reglab/statecodes huggingface dataset:
2023 Delaware Code › Title 16 - Health and Safety › Chapter 10A. HEALTH-CARE ASSOCIATED INFECTIONS DISCLOSURE ACT › § 1002A. Definitions.

§ 1002A. Definitions.
For purposes of this chapter:
(1) “Advisory Committee” means the Committee established under this chapter.
(2) “Correctional facility” means any health-care facility operated at any Department of Correction facility in this State.
(3) “Department” means the Department of Health and Social Services.
(4) “Dialysis center” means a facility approved to furnish outpatient dialysis services directly to end stage renal disease (ESRD) patients. Outpatient dialysis includes:
staff-assisted dialysis (dialysis performed by the staff of the facility) and self-dialysis (dialysis performed with little or no professional assistance by an ESRD patient who has completed an appropriate course of training). ESRD is that stage of renal impairment that appears irreversible and permanent, and requires a regular course of dialysis or kidney transplantation to maintain life.
(5) “Freestanding surgical center” means a facility licensed under Chapter 1 of this title.
(6) “Health-care associated infection” means a localized or systemic condition:
a. That results from adverse reaction to the presence of an infectious agent or agents or its toxin or toxins; and
b. That was not present or incubating at the time of admission to the health-care facility.
(7) “Health-care facility” means a correctional facility, dialysis center, freestanding surgical center, hospital, long-term care facility, or psychiatric facility.
(8) “Hospital” means an acute care health-care facility licensed under Chapter 10 of this title.
(9) “Long-term care facility” means a nursing home or intermediate care facility for persons with mental retardation licensed under Chapter 11 of this title.
(10) “Psychiatric facility” means a facility that is primarily engaged in providing, by or under the supervision of a doctor of medicine or osteopathy, psychiatric services for the diagnosis and treatment of mentally ill persons.
(11) “Public report” means the report provided to the health-care facilities and the public by the Department as set forth in this chapter.
76 Del. Laws, c. 122, §  1;  78 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 10A. HEALTH-CARE ASSOCIATED INFECTIONS DISCLOSURE ACT › § 1003A. Reporting of infections by physicians.

§ 1003A. Reporting of infections by physicians.
In accordance with this chapter, a physician who diagnoses and treats a health-care associated infection related to a clinical procedure, or a licensed practitioner who is permitted by law to diagnose and treat such infection and does so, is required to report the infection back to the health-care facility at which the clinical procedure was performed. The infection control department of the health-care facility will then be required to report to the Department only those infections that meet the accepted National Healthcare Safety Network definitions and are currently required to be reported by law.
78 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 10A. HEALTH-CARE ASSOCIATED INFECTIONS DISCLOSURE ACT › § 1004A. Hospital reports.

§ 1004A. Hospital reports.
(a) Individual hospitals shall collect data on health-care associated infection rates related to specific clinical procedures as determined by the Advisory Committee and set forth in regulations promulgated by the Department. Examples may include the following categories:
(1) Surgical site infections such as total hip and knee arthroplasty;
(2) Central line-related bloodstream infections in an intensive care unit (ICU);
(3) Direct health-care provider's influenza vaccination rates; and
(4) Other categories as provided under subsection (c) of this section.
(b) (1) Infection control professionals, or a designee, of hospitals shall submit quarterly reports on their health-care associated infection rates to the Department using the accepted Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) definitions. Prevention and control data related to quality measures will be based on nationally recognized and recommended standards that may include those developed by the CDC, Centers for Medicare and Medicaid, and/or the Agency for Healthcare, Research and Quality, to name a few. Data in quarterly reports must cover a period ending not earlier than 45 days prior to submission of the report. Quarterly reports shall be made available to each hospital 45 days after submittal to the Department for review by the hospitals. The hospitals shall have 7 days to review the quarterly reports and report any changes to the Department. Following the 7-day review period, such quarterly reports shall be made available to the public at each hospital and through the Department (the “public report”).
(2) If the hospital is a division or subsidiary of another entity that owns or operates other hospitals or related organizations, the quarterly report shall be for the specific division or subsidiary and not for the other entity.
(c) After June 30, 2010, and upon consultation with the Advisory Committee and other experts in infection, prevention, identification and control, the Department may revise categories of infections set forth in subsection (a) of this section.
76 Del. Laws, c. 122, §  1;  77 Del. Laws, c. 233, §§  1, 2;  78 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 10A. HEALTH-CARE ASSOCIATED INFECTIONS DISCLOSURE ACT › § 1005A. Department reports.

§ 1005A. Department reports.
(a) The Department shall annually submit to the legislature a report summarizing the hospital quarterly reports and shall publish the annual report on its website. The first annual report shall be published no later than June 30, 2009. Following the initial report, the Department shall update the public information on a quarterly basis.
(b) All reports issued by the Department shall be risk adjusted, or use some other method to account for the differences in patient populations among hospitals.
(c) The annual report shall compare health-care associated infection rates to national rates published by the CDC's NHSN program and collected pursuant to this chapter for each individual hospital in the State. The Department, in consultation with the Advisory Committee, shall make this report as easy to comprehend as possible. The report shall also include an executive summary, written in plain language that shall include but not be limited to a discussion of findings, conclusions and trends concerning the overall state of health-care associated infections in the State, including a comparison to prior years. The report may include policy recommendations, as appropriate.
(d) The Department shall publicize the report and its availability as widely as practical to interested parties, including but not limited to hospitals, providers, media organizations, health insurers, health maintenance organizations, purchasers of health insurance, organized labor, consumer or patient advocacy groups and individual consumers. The annual report shall be made available to any person upon request.
(e) No hospital report or Department disclosure may contain information identifying a patient, employee or licensed health-care professional in connection with a specific infection incident.
(f) The annual report shall provide background information about each hospital which shall include:
the hospital's adult and pediatric populations, bed size, and specialty divisions; whether the hospital provides tertiary care; and whether the hospital is a teaching or a nonteaching institution. This background information shall be included in the public report.
(g) The annual report shall include a brief summary report to allow hospitals to comment on performance improvement and changes in patient population and risk factors. The information contained in the summary report shall be considered proprietary information and shall be utilized by the Department but shall not be made available in the public report and shall not be subject to disclosure under the State's Freedom of Information Act (Chapter 100 of Title 29).
76 Del. Laws, c. 122, §  1;  78 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 10A. HEALTH-CARE ASSOCIATED INFECTIONS DISCLOSURE ACT › § 1006A. Correctional facility reports.

§ 1006A. Correctional facility reports.
(a) Correctional facilities shall collect data on health-care associated infections related to specific clinical procedures resulting from care in the correctional facility, as determined by the Advisory Committee and as set forth in regulations promulgated by the Department. These categories of infection data may differ from that information required from hospitals.
(b) Correctional facilities shall report data to the Department in accordance with regulations of the Department. The information from the correctional facilities shall be segregated from the hospital data contained in the reports submitted pursuant to this chapter.
76 Del. Laws, c. 122, §  1;  78 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 10A. HEALTH-CARE ASSOCIATED INFECTIONS DISCLOSURE ACT › § 1007A. Reports by other health-care facilities.

§ 1007A. Reports by other health-care facilities.
Only with the concurrence of the Advisory Committee, and not until such time that the Centers for Medicaid and Medicare or the Centers for Disease Control and Prevention issue final federal regulations requiring such, and after careful evaluation of the economic and public health impact, the Department may through regulation require the reporting of health-care associated infections from health-care facilities other than hospitals and correctional facilities. The procedures for reporting shall be consistent with procedures for reporting by hospitals as specified in this chapter, except as may be necessary to accommodate the unique characteristics and capabilities of the health-care facilities and the capabilities of the National Healthcare Safety Network.
78 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 10A. HEALTH-CARE ASSOCIATED INFECTIONS DISCLOSURE ACT › § 1008A. Advisory Committee.

§ 1008A. Advisory Committee.
(a) The Secretary of the Department shall appoint an Advisory Committee, which shall include:
1 infection control professional who has responsibility for infection control programs for each hospital or health-care system in Delaware; 4 infection disease physicians with expertise in infection control; 1 representative of the Delaware Health Care Facilities Association; 1 representative of a freestanding surgical center; 1 representative of a dialysis center; 1 representative of a psychiatric facility; 1 representative from the State Division of Public Health; and the Public Health Healthcare Associated Infections Specialist responsible for collating and reporting data. The Secretary shall also appoint 8 other members of the Committee including representatives from direct care nursing staff, academic researchers, consumer organizations, health insurers, health maintenance organizations, organized labor and purchasers of health insurance, such as employers. The Advisory Committee shall have the authority to engage personnel with appropriate training and/or certification in infection prevention and control for the purposes of collecting data.
(b) The Advisory Committee shall assist the Department in the development of all aspects of the Department's methodology for collection, analyzing and disclosing the information collected under this chapter, including collection methods, formatting and methods and means for release and dissemination.
(c) In developing the methodology for collecting and analyzing the infection rate data, the Department and the Advisory Committee shall adopt the methodologies and system for data collection from the Centers for Disease Control's National Healthcare Safety Network, or its successor. The data collection and analysis methodology shall be disclosed to the public prior to any public disclosure of health-care associated infection rates.
(d) The Advisory Committee shall assist the Department in the sharing of information and best practices toward the development of activities and policies that:
(1) Enhance coordination between health-care facilities throughout the continuum of care for the prevention and control of health-care associated infections;
(2) Promote the prevention and control of health-care associated infections generally; and
(3) Encourage the creation of benchmarks against which to measure progress in the prevention and control of health-care associated infections.
78 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 10A. HEALTH-CARE ASSOCIATED INFECTIONS DISCLOSURE ACT › § 1009A. Privacy.

§ 1009A. Privacy.
It is the express intent of the legislature that a patient's right of confidentiality shall not be violated in any manner. Patient Social Security numbers and any other information that could be used to identify an individual patient shall not be released notwithstanding any other provision of law.
76 Del. Laws, c. 122, §  1;  78 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 10A. HEALTH-CARE ASSOCIATED INFECTIONS DISCLOSURE ACT › § 1010A. Penalties.

§ 1010A. Penalties.
A determination that a health-care facility has violated the provisions of this chapter may result in any of the following:
(1) Termination of licensure or other sanctions relating to licensure under Chapter 10 of this title; or
(2) A civil penalty of up to $500 per day per violation for each day the health-care facility is in violation of this chapter.
76 Del. Laws, c. 122, §  1;  78 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 10A. HEALTH-CARE ASSOCIATED INFECTIONS DISCLOSURE ACT › § 1011A. Regulatory oversight.

§ 1011A. Regulatory oversight.
The Department shall be responsible for ensuring compliance. When the Department licenses a health-care facility according to the provisions of this title, compliance with this chapter shall be a condition of licensure.
76 Del. Laws, c. 122, §  1;  78 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 10A. HEALTH-CARE ASSOCIATED INFECTIONS DISCLOSURE ACT › § 1012A. Hospital Infection Specialist.

§ 1012A. Hospital Infection Specialist.
The Department shall establish and fund a Healthcare Associated Infection Specialist position within the Division of Public Health supporting the functions of this chapter. The Healthcare Associated Infection Specialist must have knowledge of the NHSN system and skills to appropriately analyze health-care acquired infection data.
76 Del. Laws, c. 122, §  1;  78 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 10A. HEALTH-CARE ASSOCIATED INFECTIONS DISCLOSURE ACT › § 1013A. Privilege and confidentiality protections.

§ 1013A. Privilege and confidentiality protections.
Notwithstanding any other provision of federal, state or local law, the health-care associated infection data provided pursuant to this chapter is privileged and, with the exception of §§ 1003A, 1004A and 1005A of this title, shall not be:
(1) Subject to admission as evidence or other disclosure in any federal, state or local civil, criminal or administrative proceeding, or
(2) Subject to use in a disciplinary proceeding against a health-care facility or provider, or
(3) Subject to disclosure under Chapter 100 of Title 29.
76 Del. Laws, c. 122, §  1;  78 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 10A. HEALTH-CARE ASSOCIATED INFECTIONS DISCLOSURE ACT › § 1014A. Membership in National Healthcare Safety Network.

§ 1014A. Membership in National Healthcare Safety Network.
By December 31, 2007, all hospitals in the State shall join the Centers of Disease Control and Prevention's National Healthcare Safety Network or its successor. If the Network is not open for enrollment to all hospitals by this date, all hospitals shall join the Network within 180 days after the Center of Disease Control and Prevention permits such enrollment. Hospitals shall authorize the Department to have access to hospital-specific data contained in the National Healthcare Safety Network database consistent with the requirements of this chapter. With the concurrence of the Advisory Committee the Department may require other health-care facilities through regulation to join the National Healthcare Safety Network as may be appropriate in accordance with this chapter.
76 Del. Laws, c. 122, §  1;  78 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1101. Purpose and overview.

§ 1101. Purpose and overview.
(a) It is the intent of the General Assembly that the primary purpose of the licensing and regulation of long-term care facilities is to ensure that these facilities provide a high quality of care and quality of life to their residents.
(b) This chapter and the regulations adopted to implement it establish minimum acceptable levels of care. A violation of a minimum acceptable level of care is prohibited by law.
(c) The State shall undertake measures to prevent violations. Prevention shall be promoted through education, particularly regarding any new laws and regulations adopted by the State.
(d) The State shall undertake measures to assure that violations of this chapter and the regulations promulgated under this chapter are remedied. To that end, the Department shall do all of the following:
(1) Set standards of care.
(2) Determine compliance with those standards through inspections, investigations and other compliance measures.
(3) Impose sanctions and remedies for noncompliance.
(e) (1) The Department shall be responsible for issuing licenses and certifying the compliance of facilities with state laws and regulations.
(2) Each facility licensed under this chapter shall, at a minimum, provide quality care in accordance with this chapter and the regulations promulgated thereunder. Components of quality of care and quality of life addressed by this chapter and regulations promulgated thereunder include all of the following:
a. Access to care.
b. Continuity of care.
c. Comprehensiveness of care, including activities.
d. Coordination of services.
e. Humaneness of treatment and respect for the dignity of each resident.
f. Safety of the environment.
g. Qualifications of caregivers.
(f) This chapter and its regulations are intended for use in state inspections of facilities licensed under this chapter and any investigations and enforcement actions, and are designed to be useful to consumers and providers in assessing the quality of care provided in a facility.
(g) The consumer protection goal of ensuring that residents of long-term care facilities receive quality care shall be strived for in the following ways:
(1) Monitoring the factors relating to the health, safety, welfare and dignity of each resident.
(2) Providing effective remedies and requiring their prompt imposition for noncompliance with licensing standards.
(3) Providing the public with information concerning the operation of long-term care facilities in this State.
(h) This chapter shall be construed broadly to accomplish the purposes set forth in this section.
71 Del. Laws, c. 488, §  2;  81 Del. Laws, c. 206, § 2;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1103. License and renewal requirement.

§ 1103. License and renewal requirement.
(a) A person may not establish, conduct, or maintain any long-term care facility in this State without first obtaining a license from the Department and thereafter renewing this license on an annual basis. Failure to comply with this subsection shall result in the imposition by the Department of a civil penalty not to exceed $10,000 per violation.
(b) A nursing facility, assisted living facility, or rest residential facility must operate under the direction of an individual authorized or licensed to perform the functions of a nursing home administrator under Chapter 52 of Title 24.
71 Del. Laws, c. 488, §  2;  76 Del. Laws, c. 89, §  2;  81 Del. Laws, c. 206, § 4;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1105. Denial of license or its renewal.

§ 1105. Denial of license or its renewal.
(a) The Department may deny a license to any applicant or refuse to renew a license to any license holder if the Department finds that the applicant or license holder or any partner, officer, director, managerial employee or controlling person of the applicant or license holder has done any of the following:
(1) Failed to meet the requirements of § 1104 of this title.
(2) Operated any long-term care facility without a license or under a revoked or suspended license in any jurisdiction.
(3) Knowingly, or with reason to know, made a false statement of a material fact in an application for license or renewal, or any data attached thereto, or in connection with any matter under investigation by the Department, or in any document submitted to the Department, including a plan for the correction of all violations of applicable laws or regulations.
(4) Refused to allow representatives or agents of the Department to inspect a portion of the premises of the facility or any resident-related documents, records, and files required to be maintained by the facility.
(5) Interfered with or attempted to impede in any way the work of any authorized representative of the State or protection and advocacy agency or the lawful enforcement of any provision of this chapter.
(6) Has a history of noncompliance with federal or state law or regulations in providing long-term care.
(b) The due process protections of notice and an opportunity to be heard must be provided to facilities prior to the denial of a license or its nonrenewal. The hearing process must be consistent with the Administrative Procedures Act, Chapter 101 of Title 29.
(c) In deciding whether to deny a license or its renewal under this section, the factors to be considered by the Department must include the severity and recurrence of the noncompliance.
71 Del. Laws, c. 488, §  2;  77 Del. Laws, c. 201, §  2;  81 Del. Laws, c. 206, § 6;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1106. License fees.

§ 1106. License fees.
(a) (1) The fees for issuance and renewal of licenses pursuant to this chapter for nursing facilities, assisted living facilities, rest residential facilities, and intermediate care facilities for persons with intellectual disabilities may not exceed $150 plus the following:
a. $250 for facilities with less than 100 units of capacity or bed space for which a license is sought.
b. $400 for facilities with 100 or more units of capacity or bed space.
c. A background examination fee for initial applications in an amount set by the Department necessary to defray its expenses in administering its duties under § 1104(c) and (d) of this title, but not to exceed $500.
(2) The total fee for all other facilities with 16 or fewer units of capacity or bed space is $50.
(b) The license fee required under subsection (a) of this section must be paid with each application for initial license, a renewal license, or an initial license.
(c) The State is not required to pay the license fee for any facilities it operates or owns which require licensure under this chapter.
(d) All license fees collected by the Department must be remitted to the General Fund.
(e) A new application and a fee of $50 must be submitted for changes to a license which occur during the licensure year, including any of the following changes:
(1) An approved increase in bed space.
(2) An approved decrease in bed space.
(3) A facility change of name.
71 Del. Laws, c. 488, §  2;  72 Del. Laws, c. 3, §§  1, 2;  81 Del. Laws, c. 206, § 7;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1107. Inspections and monitoring.

§ 1107. Inspections and monitoring.
(a) The Department shall inspect each long-term care facility on a regular basis to ensure compliance with this chapter and the regulations adopted pursuant to it.
(b) The Department shall have the authority to assess additional fees to recover the actual costs and expenses of the Department for any monitoring or inspections needed beyond the standard inspection in those cases in which substantiated violations are found.
(c) Any duly authorized employee or agent of the Department may enter and inspect any facility licensed under this chapter without notice at any time. All licensees are required to provide immediate access to Department personnel to conduct inspections. Such inspections may include any of the following:
(1) Interviewing residents.
(2) Interviewing family members or staff.
(3) Reviewing and photocopying any records and documents maintained by the licensee.
(4) Inspecting any portion of the physical plant of the facility.
(5) Enforcing any provision of this chapter and the regulations pursuant to it, as well as applicable federal law and regulations.
(d) Advance notice may not be given to any facility of any inspection conducted under this chapter unless specifically authorized by the Secretary of the Department or the Secretary's designee or as otherwise required by federal law or regulation. Failure to comply with this subsection results in the imposition by the Department of a civil penalty not to exceed $5,000 per violation.
(e) At the conclusion of each inspection, the Department shall promptly notify the facility of any violations of this chapter and its regulations as well as of federal law and regulations. It shall provide a comprehensive exit interview at the conclusion of each inspection whereby the facility is made aware of any problems found, including violations of applicable law or regulations. Representatives from the Long-Term Care Ombudsperson's Office shall be invited to attend each exit interview.
(f) [Repealed.]
(g) Any person who is a former employee of a long-term care facility is disqualified from participating for 2 years in any manner in any inspection of that facility.
(h) Any person who has a relative residing or working in a long-term care facility is disqualified from participating in any manner in any inspection of that facility.
71 Del. Laws, c. 488, §  2;  70 Del. Laws, c. 186, §  1;  74 Del. Laws, c. 59, §  1;  81 Del. Laws, c. 206, § 8;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1108. Posting of inspection summary and other information and public meetings.

§ 1108. Posting of inspection summary and other information and public meetings.
(a) Each facility shall prominently and conspicuously post for display in a public area of the facility that is readily available to residents, employees, and visitors the following:
(1) The license issued under this subchapter.
(2) A sign prescribed by the Department that specifies complaint procedures and provides the “1-800” hotline number to receive complaints 24 hours a day, 7 days a week.
(3) The most recent state survey report prepared by the Department of the most recent inspection report for the facility.
(4) A notice, as required by regulation, in the form prescribed by the Department stating that informational materials relating to the compliance history of the facility are available for inspection at a location in the facility specified by the sign and online at a web site specified by the sign. The notice shall also provide the telephone number to reach the Department to obtain the same information concerning the facility.
(5) A notice, as required by regulation, that the Division of Professional Regulation can provide information about the facility administrator along with the Division of Professional Regulation telephone number to call for this information.
(b) [Repealed.]
(c) The compliance history information required to be maintained for public review must be maintained in a well-lighted accessible location. The compliance history material must include all inspection reports produced for that facility during the preceding 3-year period. The information must be updated as each new inspection or other Department report is received by the facility.
(d) Following completion of the annual inspection report, the Department shall schedule a meeting, as required under regulations, to take place at the facility to present the findings of the annual report.
(1) The Department shall require the facility to notify residents and their families of the meetings required under this subsection.
(2) The Department shall provide staff for these meetings and the staff shall be prepared to present the findings of the surveys and to answer questions regarding the surveys and plans of action.
71 Del. Laws, c. 488, §  2;  72 Del. Laws, c. 3, §  3;  77 Del. Laws, c. 401, §§  1, 2;  81 Del. Laws, c. 206, § 9;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1109. Civil penalties.

§ 1109. Civil penalties.
(a) (1) The Department may impose civil money penalties for the violation of provisions of this chapter or the regulations adopted pursuant to it.
(2) A licensee or other person is liable for a civil penalty of not less than $1,000 nor more than $10,000 per violation for violations which the Department determines pose a serious threat to the health and safety of a resident.
(b) In determining the amount of the penalty to be assessed under subsection (a) of this section, the Department must consider all of the following:
(1) The seriousness of the violation, including the nature, circumstances, extent, and gravity of the violation and the hazard or potential hazard created by the violation to the health or safety of a resident or residents.
(2) The history of violations committed by the person or the person's affiliate, employee, or controlling person.
(3) The efforts made by the facility to correct the violation.
(4) The culpability of the person who committed the violation.
(5) A misrepresentation made to the Department or to another person regarding any of the following:
a. The quality of services provided by the facility.
b. The compliance history of the facility.
c. The identity of an owner or controlling person of the facility.
(6) Any other matter that affects the health, safety, or welfare of a resident.
(c) For all other violations that do not constitute a serious threat to the health and safety of a resident, but do violate this chapter or the regulations adopted pursuant to it, the maximum civil penalty is $5,000 per violation. Violations in this category include any of the following:
(1) Making a false statement that the person knows or should know is false, about 1 of the following:
a. A material fact on an application for issuance or renewal of a license or any document attached to an application.
b. A material fact with respect to a matter under investigation by the Department.
(2) Refusing to allow a representative of the Department to inspect without notice at any time either of the following:
a. Any portion of the premises of a facility.
b. Any documents, records, or files required to be maintained by a facility.
(3) Wilfully interfering with the work of a representative of the Department or with the enforcement of this chapter.
(4) Wilfully interfering with the preservation of evidence of a violation of this chapter or regulation pursuant to it.
(d) In determining the amount of the penalty to be assessed under subsection (c) of this section, the Department shall consider the factors in subsection (b) of this section.
(e) Each day of a continuing violation constitutes a separate violation. However, a penalty for a health and safety violation may not exceed $2,500 per day beyond the initial day. A penalty for a nonhealth and safety violation may not exceed $1,250 per day beyond the initial day.
71 Del. Laws, c. 488, §  2;  72 Del. Laws, c. 305, §  2;  81 Del. Laws, c. 206, § 10;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1111. Overlap of state licensing and federal certification penalties.

§ 1111. Overlap of state licensing and federal certification penalties.
(a) The Department may not collect a civil monetary penalty for the same deficient practice for which the federal government has levied a civil monetary penalty.
(b) In the event that a civil monetary penalty has been collected by the State and the federal government subsequently collects a penalty for the same conditions, the State shall refund the previously collected penalty.
71 Del. Laws, c. 488, §  2;  72 Del. Laws, c. 428, §  1;  81 Del. Laws, c. 206, § 12;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1112. Collection of civil penalties.

§ 1112. Collection of civil penalties.
(a) All civil penalties collected under this chapter must be remitted to the Long-Term Care Residents' Trust Fund if based on a federal regulation, or to the State Civil Penalty Trust Fund, if based on a state statute or regulation.
(b) Payment of any civil penalty by a facility is not an allowable cost for reimbursement under the state Medicaid program or under other state-funded programs.
(c) If a long-term care facility, after notice and opportunity for hearing, does not pay a properly assessed penalty in accordance with this subchapter, the Department shall deduct the amount of the civil penalty from amounts otherwise due from the State to the long-term care facility and remit that amount to the State Civil Penalty Trust Fund.
(d) Alternatively, the Department may add the amount of the civil penalty to the licensing fee for the long-term care facility. If the licensee refuses to make the payment at the time of the application for renewal of its license, its license may not be renewed.
(e) The Department may also proceed for the collection of the civil money penalty in an action brought in the name of the Department in any court of competent jurisdiction.
(f) In the event of financial hardship, as determined by the Department, the Department may redirect the payment of penalties by the facility to take remedial action to correct the violation or violations.
71 Del. Laws, c. 488, §  2;  74 Del. Laws, c. 194, §  1;  77 Del. Laws, c. 309, §§  2, 3;  81 Del. Laws, c. 206, § 13;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1113. Other remedies for noncompliance.

§ 1113. Other remedies for noncompliance.
In addition to civil money penalties, the Department may impose any or all of the following remedies for noncompliance with this chapter and the regulations promulgated pursuant to it or for noncompliance with § 1731A of Title 24 or § 903 of this title:
(1) Require monitoring at facility expense, according to the terms and conditions, including timeframes, determined necessary by the Department.
(2) Suspend the admission or readmission of residents to the long-term care facility under the terms and conditions, including timeframes, determined by the Department.
(3) Transfer residents whose care needs are not being met by the licensee.
(4) Suspend, revoke, or refuse to renew a license.
(5) In cases where the physical health or safety of residents is in imminent risk, issue an emergency order temporarily transferring the management of the facility to another qualified entity under the terms and conditions, including timeframes, determined by the Department.
(6) Issue a provisional license for a long-term care facility that is in substantial but not full compliance with applicable laws and regulations.
71 Del. Laws, c. 488, §  2;  72 Del. Laws, c. 305, §  3;  77 Del. Laws, c. 320, §  8;  81 Del. Laws, c. 206, § 14;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1114. Right to hearing on deficiencies and remedies for noncompliance.

§ 1114. Right to hearing on deficiencies and remedies for noncompliance.
The due process protections of notice and opportunity to be heard shall be provided to facilities to appeal survey deficiencies, as well as the imposition of remedies for noncompliance imposed under §§ 1112 and 1113 of this title. The hearing process shall be consistent with the Administrative Procedures Act, Chapter 101 of Title 29.
71 Del. Laws, c. 488, §  2;  74 Del. Laws, c. 59, §  2;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1115. Injunctive relief.

§ 1115. Injunctive relief.
In addition to any other remedy provided by law, the Department may bring an action in Chancery Court to enjoin a long-term care facility from engaging in activities that pose a threat to the health or safety of a resident of the long-term care facility. A temporary restraining order may be granted by the court if continued activity by the long-term care facility would create an imminent risk to a resident at the facility.
71 Del. Laws, c. 488, §  2;  81 Del. Laws, c. 206, § 15;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1116. Coordination of enforcement actions with the attorney general's office.

§ 1116. Coordination of enforcement actions with the attorney general's office.
(a) The Department and the Attorney General shall work in close cooperation throughout any legal proceeding initiated by the Department to enforce this chapter and the regulations promulgated under it.
(b) The Secretary of the Department or the Secretary's designee must be fully consulted before concluding any settlement agreement to a lawsuit brought under this chapter or any other law relating to the health and safety of residents in long-term care facilities.
71 Del. Laws, c. 488, §  2;  70 Del. Laws, c. 186, §  1;  81 Del. Laws, c. 206, § 16;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1117. Retaliation or discrimination against complainant.

§ 1117. Retaliation or discrimination against complainant.
(a) A licensee or other person may not discriminate or retaliate in any manner against a resident or employee in its facility on the basis that such resident or employee or any other person on behalf of the resident or employee has initiated or participated in any proceeding pursuant to this chapter, including providing information in connection with an inspection or facilitating a protection and advocacy agency investigation. The Department shall impose a civil penalty of not more than $10,000 per violation upon any licensee or other person who violates this subsection.
(b) Any attempt to expel a resident of the long-term care facility or any other type of retaliatory or discriminatory treatment of a resident or employee or any other person by whom, or upon whose behalf, a complaint has been submitted to the Department or protection and advocacy agency or who has participated in any proceeding instituted under this chapter within 1 year of the filing of the complaint or the institution of such action, shall raise a rebuttable presumption that such action was taken by the licensee or other person in retaliation for the filing of the complaint or the cooperation with the proceeding.
71 Del. Laws, c. 488, §  2;  77 Del. Laws, c. 201, §§  3, 4;  81 Del. Laws, c. 206, § 17;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1118. Third-Party reimbursement.

§ 1118. Third-Party reimbursement.
Consistent with federal law, 42 U.S.C. § 1395i-3 (c)(5), with respect to admissions policy and practices, a long-term care facility must not require a third-party guarantee or payment to the facility as a condition of admission or expedited admission to, or continued stay in the facility.
71 Del. Laws, c. 488, §  2;  81 Del. Laws, c. 206, § 18;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1119A. Confidentiality of resident records.

§ 1119A. Confidentiality of resident records.
To protect the privacy of residents of a long-term care facility, the Department shall establish guidelines to protect the confidentiality of any records, documents, or files pertaining to such residents.
71 Del. Laws, c. 488, §  2;  81 Del. Laws, c. 206, § 20;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1119B. Pediatric nursing services.

§ 1119B. Pediatric nursing services.
A facility that provides services to a resident younger than 18 years of age shall ensure all of the following:
(1) Nursing services for a resident younger than 18 years of age are provided by staff who have received training and demonstrated competence in the care of children.
(2) Consultative pediatric nursing services are available to the staff.
71 Del. Laws, c. 488, §  2;  81 Del. Laws, c. 206, § 21;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter I. Licensing By The State › § 1119C. Regulations.

§ 1119C. Regulations.
(a) The Department has the authority to adopt, amend, repeal, or issue regulations to implement this chapter. In addition to regulations by category of facility to be licensed, the Department shall also develop pediatric regulations regarding the care of children in long-term care facilities.
(b) The Department shall include in its regulations for all facilities licensed under this chapter a requirement of full cooperation with the protection and advocacy agency in fulfilling functions authorized by this chapter. Without limiting the protection and advocacy's agency's pursuit of other legal remedies, the Department shall enforce violations of such regulations consistent with §§ 1109 and 1113 of this title.
71 Del. Laws, c. 488, §  2;  77 Del. Laws, c. 201, §  5;  81 Del. Laws, c. 206, § 22;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter II. Rights of Residents. › § 1122. Devolution of rights.

§ 1122. Devolution of rights.
Where consistent with the nature of each right in § 1121 of this title, all rights, particularly as they pertain to a resident adjudicated incompetent in accordance with state law, or a resident who is found medically incapable by the resident's own attending physician, or a resident who is unable to communicate with others, shall devolve to the resident's authorized representative, as established under any of the following:
(1) An advance health-care directive.
(2) A medical durable power of attorney for health-care decisions.
(3) A court-appointed guardian pursuant to Chapters 39 and 39A of Title 12, in accordance with the authority granted by the appointing court.
(4) A surrogate appointed under Chapter 25 of this title.
(5) An individual who is otherwise authorized under applicable law to make the health-care decisions being made by execution of the DMOST form on the patient's behalf under Chapter 25A of this title.
(6) A sponsoring agency or representative payee, except where the facility itself is the representative payee, selected under § 205(j) of the Social Security Act (42 U.S.C. § 405(j)).
61 Del. Laws, c. 373, §  2;  70 Del. Laws, c. 186, §  1;  81 Del. Laws, c. 206, § 25;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter II. Rights of Residents. › § 1123. Notice to resident.

§ 1123. Notice to resident.
(a) The Department must prepare a notice that includes § 1121 of this title in its entirety. This notice must be available in a language and format that is accessible to each resident or their authorized representative under § 1122 of this title.
(b) Each long-term care facility must post the notice described in subsection (a) of this section conspicuously in a public area of the facility.
(c) Each long-term care facility must furnish copies of the notice required under subsection (a) of this section to all of the following:
(1) Each resident upon admittance to the facility.
(2) All residents currently residing in the facility.
(3) Each authorized representative under § 1122 of this title.
(d) The long-term care facility must retain in its files a statement signed by each individual listed in subsection (c) of this section that the individual has received a copy of § 1121 of this title.
61 Del. Laws, c. 373, §  2;  81 Del. Laws, c. 206, § 26;  84 Del. Laws, c. 199, § 1;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter II. Rights of Residents. › § 1124. Staff training; issuance of regulations.

§ 1124. Staff training; issuance of regulations.
(a) Each facility shall provide appropriate staff training to implement the bill of rights under § 1121 of this title.
(b) Rules and regulations implementing this subchapter shall be developed by the Department.
61 Del. Laws, c. 373, §  2;  81 Del. Laws, c. 206, § 27;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter II. Rights of Residents. › § 1125. Investigation of grievances.

§ 1125. Investigation of grievances.
(a) The Department shall independently investigate any grievance concerning long-term care facilities.
(b) Upon completion of an investigation, the Department shall report the findings to the complainants and to all other appropriate agencies of the State, county, or municipality as the case may be. If a grievance involves a protection and advocacy agency client, the findings shall be shared with the protection and advocacy agency.
61 Del. Laws, c. 373, §  2;  70 Del. Laws, c. 186, §  1;  77 Del. Laws, c. 201, §  8;  81 Del. Laws, c. 206, § 28;
2023 Delaware Code › Title 16 - Health and Safety › Chapter 11. Long-Term Care Facilities and Services › Subchapter II. Rights of Residents. › § 1126. Recording anatomical gift data.

§ 1126. Recording anatomical gift data.
(a) All long-term care facilities shall, if possible, ascertain from a resident upon admission whether or not the resident has donated all or part of the resident's own body as an anatomical gift in a manner permitted by § 2713 of this title and the person, institution, or organization to which such gift has been made.
(b) All long-term care facilities, as required by regulation, shall maintain as part of a resident's permanent record the information required under this section and such other pertinent information about said anatomical gift which will facilitate the carrying out of the resident's wishes in the event of the resident's death.
(c) Upon the death of a resident who has made an anatomical gift, long-term care facilities shall make every reasonable effort to contact without delay the person, institution, or organization to which such gift has been made.
63 Del. Laws, c. 238, §  2;  70 Del. Laws, c. 186, §  1;  81 Del. Laws, c. 206, § 29;