The Department of Health and Human Services shall impose

• Type A1 Violation  
   A violation by a facility which results in death or serious physical harm, abuse,   
   neglect, or exploitation. 

• Type A2 Violation
   A violation by a facility which results in substantial risk that death or serious physical 
   harm, abuse, neglect or exploitation.

• Type B
   A violation by a facility is detrimental to the health, safety, or welfare of any resident,
   but which does not result in substantial risk that death or serious physical harm,
   abuse, neglect, or exploitation will occur. 

• Repeated Violations
  The Department shall impose a civil penalty which is treble the amount assessed under subsection (a) of G.S. 131D-24 when a facility under the same management
  or ownership has received a citation during the previous 12 months for which the
  appeal rights are exhausted and penalty payment is expected or has occurred, and
  the current violation is for the same specific provision of a statute or regulation for which is received a violation during the previous 12 months.

Civil monetary penalties will be imposed for Type A violations and if a facility fails to correct a Type B violation by a specified timeframe, a civil monetary penalty will be imposed.
  

• 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 the situations in which the Division has needed to use this option, we 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, in compliance with G.S. 150B-3, which encourages the state to settle disputes through informal means, gives 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.