Nursing Home Penalties

Levels of Fines and Citations

Class “B” Citation: The violation has a direct or immediate relationship to patient health, safety, or security. Any violation of resident’s rights as described in applicable sections of Title 22 of the California Code of Regulations is also classified as a Class “B” violation, unless otherwise determined by the Department that such a violation meets the criteria of an “A” citation. Penalties for Class “B” violations range from a minimum of $100 to a maximum of $1,000 for each violation.

 

Class “A” Citation: The violation is determined to present imminent danger of death or serious harm to the residents or substantial probability of death or serious physical harm. Penalties for Class “A” violations issued against skilled nursing facilities or intermediate care facilities range from a minimum of $2,000 to a maximum of $20,000 for each citation.

Class “AA” Citation: The violation meets the criteria for a class “A” violation and the department determines the violation was the direct proximate cause of death of a resident, resulting from an occurrence the nature of which the regulation violated was designed to prevent. Penalties for Class “AA” violations issued against skilled nursing facilities or intermediate care facilities range from a minimum of $25,000 to a maximum of $100,000 for each citation.

For any second or subsequent “AA” citation issued within a 24 month period that has been sustained following a Citation Review Conference or where the licensee has chosen not to file for a review, the department is required to initiate action to suspend or revoke the facility’s license.

Willful Material Omission (WMO): The willful failure to record any untoward event which has affected the health, safety, or security of a resident and which was omitted with the knowledge that the record falsely reflects the condition of the resident or the services provided.

Willful Material Falsification (WMF): Any entry in the resident’s health record pertaining to the administration of medications, or treatments ordered for the resident, or pertaining to services for the prevention of decubitus ulcers or contractures, or pertaining to tests and measurements of vital signs, or notations of intake and output of fluids, which was made with the knowledge that the record falsely reflects the condition of the resident or the care or services provided.

Fines for WMO or WMF violations range from minimum of $2,500 to a maximum of $10,000 in instances where the health care record is relied upon by a health care professional to the detriment of the resident by affecting the administration of medications or treatment, the issuance of orders, or the development of plans of care. In all other cases, the maximum penalty is $2,500.

Trebling of Penalties: California law requires that civil penalties for Class “A” or Class “B” violations be trebled for “...second or subsequent violations of the same class occurring within any 12-month period.” Even if the action on the first citation is not final, the penalty for a second or subsequent violation is required to be trebled if the first citation was issued in the same class, a civil penalty was assessed for the first citation and a plan of correction was submitted for the previous violation in the same 12-month period.

Appeal System: Once a facility is issued a citation, the licensee has numerous levels of appeal.

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