in-20260527-IR-410260014FRA: CIVIL PENALTIES

TITLE 410 INDIANA DEPARTMENT OF HEALTH Final Rule LSA Document #26-14 DIGEST CIVIL PENALTIES Amends 410 IAC 15 and 410 IAC 16.2 regarding civil penalties for hospitals, comprehensive care facilities, and residential care facilities. Effective 30 days after filing with the publisher. HISTORY Notice of First Public Comment Period: 20260121-IR-410260014FNA Regulatory Analysis submitted with Notice of First Public Comment Period: 20260121-IR-410260014RAA Date of First Hearing: February 24, 2026 SUMMARY/RESPONSE TO COMMENTS The Indiana Department of Health (IDOH) requested public comment from January 21, 2026, through February 20, 2026, and during the public hearing on February 24, 2026. IDOH received no comments in response to the Notice of First Public Comment Period or at the public hearing. FINAL RULE 410 IAC 15-1.3-3 Suspension or revocation of license Sec. 3. (a) The commissioner may take any of the following actions on any of the grounds listed in subsection (b): (b) The commissioner may take action under subsection (a) on any of the following grounds: (c) In determining the seriousness of a violation and the specific amount of the civil penalty to be sought for each violation, the commissioner may consider the following: (c) (d) IC 4-21.5 applies to an action under this section. (d) A licensee or an applicant for a license aggrieved by an action under this rule may request review under IC 4-21.5. (e) The Indiana department of health shall appoint an appeals panel consisting of three (3) members as follows: (f) An employee of the department may not be a member of the panel. (g) The panel shall conduct proceedings for review of an order issued by an administrative law judge under this rule. The panel is the ultimate authority under IC 4-21.5. 410 IAC 16.2-3.1-2 Licenses Sec. 2. (a) Any A person, in order to lawfully operate a health facility as defined in IC 16-18-2-167, shall first obtain an authorization to occupy the facility or a license from the director. The applicant shall notify the director, in writing, before the applicant begins to operate a facility that is being purchased or leased from another licensee. Failure to notify the director precludes the issuance of a full license. (b) The director may approve occupancy and use of the a structure pending a final licensure decision. (c) The director may issue a health facility license for a new facility upon receipt, review, and approval of the following requirements: (d) The director may issue a health facility license for an existing facility that proposes a change from a previously approved plan review upon receipt, review, and approval of the following requirements: (e) The director may issue a health facility license for an existing facility that proposes a change in beds upon receipt, review, and approval of the following requirements: (f) The director may issue a health facility license for a facility that has changed ownership upon receipt, review, and approval of the following requirements: (g) The director may issue a provisional license to a new facility or to a facility under new ownership in accordance with IC 16-28-2-4(2). (h) For the renewal of a license, the director may issue a full license for any period up to one (1) year, issue a probationary license, or deny a license application upon receipt and review of the following requirements: (i) If the director issues a probationary license, the license may be granted for a period of three (3) months. However, no not more than three (3) probationary licenses may be issued in a twelve (12) month period. Although the license fee for a full twelve (12) month period has been paid, a new fee shall be is required prior to the issuance of before a probationary license is issued. (j) Any A change in direct or indirect corporate ownership of at least five percent (5%) or more that occurs during the licensure period shall must be reported to the director, in writing, at the time of the change. The facility must shall also provide written notice at the time the change occurs in the officers, directors, agents, or managing employees, or the corporation, association, or other company responsible for the management of managing the facility. (k) For a good cause shown, waiver of any nonstatutory provisions of this rule may be granted by the executive board for a specified period in accordance with IC 16-28-1-10. (l) A licensure survey finding or complaint allegation does not constitute a breach for the purposes of IC 16-28-2 until or unless the commissioner makes a specific determination that a breach has occurred. Moreover, the director shall issue a citation only upon on a determination by the commissioner that a breach has occurred. Regardless of whether the commissioner makes a determination that a breach has occurred, a licensure survey finding or complaint allegation may be used as evidence as to whether a violation actually occurred for the purposes of licensure hearings or any other proceedings initiated under IC 16-28-2 or this article. (m) The classification of rules into the categories that are stated at the end of each section of this rule and 410 IAC 16.2-5 through 410 IAC 16.2-7 shall be are used to determine the corrective actions and penalties, if appropriate, to be imposed by the commissioner upon on a determination that a breach has occurred, as follows: (n) For Medicare or Medicaid certified facilities, or both, the department shall not collect both a civil money penalty under 42 CFR 488 and a fine under IC 16-28 and this article. (n) In determining the seriousness of a violation and the specific amount of the civil penalty to be sought for each violation, the department may consider the following: (o) For Medicare or Medicaid certified facilities, or both, the department may not collect both a civil money penalty under 42 CFR 488 and a fine under IC 16-28 and this article. 410 IAC 16.2-5-1.1 Licenses Sec. 1.1. (a) Any A person, in order to lawfully operate a health facility as defined in IC 16-18-2-167, shall first obtain an authorization to occupy the facility or a license from the director. The applicant shall notify the director, in writing, before the applicant begins to operate a facility that is being purchased or leased from another licensee. Failure to notify the director precludes the issuance of a full license. (b) The director may approve occupancy and use of the a structure pending a final licensure decision. (c) The director may issue a health facility license for a new facility upon receipt, review, and approval of the following requirements: (d) The director may issue a health facility license for an existing facility that proposes a change from a previously approved plan review upon receipt, review, and approval of the following requirements: (e) The director may issue a health facility license for an existing facility that proposes a change in beds upon receipt, review, and approval of the following requirements: (f) The director may issue a health facility license for a facility that has changed ownership upon receipt, review, and approval of the following requirements: (g) The director may issue a provisional license to a new facility or to a facility under new ownership in accordance with IC 16-28-2-4(2). (h) For the renewal of a license, the director may issue a full license for any period up to one (1) year, issue a probationary license, or deny a license application upon receipt and review of the following requirements: (i) If the director issues a probationary license, the license may be granted for a period of three (3) months. However, no not more than three (3) probationary licenses may be issued in a twelve (12) month period. Although the license fee for a full twelve (12) month period has been paid, a new fee shall be is required prior to the issuance of before a probationary license is issued. (j) Any A change in direct or indirect corporate ownership of at least five percent (5%) or more that occurs during the licensure period shall must be reported to the director, in writing, at the time of the change. The facility must shall also provide written notice at the time the change occurs in the officers, directors, agents, or managing employees, or the corporation, association, or other company responsible for the management of managing the facility. (k) For a good cause shown, waiver of any nonstatutory provisions of this rule may be granted by the executive board for a specified period in accordance with IC 16-28-1-10. (l) A licensure survey finding or complaint allegation does not constitute a breach for the purposes of IC 16-28-2 until or unless the commissioner makes a specific determination that a breach has occurred. Moreover, the director shall issue a citation only upon on a determination by the commissioner that a breach has occurred. Regardless of whether the commissioner makes a determination that a breach has occurred, a licensure survey finding or complaint allegation may be used as evidence as to whether a violation actually occurred for the purposes of licensure hearings or any other proceedings initiated under IC 16-28-2 or this article. (m) The classification of rules into the categories that are stated at the end of each section of this rule and 410 IAC 16.2-6 through 410 IAC 16.2-7 shall be are used to determine the corrective actions and penalties, if appropriate, to be imposed by the commissioner upon on a determination that a breach has occurred as follows: (n) In determining the seriousness of a violation and the specific amount of the civil penalty to be sought for each violation, the department may consider the following: LSA Document #26-014 Notice of First Public Comment Period: January 21, 2026 Last Hearing Held: February 24, 2026 Approved by Attorney General: April 29, 2026 Approved by Governor: April 29, 2026 Filed with Publisher: May 1, 2026, 2:32 p.m. Documents Incorporated by Reference: None Received by Publisher Small Business Regulatory Coordinator: Ann Knotek, Staff Attorney, 2 North Meridian Street, Indianapolis, IN 46204, (317) 233-7874, aknotek@health.in.gov