violation per day, capped\n   at $10,000 for a series of related incidents of noncompliance. Any civil\n   penalties collected by the Commissioner pursuant to this subdivision shall be\n   paid to the Nursing Scholarship and Loan Repayment Fund established pursuant\n   to &#xA7; 54.1-3011.2 to be used for the nursing scholarship and loan\n   repayment program for nurses who agree to perform a period of service in a\n   Commonwealth long-term care facility established pursuant to subsection B of\n   &#xA7; 32.1-122.6:01.\n\nD. A nursing home sanctioned by the Commissioner pursuant to subsection C shall\nretain responsibility for the health, safety, and welfare of any person under\nsuch nursing home&#8217;s care, including the timely transfer or relocation of\nany persons under such nursing home&#8217;s care as may be deemed necessary by\nthe Commissioner.\n\n   1. Prior to imposing sanctions pursuant to subsection C, the Commissioner\n   shall first require the submission of and compliance with a plan of\n   correction. Such plan of correction shall include mandated training for the\n   nursing home&#8217;s employees, with all costs borne by the facility, when the\n   Commissioner concludes that the lack of training has led directly to\n   noncompliance.\n\n   2. Upon expiration of the initial plan of correction, the Commissioner may\n   extend the time period for the plan of correction or may impose sanctions\n   pursuant to subsection C.\n\nE. The Commissioner shall impose a sanction pursuant to subsection C only after\nthe person subject to such disciplinary action is provided reasonable notice and\nan opportunity to be heard within no fewer than 30 days from the day of such\nnotice by the Commissioner&#8217;s presiding officer in accordance with \u00a7\n2.2-4019. Such sanction may be in addition to any penalty imposed by law for the\nviolation for which such sanction is imposed.\n\n   1. All requests for an opportunity to be heard following a notice of the\n   imposition of such sanction shall be received in writing within 15 days of the\n   date of receipt of such notice.\n\n   2. All administrative proceedings under this section shall be separate from\n   the regulatory office of the Department that conducted the inspection,\n   investigation, examination, or review.\n\n   3. The adjudication officer shall provide a recommendation to the\n   Commissioner, including findings of fact, conclusions, and appropriate\n   disciplinary action.\n\n   4. The Commissioner may affirm, modify, or reverse such recommendation and\n   shall issue a final case decision.\n\n   5. Any person aggrieved by the final case decision of the Commissioner to\n   impose disciplinary action is entitled to judicial review in accordance with\n   the provisions of the Administrative Process Act (&#xA7; 2.2-4000 et seq.).\n\nF. If a nursing home has been sanctioned by the Centers for Medicare and\nMedicaid Services for conduct that also subjects the nursing home to sanctions\npursuant to subsection A, the Commissioner shall not issue a sanction under this\nsection. If the Centers for Medicare and Medicaid Services fail to issue a\nsanction to a nursing home in the Commonwealth for conduct described in\nsubsection A within 60 days, the Commissioner may issue a sanction under this\nsection if he determines that issuing such sanction is necessary to protect the\npublic health and welfare or the health and safety of the nursing home&#8217;s\nclients. In the event the Centers for Medicare and Medicaid Services issue a\nsanction on a violation for which the Commissioner has issued a sanction\npursuant to this section, the sanction issued by the Commissioner shall be\nnullified with any civil penalty imposed refunded to the nursing home within 60\ndays.\n\nG. If a license of any nursing home issued pursuant to Chapter 5 (\u00a7 32.1-123 et\nseq.) is revoked, a new license may be issued by the Commissioner after:\n\n   1. Satisfactory evidence is submitted to him that the conditions upon which\n   revocation was based have been corrected; and\n\n   2. Proper inspection has been made and compliance with all provisions of\n   Chapter 5 (&#xA7; 32.1-123 et seq.) and applicable state and federal laws and\n   regulations hereunder has been obtained.\n\nH. The Board shall promulgate regulations to implement the provisions of this\nsection that include:\n\n   1. Criteria for when the imposition of sanctions or initiation of court\n   proceedings as specified in &#xA7; 32.1-27, 32.1-27.1, or a combination\n   thereof are appropriate in order to ensure prompt correction of violations\n   involving noncompliance with requirements of any order of the Board or\n   Commissioner or any provision of or regulation promulgated pursuant to Chapter\n   5 (&#xA7; 32.1-123 et seq.);\n\n   2. Criteria for the imposition of sanctions;\n\n   3. A schedule of civil penalties, which shall be uniform for each type of\n   specific violation;\n\n   4. Procedures for the imposition of sanctions consistent with the\n   Administrative Process Act (&#xA7; 2.2-4000 et seq.); and\n\n   5. Provisions for the prompt notification of the Department of Medical\n   Assistance Services whenever any license is revoked or suspended for the\n   purpose of terminating or suspending the applicable Medicaid provider\n   agreement.\n\nHISTORY: 2025, cc. 166, 180.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}