Situation:  Your entity (nursing home, personal care home, assisted living facility, etc.) receives notice from your relevant state department of needed corrections to your facility operations in order to be compliant with relevant state laws.  The state requires you to prepare a Corrective Action Plan (CAP) within fourteen days.  Your facility prepares the CAP and returns it to the state.  The state does not accept your CAP.  It issues a Directed CAP (DCAP) with which you must comply.  You do not agree with the requirements of the DCAP.  Now what?

Potential Issues:  Resources; expense; non-compliance; deficiencies; reputation; operations; sanctions; non-renewal.

Solution:  You must comply with the DCAP.  If you do not, you certainly risk non-renewal of your license.  In Pennsylvania, for example, a personal care home must submit an “acceptable” plan to correct non-compliance.  If the department concludes that a plan is not acceptable, case law supports non-renewal.  See Cites v. Department of Public Welfare, 548 A.2d 1345 (Pa. Cmwlth. 1988) (non-renewing a personal care home license for failure to submit an acceptable plan to correct non-compliance); McFarland v. Department of Public Welfare, 551 A.2d 364 (Pa. Cmwlth. 1988) (failure to file a plan of correction is grounds for non-renewal).

What could have been done differently?  The audit and CAP process should be taken seriously.  The more you invest on the front end, the more likely you will not end up in a DCAP or non-renewal situation.  Truly evaluate the issues of non-compliance raised and propose real and actionable corrections.  Work with the department before you ever get to the point of a DCAP.  Involve legal counsel early who can help to facilitate coordination with the state department and advise on issues, including appeals.