<?xml version="1.0"?>
<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>77478</law_id><section_number>32.1-27.3</section_number><catch_line>Sanctions; civil penalty</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>32.1-127.01</reference><reference>32.1-134.1</reference><reference>32.1-134.4</reference></referred_to_by><structure><unit label="title" level="1" order_by="1" identifier="32.1">Health</unit><unit label="chapter" level="2" order_by="1" identifier="1">Administration Generally</unit><unit label="article" level="3" order_by="1" identifier="4">Procedures; Inspections; Orders; Penalties; Representation by Attorney General</unit></structure><text>
						<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 (&#xA7;&#xA0;<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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&#x2019;s care, including the timely transfer or relocation of any <span class="dictionary">persons</span> under such nursing home&#x2019;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"/></a></p></section>
						<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&#x2019;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"/></a></p></section>
						<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"/></a></p></section>
						<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>&#x2019;s presiding officer in accordance with &#xA7;&#xA0;<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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&#x2019;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"/></a></p></section>
						<section id="G"><p><span class="prefix-number">G.</span> If a license of any nursing home issued pursuant to Chapter 5 (&#xA7;&#xA0;<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section></text><history>2025, cc. 166, 180.</history><metadata></metadata></law>
