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Penalties
and Enforcement for Adult Care Homes
The North Carolina legislature authorizes the Secretary of the Department
of Health and Human Resources to establish a Penalty
Review Committee of nine members to review all violations.
There
are two basic types of violations:
Type
A
Violations are those that create substantial risk that death or serious
physical harm will occur or where such harm has occurred. Penalty amounts
for this type can range from $250 to $5,000 for homes licensed for nine
or fewer beds and $500 to $10,000 for adult care homes of ten or more beds.
Uncorrected Type A violations are subject to a daily penalty of up to $500.00
a day if not corrected within the time frame specified in the plan of correction.
Type
B
Violations are those that present a direct relationship to the health, safety,
or welfare of residents, but not substantial risk of death or serious physical
harm. No monetary fines are imposed unless violations are not corrected
within the time frame specified on the plan of correction. There is a daily
fine of up to $200 for each day the violation is not corrected.
Other Means of Enforcement
In addition to civil money penalties, the Division of Health Service Regulation has several other enforcement remedies
available in state law as follows:
- Provisional
License
Reduction from a full to a provisional license can occur when the provider
fails to substantially comply with applicable laws and rules and there is
reasonable expectation that the home will comply in a reasonable amount
of time and remain in compliance.
- Suspension
of Admissions
Suspension of new admissions may also be imposed when the provider fails
to substantially comply with applicable laws and rules. This is a more severe
penalty than a provisional license and is normally not imposed unless it
is felt that continued admissions would place a threat on the safety and
welfare of residents.
- Temporary
Management
The General Assembly passed a law in 1993 which enables DHSR, in lieu of
using revocation or summary suspension action, to ask the courts to appoint
a temporary manager to operate a facility where conditions exist that create
a substantial risk of death or serious physical harm to residents. Unfortunately,
in situations where this option is needed, action needs to be taken immediately
- the situation could not afford to have the court take up to 20 days to
act.
- Revocation
Revocation of a license can occur when a provider fails to substantially
comply with applicable laws and rules and there is no reasonable expectation
for the facility to come into compliance within a reasonable amount of time
or remain in compliance even if it comes into compliance. Obviously, this
is the most severe action short of summarily suspending a license.
- Summary
Suspension of a License
A license can be summarily suspended and residents relocated (closing the
home and moving the residents) without prior due process in the event that
there are imminent life-threatening conditions in a facility.
The
Division of Health Service Regulation encourages all involved to settle disputes through
informal means. They
give providers an opportunity to informally dispute actions taken against
them and to provide additional information that may not have been available
to the surveyors at the time of the monitoring visit.
Following
all informal appeals, the Administrative
Procedures Act governs through use of a contested case
process (except for summary suspension of a license which is implemented
without prior due process). If a provider is dissatisfied with the
decision at the administrative level, the provider can appeal to
superior court.
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