Current through Register Vol. 46, No. 19, March 20, 2024
Citations which are issued by the director of the department
of inspections and appeals for violations of the statutes or rules relating to
health care facilities will subject the facility to the following
penalties.
(1)
Citation for a
class I violation. The penalty shall not be less than $2,000 nor more
than $10,000. The penalty for a class I violation shall be doubled when the
violation is due to an intentional act by the facility in violation of a
provision of Iowa Code chapter 135C or a rule adopted pursuant
thereto.
(2)
Citation for a
class II violation. The penalty shall not be less than $100 nor more
than $500. Using the criteria established in paragraph
56.3(2)"a," the director of the department of inspections and
appeals may, upon written request, waive the penalty if the class II violation
is corrected within the time specified in the citation. The director shall not
waive penalties related to the items listed in subrule 56.3(4).
a.
Criteria for waiving the penalty
for a class II violation. The director shall consider the following
criteria, among others, when deciding whether to grant a waiver of a class II
penalty.
(1) The past history of the facility
within the last 24 months of the violation as it relates to the nature of the
violation;
(2) The rights of
residents to make informed decisions with their doctor(s) and family/legal
representative(s); and
(3) The
financial hardship the fine will cause the facility.
b.
Process for requesting a waiver of
the penalty for a class II violation.
(1) A facility shall submit documentation
that supports the waiver request.
(2) If the facility has requested a waiver
based on financial hardship, the facility must provide proof of the hardship
for the individual facility, along with the parent corporation, if any.
Supporting documentation shall, at minimum, include the facility's, and the
parent corporation's, if any, most recent profit and loss statement and balance
sheet.
(3) Requests for a waiver
shall be submitted within ten working days of receipt by the facility of the
notice that the violation has been corrected.
(4) The department shall make a decision on
the waiver request or request additional information, if necessary, within ten
working days of receipt of a waiver request and shall notify the facility in
writing of the department's determination by personal service, by electronic
mail, or by certified mail. If additional information is requested, such
information shall be provided by the facility within five working days. If
additional information is necessary, the department shall make a decision on
the waiver request within ten working days of receipt of the additional
information requested by the department.
(5) If the waiver request is granted and the
facility has paid the penalty, the facility shall be refunded the amount of the
penalty paid that was subject to the approved waiver request.
c.
Denial of penalty
waiver request for a class II violation. The director's decision to
deny a waiver request is not subject to appeal. The underlying citation or
state statement of deficiencies is eligible for appeal.
(3)
Citation for a class III
violation. No penalty shall be assessed for a class III violation
except as provided in rule
481-56.5 (135C).
(4)
Self-identification and
correction of a class II or class III violation prior to the on-site
inspection.
a.
Self-identification and correction. If a facility
self-identifies a deficient practice prior to the on-site visit inspection,
there has been no complaint filed with the department related to that specific
deficient practice, and the facility corrects such practice prior to an
inspection, no citation shall be issued or fine assessed for class II or III
violations except as identified in Iowa Code section
135C.36(5).
b.
Process for documenting
self-identification. If, during the inspection, an area of concern is
identified to the facility that was self-identified and corrected by the
facility prior to the inspection, no complaint has been filed, and the
violation does not fall in the exemptions listed in Iowa Code section
135C.36(5), the facility shall complete a "Self-Identification and Correction
Form" and submit it to the inspector(s) prior to the conclusion of the
inspection, or to the department within two working days of the exit interview
via email, facsimile, or overnight courier. The documentation shall include:
(1) The nature of the problem;
(2) The date the problem was
identified;
(3) Who identified the
problem, i.e., family, resident, staff, physician, pharmacist;
(4) Action steps taken to correct the
problem;
(5) The date the facility
determined correction was completed; and
(6) All documentation that substantiates the
above information.
(5)
State penalty dismissed if the
corresponding federal deficiency or citation is dismissed or removed.
Any state penalty, including a fine or citation, issued as a result of a joint
state and federal survey and certification process shall be dismissed if the
corresponding federal deficiency or citation is dismissed or removed.
a. If the federal deficiency is dismissed or
removed during the federal informal dispute resolution process, the department
shall remove any corresponding state fine, citation or deficiency within 20
working days of issuance of the decision.
b. If the federal deficiency is dismissed or
removed at the conclusion of the federal administrative hearing process, the
facility shall submit to the department a copy of the decision, along with a
written request for the removal of the corresponding state fine, citation, or
deficiency.
c. Any state penalty,
including a fine or citation, shall be retained or reinstated if the federal
deficiency is retained or reinstated.
(6)
Reduction of fine amount by 35
percent. If a facility has been assessed a penalty, does not request a
formal hearing pursuant to Iowa Code section
135C.43 and rule
481-56.17 (135C), or withdraws
its request for a formal hearing within 30 days of the date that the penalty
was assessed, and the penalty is paid within 30 days of receipt of notice or
service, the amount of the civil penalty shall be reduced by 35
percent.
