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The Division of Health Care Quality is authorized to impose a number of different enforcement actions when individuals, agencies, or facilities are in violation of laws or regulations regarding long term care services.

Adult Abuse Registry Law

The Division can place a person on the Adult Abuse Registry for periods ranging from one year to life if an allegation of abuse, neglect, mistreatment, and/or financial exploitation of a long term care resident is substantiated.

The Division can impose civil money penalties against an employer for failing to request and receive an Adult Abuse Registry check for a job applicant. Penalties can be from $1,000 to $5,000 for each violation.

The website for the Adult Abuse Registry Law (Delaware Code, Title 11, Chapter 85, Section 8564, cited as 11 Del.C., §8564 ) in Online Delaware Code is:

When there, either follow the link to this section at the top of the web page or scroll down to §8564.)

Criminal Background Check Law

The Division can impose civil money penalties of $1,000 to $5,000 per occurrence for violations of the Criminal Background Check Law (16 Del. C., §§1141, 1142, 1145, & 1146).

The website for Sections 1141 and 1142 is:

The website for Sections 1145 and 1146 is:

State Resident/Patient Abuse and Neglect Law

The Division can impose civil money penalties of $1,000 to $5,000 per occurrence for violations of the Delaware law regarding abuse, neglect, mistreatment, or financial exploitation of residents or patients, according to 16 Del. C., §1136.

The website pertaining to violations of the Resident/Patient Abuse and Neglect Law is:

State and Federal Laws and Regulations regarding Nursing Homes/Facilities

The Division is responsible for imposing State enforcement actions and for recommending to the Centers for Medicare & Medicaid Services (CMS) Federal enforcement actions to be imposed for non-compliance with State and Federal long term care (nursing home) regulations.

State Enforcement Actions

State enforcement actions (16 Del. C., §§1109 & 1113) that can be imposed include the following:

  • Civil money penalty of $1,000-$10,000 per violation
  • State monitoring of the nursing facility
  • Suspension of the admission or readmission of residents to the nursing facility
  • Selective transfer of residents whose care needs are not being met
  • In cases in which the physical health or safety of residents is in imminent risk, issuance of an emergency order temporarily transferring the management of the facility to another qualified entity.

The website for Section 1109 is:

The website for Section 1113 is:

Federal Enforcement Actions

Federal enforcement actions (Code of Federal Regulations, Chapter IV, Part 488, Subpart F, cited as 42CFR488, Subpart F) that can be imposed include the following:

  • Temporary management (Section 415, cited as §488.415)
  • Denial of payments for new admissions (Section 417)
  • Denial of payments for all individuals (Section 418)
  • State monitoring of the nursing facility (Section 422)
  • Directed plan of correction (Section 424)
  • Directed in-service training by an outside agency (Section 425)
  • Transfer of residents, or closure of the facility and transfer of residents (Section 426)
  • Civil money penalties (Section 430)
  • Termination of the provider agreement (Section 456).

This website for 42CFR488, Subpart F gives the Text file/version of the regulations.