(a)    If a deficiency exists, the Secretary may impose sanctions that include:

(1)    A directed plan of correction with corrective measures necessary to protect residents;

(2)    Imposing adequate staffing levels in a nursing home;

(3)    Appointing a State monitor subject to § 19-1405 of this subtitle; and

(4)    Imposing a civil money penalty.

(b)    A civil money penalty may be imposed when a deficiency exists or an ongoing pattern of deficiencies exists in a nursing home.

(c)    In determining whether a civil money penalty is to be imposed, the Secretary shall consider, pursuant to guidelines set forth in regulations promulgated by the Secretary, the following factors:

(1)    The number, nature, and seriousness of the deficiencies;

(2)    The extent to which the deficiency or deficiencies are part of an ongoing pattern during the preceding 24 months;

(3)    The degree of risk to the health, life, or safety of the residents of the nursing home caused by the deficiency or deficiencies;

(4)    The efforts made by, and the ability of, the nursing home to correct the deficiency or deficiencies; and

(5)    A nursing home’s prior history of compliance.

(d)    Upon determination by the Department that a deficiency or deficiencies exist, the Department shall notify the nursing home that:

(1)    Unless corrective action taken pursuant to this section is substantially completed, a civil money penalty will be imposed; or

(2)    An order imposing a civil money penalty will be issued, pursuant to § 19-1403 of this subtitle which shall include a list of all deficiencies and notice that a civil money penalty may be imposed until the time that the cited deficiencies have been rectified.