1. (a) Prior to taking enforcement action against an applicant or licensee, the department shall send to the applicant or licensee a written notice that sets forth:

   1. (1) The reasons for the proposed action;
   2. (2) The action to be taken by the department;
   3. (3) If a fine is imposed, the automatic reduction of the fine by 25% if the fine is paid within 10 days of the date on the written notice from the department and the area of non-compliance has been corrected, or a POC has been accepted and approved by the department; and
   4. (4) The right of an applicant or licensee to an administrative hearing in accordance with RSA 151:8 or RSA 541-A:30, III, as applicable, before the enforcement action becomes final.

2. (b) The department shall deny an application or revoke a license if:

   1. (1) An applicant or a licensee violated a provision of RSA 151 or He-P 810 which poses a threat to the health, safety, or well-being of a patient;
   2. (2) An applicant or a licensee has failed to pay an administrative fine imposed by the department;
   3. (3) An applicant or a licensee has had a check returned to the department for insufficient funds and has not re-submitted the outstanding fee in the form of cash, money order, or certified check;
   4. (4) An applicant or licensee fails to submit an application that meets the requirements of He-P 810.05 within 30 days of being notified to supply missing information;

   5. (5) An applicant, licensee, or any representative or employee of the applicant or licensee:

      1. a. Provides false or misleading information to the department;
      2. b. Prevents, interferes, or fails to cooperate with any inspection or investigation conducted by the department; or
      3. c. Fails to provide requested files or documents to the department;
   6. (6) A licensee failed to fully implement or continue to implement a POC that has been accepted or imposed by the department, in accordance with He-P 810.13(c), (d), and (e);
   7. (7) A licensee has submitted a POC that has not been accepted by the department in accordance with He-P 810.13(c)(5) and has not submitted a revised POC as required by He-P 810.13(c)(6);
   8. (8) A licensee is cited a third time under RSA 151 or He-P 810 for the same violation within the last 5 inspections;
   9. (9) A licensee, or its corporate officers or board members, has had a license revoked and submits an application during the 5-year prohibition period specified in (k) below;
   10. (10) Unless a waiver has been granted, upon inspection, the applicant’s premise is not in compliance with RSA 151 or He-P 810;
   11. (11) Unless a waiver has been granted, the department makes a determination that the applicant, administrator, licensee, or a household member has been found guilty of or pled guilty to a felony assault, fraud, theft, abuse, neglect, or exploitation adjudicated and founded by the department or any administrative agency in this or any other state;
   12. (12) The applicant or licensee employs an administrator or medical director who does not meet the qualifications for the position under circumstances in which the department has not granted a waiver; or
   13. (13) The applicant has had a license revoked by any division or unit of the department within 5 years prior to the application.

3. (c) The department shall impose fines as follows:

   1. (1) For failure to cease providing unlicensed services after being notified by the department of the need for a license, in violation of RSA 151:2, the fine for an applicant or unlicensed provider shall be $2000.00;
   2. (2) For failure to cease operations after a denial of a license or after receipt of an order to cease and desist operations immediately, in violation of RSA 151:2 and RSA 541-A:30, the fine for the applicant, unlicensed provider, or licensee shall be $2000.00;
   3. (3) For advertising services or otherwise representing themselves as having a license to provide services that the licensee is not licensed to provide, in violation of RSA 151:2, III, the fine for an applicant, licensee, or unlicensed provider shall be $500.00;
   4. (4) For failure to transfer a patient whose needs exceeds the services or programs provided by the birthing center, in violation of RSA 151:5-a and He-P 810.15(n), the fine for a licensee shall be $500.00;
   5. (5) For acceptance or admission of a patient whose needs exceed the services or programs authorized by the birthing center’s licensing classification, in violation of RSA 151:5-a, II and He-P 810.15(m), the fine for a licensee shall be $1000.00;
   6. (6) For failure to comply with the directives of a warning issued by the department, in violation of RSA 151:7-a and He-P 810.12, the fine for an unlicensed provider or licensee shall be $500.00;
   7. (7) For failure to submit a renewal application for a license prior to the expiration date, in violation of He-P 810.07(b), the fine for the licensee shall be $100.00;
   8. (8) For failure to notify the department prior to a change of ownership, in violation of He-P 810.09(a)(1), the fine for a licensee shall be $500.00;
   9. (9) For failure to notify the department prior to a change in the physical location, in violation of He-P 810.09(a)(2), the fine for a licensee shall be $500.00;
   10. (10) For a failure to notify the department of a change in e-mail address, in violation of He-P 810.09(m), the fine shall be $100.00;
   11. (11) For failure to allow access by the department to a birthing center’s premises, programs, services, patients, or records, in violation of He-P 810.15(q), the fine for an applicant, unlicensed individual, or licensee shall be $2000.00;
   12. (12) For a failure to notify the department prior to a change in the administrator or medical director, in violation of He-P 806.09(j), the fine for a licensee shall be $100.00;
   13. (13) For failure to submit a POC or a revised POC, within 21 or 14 days, respectively, of the date on the letter that transmits the statement of findings or notice to correct, in violation of He-P 810.13(c)(2) or He-P 810.13(c)(6), the fine for a licensee shall be $100.00;
   14. (14) For failure to implement the corrective action set forth in any POC that has been accepted or issued by the department, in violation of He-P 810.13(c)(11), the fine for a licensee shall be $1000.00;
   15. (15) For failure to establish, implement, or comply with licensee policies the fine for a licensee shall be $500.00;
   16. (16) For failure to provide services or programs required by the licensing classification and specified by He-P 810.16(h), the fine for a licensee shall be $500.00;
   17. (17) For exceeding the licensed capacity of the birthing center, in violation of He-P 810.15(o), the fine for a licensee shall be $500.00 per day;
   18. (18) For providing false or misleading information or documentation to the department in violation of He-P 810.15(h), the fine for an applicant or licensee shall be $1,000.00 per offense;
   19. (19) For failure to meet the needs of the patient, in violation of He-P 810.15(k)(2), the fine for a licensee shall be $1,000.00 per patient;
   20. (20) For employing an administrator or other personnel who do not meet the qualifications for the position, in violation of He-P 810.16(a) and He-P 810.16(h), respectively, or under circumstances where the department has not granted a waiver in accordance with He-P 810.11, the fine for a licensee shall be $500.00;
   21. (21) For failure to submit architectural plans or drawings, when applicable, prior to undertaking construction or renovation of the licensed facility, in violation of He-P 810.08(a), the fine for a licensed facility shall be $500.00;
   22. (22) For occupying a renovated area of a licensed facility or a new construction prior to approval by local and state authorities, the fine shall be $500.00 which shall be assessed daily if the facility fails to vacate the renovated area immediately upon receiving notice from the department;

   23. (23) When an inspection determines that a violation of RSA 151 or He-P 810 has the potential to jeopardize the health, safety, or well-being of a patient, in addition to any other enforcement actions taken by the department, the fines assessed shall be as follows:

       1. a. If the same area of non-compliance is cited within 2 years of the original area of non-compliance the fine for a licensee shall be double the original fine, but not exceed $1000.00; and
       2. b. If the same area of non-compliance is cited for a third time within 2 years of being fined in a. above, the fine for a licensee shall be $2000.00; and
   24. (24) Each day that the individual or licensee continues to be in violation of the provisions of RSA 151 or He-P 810 shall constitute a separate violation and shall be fined provided that if the applicant or licensee is making good faith efforts to comply with the provisions of RSA 151 or He-P 810, as verified by documentation or other means, the department shall not issue a daily fine.

4. (d) Payment of any imposed fine to the department shall meet the following requirements:

   1. (1) Payment shall be made in the form of check or money order made payable to the “Treasurer, State of New Hampshire” or cash in the exact amount due; and
   2. (2) Cash, money order, or certified check shall be required when an applicant or licensee has issued payment to the department by check, and such check was returned for insufficient funds.
5. (e) An applicant or licensee shall have 10 days after receipt of the notice of enforcement action to request a hearing to contest the action.
6. (f) If a written request for a hearing is not made pursuant to (e) above, the action of the department shall become final.
7. (g) The department shall order the immediate suspension of a license and the cessation of operations when it finds that the health, safety, or welfare of a patient is in jeopardy and emergency action is required, in accordance with RSA 541-A:30, III.
8. (h) If an immediate suspension is upheld, the licensee shall not resume operating until the department determines through inspection that compliance with RSA 151 and He-P 810 is achieved.
9. (i) Hearings and appeals of department decisions under this section shall be conducted in accordance with RSA 541-A and He-C 200.
10. (j) RSA 541 shall govern further appeals of department decisions under this section.
11. (k) When a birthing center’s license has been denied or revoked, the applicant, licensee, administrator, or medical director shall not be eligible to reapply for a license, or be employed as an administrator or medical director for at least 5 years, if the enforcement action specifically pertained to their role in the birthing center.

12. (l) The 5-year period referenced in (k) above shall begin on:

    1. (1) The date of the department’s decision to revoke or deny the license, if no appeal is filed; or
    2. (2) The date a final decision upholding the action of the department is issued, if a request for a hearing is made and a hearing was held.
13. (m) Notwithstanding (k) above, the department shall consider an application submitted after the decision to revoke or deny becomes final, if the applicant demonstrates that circumstances have changed to the extent that the department now has good cause to believe that the applicant has the requisite degree of knowledge, skills, and resources necessary to maintain compliance with the provisions of RSA 151 and He-P 810.
14. (n) If the department has reasonable information or evidence that a licensee, applicant, administrator, or others are circumventing (k) above by applying for a license through an agent or other individual and will retain ownership, management authority, or both, the department shall deny the application.
15. (o) No ongoing enforcement action shall preclude the imposition of any remedy available to the department under RSA 151, RSA 541-A, or He-P 810.

Source. #8957, eff 7-27-07, EXPIRED: 7-27-15 New. #11039, INTERIM, eff 2-24-16, EXPIRES: 8-22-16; ss by #11161, eff 8-20-16; ss by #14074, eff 9-20-24, EXPIRES: 9-20-34 (formerly He-P 810.13)