441—81.51 (249A) Civil money penalties—effective date and duration of penalty.
	 81.51(1) When penalty begins to accrue. The civil money penalty may start accruing as early as the date the facility was first out of compliance, as determined by the department of inspections and appeals.
	 81.51(2) Duration of penalty. The civil money penalty is computed and collectible, as specified in rules 441—81.47(249A) and 441—81.52(249A), for the number of days of noncompliance until the date the facility achieves substantial compliance or, if applicable, the date of termination when:
	  a.   	 The department of inspections and appeals’ decision of noncompliance is upheld after a final administrative decision;
	  b.   	 The facility waives its right to a hearing in accordance with rule 441—81.49(249A); or
	  c.   	 The time for requesting a hearing has expired and the department of inspections and appeals has not received a hearing request from the facility.
	 81.51(3)  Penalty due. The entire accrued penalty is due and collectible, as specified in the notice sent to the provider under subrules 81.51(4) and 81.54(5).
	 81.51(4) Notice after facility achieves compliance. When a facility achieves substantial compliance, the department of inspections and appeals shall send a separate notice to the facility containing:
	  a.   	 The amount of penalty per day;
	  b.   	 The number of days involved;
	  c.   	 The total amount due;
	  d.   	 The due date of the penalty; and
	  e.   	 The rate of interest assessed on the unpaid balance beginning on the due date, as provided in rule 441—81.52(249A).
	 81.51(5) Notice to terminated facility. In the case of a terminated facility, the department of inspections and appeals shall send this penalty information after the:
	  a.   	 Final administrative decision is made;
	  b.   	 Facility has waived its right to a hearing in accordance with rule 441—81.49(249A); or
	  c.   	 Time for requesting a hearing has expired and the department of inspections and appeals has not received a hearing request from the facility.
	 81.51(6) Accrual of penalties when there is no immediate jeopardy.
	  a.   	 In the case of noncompliance that does not pose immediate jeopardy, the daily accrual of civil money penalties is imposed for the days of noncompliance prior to the notice specified in rule 441—81.48(249A) and an additional period of no longer than six months following the last day of the survey.
	  b.   	 After the period specified in paragraph “a,” if the facility has not achieved substantial compliance, the provider agreement may be terminated.
	 81.51(7) Accrual of penalties when there is immediate jeopardy.
	  a.   	 When a facility has deficiencies that pose immediate jeopardy, the provider agreement shall be terminated within 23 calendar days after the last day of the survey if the immediate jeopardy remains.
	  b.   	 The accrual of the civil money penalty stops on the day the provider agreement is terminated.
	 81.51(8) Documenting substantial compliance.
	  a.   	 If an on-site revisit is necessary to confirm substantial compliance and the provider can supply documentation acceptable to the department of inspections and appeals that substantial compliance was achieved on a date preceding the revisit, penalties only accrue until that date of correction for which there is written credible evidence.
	  b.   	 If an on-site revisit is not necessary to confirm substantial compliance, penalties only accrue until the date of correction for which the department of inspections and appeals receives and accepts written credible evidence.