                                 CODE OF VIRGINIA

SANCTIONS; CIVIL PENALTY (§ 32.1-27.3)

A. 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 (§ 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. 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

   2. Permitting, aiding, or abetting the commission of any illegal act during
   the provision of health care services delivered by such nursing home.

B. 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.

C. The sanctions that the Commissioner may impose pursuant to subsection A shall
include the following:

   1. Placing on probation any license issued pursuant to Chapter 5 (&#xA7;
   32.1-123 et seq.); and

   2. 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.

D. 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.

   1. 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.

   2. 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.

E. 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 §
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. 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.

   2. All administrative proceedings under this section shall be separate from
   the regulatory office of the Department that conducted the inspection,
   investigation, examination, or review.

   3. The adjudication officer shall provide a recommendation to the
   Commissioner, including findings of fact, conclusions, and appropriate
   disciplinary action.

   4. The Commissioner may affirm, modify, or reverse such recommendation and
   shall issue a final case decision.

   5. 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.).

F. 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.

G. If a license of any nursing home issued pursuant to Chapter 5 (§ 32.1-123 et
seq.) is revoked, a new license may be issued by the Commissioner after:

   1. Satisfactory evidence is submitted to him that the conditions upon which
   revocation was based have been corrected; and

   2. 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.

H. The Board shall promulgate regulations to implement the provisions of this
section that include:

   1. 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.);

   2. Criteria for the imposition of sanctions;

   3. A schedule of civil penalties, which shall be uniform for each type of
   specific violation;

   4. Procedures for the imposition of sanctions consistent with the
   Administrative Process Act (&#xA7; 2.2-4000 et seq.); and

   5. 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.

HISTORY: 2025, cc. 166, 180.