(e) Midnight census data. Should a nursing facility fail to submit midnight census data to the division within the time specified in Acts 2001, No. 635, the following sanctions shall be imposed:

1. (1) If the midnight census data is not received within ten (10) days after the date on which the data must be postmarked for transmission to the division, the division shall issue a letter of caution to the nursing facility;

2. (2) If the midnight census data is not received within twenty (20) days after the date on which the data must be postmarked for transmission to the division, the nursing facility shall be deemed to be in noncompliance with Acts 2001, No. 635, and the nursing facility shall be fined at least ten thousand dollars ($10,000) but no more than twenty thousand dollars ($20,000), such amount to be dependent upon the number of times the nursing facility has been found to be in noncompliance with the midnight census data reporting requirement of Acts 2001, No. 635, within the twelve (12) months immediately preceding the date of noncompliance:

   1. (A) First finding of noncompliance, ten thousand dollars ($10,000);
   2. (B) Second finding of noncompliance, fifteen thousand dollars ($15,000); and
   3. (C) Third finding of noncompliance, twenty thousand dollars ($20,000); and
3. (3) Failure to provide midnight census data on four (4) or more occasions within any twelve-month period will result in the division directing the Office of Long-Term Care to suspend a nursing facility’s license to operate for a period of not less than thirty (30) days and not more than ninety (90) days, such period to be determined by the Director of the Division of Medical Services.

(f) Gross receipts data. Should a nursing facility fail to submit gross receipts data to the division within the time specified in Acts 2001, No. 635, the following sanctions shall be imposed:

1. (1) If the gross receipts data is not received within ten (10) days after the date on which the data must be postmarked for transmission to the division, the division shall issue a letter of caution to the nursing facility;

2. (2) If the gross receipts data is not received within twenty (20) days after the date on which the data must be postmarked for transmission to the division, the nursing facility shall be deemed to be in noncompliance with Acts 2001, No. 635, and the nursing facility shall be fined at least ten thousand dollars ($10,000) but no more than twenty thousand dollars ($20,000), such amount to be dependent upon the number of times the nursing facility has been found to be in noncompliance with the gross receipts data reporting requirement of Acts 2001, No. 635, within the twelve (12) months immediately preceding the date of noncompliance:

   1. (A) First finding of noncompliance, ten thousand dollars ($10,000);
   2. (B) Second finding of noncompliance, fifteen thousand dollars ($15,000);
   3. (C) Third finding of noncompliance, twenty thousand dollars ($20,000); and
3. (3) Failure to provide gross receipts data on four (4) or more occasions within any twelve-month period will result in the division directing the office to suspend a nursing facility’s license to operate for a period of not less than thirty (30) days and not more than ninety (90) days, such period to be determined by the director.

(g) Payment of quality assurance fee. Should a nursing facility fail to pay any quality assurance fee to the division, the following sanctions shall be imposed upon that nursing facility:

1. (1)

   1. (A) If the quality assurance fee is not received within ten (10) days of the date it is due to the division, the nursing home shall be deemed to be in noncompliance with Acts 2001, No. 635.
   2. (B) The Department of Human Services will assess a fine on any nursing facility found to be in noncompliance with its obligation to remit this fee to the division, and the nursing facility shall be fined at least ten thousand dollars ($10,000) but no more than twenty thousand dollars ($20,000), such amount to be dependent upon the number of times the nursing facility has been found to be in noncompliance with the obligation to remit imposed fees to the division within the twelve (12) months immediately preceding the date of noncompliance:

(i) First finding of noncompliance, ten thousand dollars ($10,000);

1. (ii) Second finding of noncompliance, fifteen thousand dollars ($15,000);

   1. (iii) Third finding of noncompliance, twenty thousand dollars ($20,000); and
2. (2) Failure to pay the quality assurance fee within the time specified by this part on four (4) or more occasions within any twelve-month period will result in the division directing the office to suspend a nursing facility’s license to operate for a period of not less than thirty (30) days and not more than ninety (90) days, such period to be determined by the director.

(h) Procedures for reinstatement of license. Should a license for a nursing facility be suspended under the terms of this part, except for those suspensions provided for in subsection (i) of this section, the license will be reinstated upon full payment of all fines, fees, interest, or other charges imposed by the division, along with a showing, to the division’s satisfaction, that measures are in place to ensure future compliance with Acts 2001, No. 635.

1. (i) Procedures for chronic violations.
2. (1) Any facility that is in noncompliance on six (6) or more occasions in any twelve-month period with any obligation imposed by Acts 2001, No. 635, as implemented in this part, shall be deemed to be a chronic violator of Acts 2001, No. 635, and a threat to the safety of Arkansans in nursing facilities.
3. (2) Any nursing facility found to a chronic violator of Acts 2001, No. 635, shall have its license suspended by the office and such license will be reinstated only after the nursing facility complies with the requirements of Acts 2001, No. 635, including payment of all applicable fees, fines, interest or other sanction and adopts measures that, to the satisfaction of the division, will ensure future compliance with Acts 2001, No. 635.
4. (3) After the adoption of these measures and satisfaction of all sanctions, the license for the nursing facility shall be reinstated.
5. (4) Any subsequent violation of Acts 2001, No. 635, by a nursing facility within twelve (12) months after its license is reinstated pursuant to the procedures set forth in this subsection will result in a suspension of the nursing facility’s license by the office for a period of not less that ninety (90) days and no more than one hundred eighty (180) days, such duration to be determined by the director and such license shall be reinstated only for good cause shown.

(k) Recoupment provisions.

1. (1) The division may withhold from a licensee’s vendor payment any amount owed the Medicaid program as a result of an imposed fine for noncompliance as detailed in subsections (e), (f), and (g) of this section, or any quality assurance fee not paid by the due date.
2. (2) For purposes of this section, a fine is considered imposed once the division notifies the licensee of the fine and the licensee has an opportunity to appeal the fine.