APPROVED CHAPTER
JUNE 12, 2025 305
BY GOVERNOR PUBLIC LAW
STATE OF MAINE
_____
IN THE YEAR OF OUR LORD
TWO THOUSAND TWENTY-FIVE
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S.P. 768 - L.D. 1961
An Act to Clarify the Laws Relating to the Licensure of Certain Facilities by
the Department of Health and Human Services
Be it enacted by the People of the State of Maine as follows:
PART A
Sec. A-1. 22 MRSA §1717, sub-§2-C, ¶C, as enacted by PL 2023, c. 309, §7, is
amended to read:
C. A conditional license for a personal care agency with a provisional or a full license
that fails to comply with applicable laws and rules when, in the judgment of the
commissioner, issuing a conditional license is in the best interest of the public. The
conditional license must specify what corrections the personal care agency is required
to make during the term of the conditional license and a timeline for those corrections.
The conditional license may be issued for a period of time not more than 12 months or
the remaining period of the personal care agency's full license, whichever the
commissioner determines is appropriate considering the laws and rules violated. A
conditional license may be issued to an agency upon initial application if the agency
has failed to comply with applicable laws and rules while operating under another
license.
Sec. A-2. 22 MRSA §1813, 3rd ¶, as enacted by PL 1997, c. 488, §1, is amended
to read:
For nursing facilities providing both nursing home facility and assisted living housing
services, the department shall issue one license reflecting both levels of care. The
commissioner shall adopt rules to implement this paragraph. Rules adopted pursuant to
this paragraph are routine technical rules as defined by Title 5, chapter 375, subchapter
II‑A 2-A.
Sec. A-3. 22 MRSA §7701, sub-§2, as amended by PL 2001, c. 645, §2, is further
amended to read:
2. Facility. As used in this subtitle, the word "facility" means any of the places
described in section 7801 or defined in section 8001, 8101, 8201 or 8301‑A, subsection
1‑A, paragraph B.
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 Sec. A-4. 22 MRSA §7802, sub-§1, ¶C, as enacted by PL 1983, c. 386, §2, is
amended to read:
C. A conditional license or approval may be issued by the department when the
individual or agency fails to comply with applicable law laws and rules and, in the
judgment of the commissioner, the best interest of the public would be so served by
issuing a conditional license or approval. The conditional license or approval shall
must specify when and what corrections must be made during the term of the
conditional license or approval. A conditional license or approval may be issued upon
initial application to an individual or agency that has failed to comply with applicable
laws and rules while operating under another license.
Sec. A-5. 22 MRSA §7852, sub-§6, as amended by PL 2023, c. 176, §14, is further
amended to read:
6. Independent housing with services program. "Independent housing with services
program" means a program of supportive services provided to residents in private
apartments who receive that receives funds through a written agreement with the
department's office of aging and disability services.
Sec. A-6. 26 MRSA §683, sub-§1, ¶B, as amended by PL 2011, c. 657, Pt. AA,
§72, is repealed.
Sec. A-7. 34-B MRSA §1203-A, sub-§2, ¶A, as enacted by PL 1989, c. 227, §1,
is amended to read:
A. The commissioner may issue a conditional license to an agency or facility applying
or reapplying for a provisional or full license, if:
(1) The applicant fails to comply with applicable laws and rules; and
(2) In the judgment of the commissioner, the best interests of the public would be
served by issuance of a conditional license.
Sec. A-8. 34-B MRSA §1203-A, sub-§5, as enacted by PL 1989, c. 227, §1, is
amended to read:
5. Monitoring for compliance. Regardless of the term of the license, the
commissioner shall monitor the licensee, at least once a year every 2 years, for continued
compliance with applicable laws and rules.
Sec. A-9. 34-B MRSA §1203-B, sub-§4, ¶A, as enacted by PL 2023, c. 89, §7, is
amended to read:
A. The department may issue a conditional license to an agency applying for or
renewing a provisional or full license if:
(1) The applicant fails to comply with applicable laws and rules; and
(2) In the judgment of the department, the best interests of the public would be
served by issuance of a conditional license.
PART B
Sec. B-1. 22 MRSA §8752, sub-§1, as amended by PL 2009, c. 358, §1, is further
amended to read:
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 1. Division. "Division" means the Department of Health and Human Services,
Division of Licensing and Regulatory Services department's division of licensing and
certification.
Sec. B-2. 22 MRSA §8752, sub-§2, as amended by PL 2011, c. 542, Pt. A, §48, is
repealed and the following enacted in its place:
2. Health care facility. "Health care facility" or "facility" means a general or specialty
hospital including all facilities under the hospital's license, an ambulatory surgical facility,
an end-stage renal disease facility and a state institution as defined under Title 34‑B,
chapter 1, except that it does not include a facility licensed as a nursing facility or licensed
under chapter 1664.
Sec. B-3. 22 MRSA §8752, sub-§3-A, as enacted by PL 2009, c. 358, §1, is
repealed.
Sec. B-4. 22 MRSA §8752, sub-§4-A, as enacted by PL 2009, c. 358, §1, is
amended to read:
4-A. Sentinel event. "Sentinel event" means:
A. An unanticipated death, or patient transfer to another health care facility, unrelated
to the natural course of the patient's illness or underlying condition or proper treatment
of that illness or underlying condition in a health care facility;
B. A major permanent loss of function unrelated to the natural course of the patient's
illness or underlying condition or proper treatment of that illness or underlying
condition in a health care facility that is present at the time of the discharge of the
patient or that occurs within 48 hours of treatment. If within 2 weeks of discharge from
the facility, evidence is discovered that the major loss of function was not permanent,
the health care facility is not required to submit a report pursuant to section 8753,
subsection 2;
C. An unanticipated perinatal death or major permanent loss of function in an infant
with a birth weight over 2,500 grams that is unrelated to the natural course of the
infant's or mother's illness or underlying condition or proper treatment of that illness
or underlying condition in a health care facility; and
C-1. The suicide of a patient within 48 hours of receiving health care services in a
health care facility; and
D. Other serious and preventable events as identified by using the most recent version
of a nationally recognized quality forum and determined in rules adopted by the
department pursuant to section 8756.
Sec. B-5. 22 MRSA §8753, sub-§1, as amended by PL 2009, c. 358, §2, is repealed
and the following enacted in its place:
1. Notification. Using the sentinel event notification process under this chapter, a
health care facility shall notify the division of a sentinel event within 3 business days after
the facility discovers that the event occurred.
Sec. B-6. 22 MRSA §8753, sub-§2, as amended by PL 2009, c. 358, §2, is further
amended to read:
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 2. Reporting Written report. The health care facility shall file a written report no
later than 45 days following the notification of the occurrence of a sentinel event pursuant
to subsection 1. The written report must be signed by the chief executive officer of the
facility and must contain the following information:
A. Facility name and address;
B. Name, title and phone number of the contact person for the facility;
C. The date and time of the sentinel event and the sentinel event case number;
D. The type of sentinel event and a brief description timeline of the sentinel event; and
H. A thorough and credible root cause analysis. A root cause analysis is thorough and
credible only in accordance with the following.
(1) A thorough root cause analysis must include: a determination of the human
and other factors most directly associated with the sentinel event and the processes
and systems related to its occurrence; an analysis of the underlying systems and
processes to determine where redesign might reduce risk; an inquiry into all areas
appropriate to the specific type of event; an identification of risk points and their
potential contributions to the event; a determination of potential improvement in
processes or systems that would tend to decrease the likelihood of such an event in
the future or a determination, after analysis, that no such improvement
opportunities exist; an action plan that identifies changes that can be implemented
to reduce risks or formulates a rationale for not undertaking such changes; and,
where improvement actions are planned, an identification of who is responsible for
implementation, when the action will be implemented and how the effectiveness
of the action will be evaluated.
(2) A credible root cause analysis must include participation by the leadership of
the health care facility and by the individuals most closely involved in the
processes and systems under review, is internally consistent without contradictions
or unanswered questions, provides an explanation for all findings, including those
identified as "not applicable" or "no problem," and includes the consideration of
any relevant literature.
(3) The root cause analysis submitted to the division may exclude protected
professional competence review information pursuant to the Maine Health Security
Act.
Sec. B-7. 22 MRSA §8753, sub-§4, as amended by PL 2009, c. 358, §2, is further
amended to read:
4. Immunity. A person who in good faith reports a near miss, a suspected sentinel
event or a sentinel event or provides a root cause analysis pursuant to this chapter is immune
from any civil or criminal liability for the act of reporting or participating in the review by
the division. "Good faith" does not include instances when a false report is made and the
person reporting knows the report is false. This subsection may not be construed to bar
civil or criminal action regarding perjury or regarding the sentinel event that led to the
report.
Sec. B-8. 22 MRSA §8753, sub-§5, as enacted by PL 2009, c. 358, §2, is repealed.
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 Sec. B-9. 22 MRSA §8754, sub-§1, as amended by PL 2009, c. 358, §4, is further
amended to read:
1. Initial review; other action. Upon receipt of a notification or report of a sentinel
event, the division shall complete an initial review and may take such other action as the
division determines to be appropriate under applicable rules and within the jurisdiction of
the division. Upon receipt of a notification or report of a suspected sentinel event the
division shall determine whether the event constitutes a sentinel event and complete an
initial review and may take such other action as the division determines to be appropriate
under applicable rules and within the jurisdiction of the division. The division may conduct
on-site reviews of request medical records and may retain the services of consultants when
necessary to the division.
A. The division may conduct on-site visits to health care facilities to determine
compliance with this chapter.
B. Division personnel responsible for sentinel event oversight shall report to the
division's licensing section only incidences of immediate jeopardy and each condition
of participation in the federal Medicare program related to the immediate jeopardy for
which the provider is out of compliance.
Sec. B-10. 22 MRSA §8754, sub-§4, as amended by PL 2009, c. 358, §6, is further
amended to read:
4. Report. The division shall submit an annual report by February April 1st each year
to the Legislature, health care facilities and the public that includes summary data of the
number and types of sentinel events of the prior calendar year by type of health care facility,
rates of change and other analyses and an outline of areas to be addressed for the upcoming
year.
Sec. B-11. 22 MRSA §8755, sub-§1, as enacted by PL 2009, c. 358, §7, is amended
to read:
1. Oversight. The division shall place primary emphasis on ensuring effective
corrective action by the facility. The division may conduct on-site visits to health care
facilities to determine compliance with this chapter.
PART C
Sec. C-1. 22 MRSA §1812-G, sub-§2-C, as amended by PL 2023, c. 241, §7 and
c. 309, §24, is repealed and the following enacted in its place:
2-C. Registry notations. The registry must include for a certified nursing assistant, a
direct care worker and an immediate supervisor listed on the registry a notation of:
A. Disqualifying criminal convictions;
B. Nondisqualifying criminal convictions, except that a notation is not required on the
registry for Class D and Class E criminal convictions over 10 years old that did not
involve as a victim of the act a patient, client or resident; and
C. Substantiated findings, including but not limited to the following information:
(1) Documentation of an investigation of the certified nursing assistant, direct care
worker or immediate supervisor, including the nature of the allegation and
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 evidence supporting a determination that substantiates the allegation of abuse,
neglect or misappropriation of property of a client, patient or resident;
(2) Documentation of substantiated findings of abuse, neglect or misappropriation
of property of a client, patient or resident;
(3) If the certified nursing assistant, direct care worker or immediate supervisor
appealed the substantiated finding, the date of the hearing; and
(4) The statement of the certified nursing assistant, direct care worker or
immediate supervisor disputing the allegation of abuse, neglect or
misappropriation of property of a client, patient or resident if the certified nursing
assistant, direct care worker or immediate supervisor submitted such a statement.
Sec. C-2. 22 MRSA §1812-G, sub-§3-B, as enacted by PL 2023, c. 241, §9, is
amended to read:
3-B. Petition for removal of a substantiated finding of neglect or
misappropriation of property. No sooner than 12 months after the date a substantiated
finding of neglect or misappropriation of property is placed on the registry, a direct care
worker may petition the department to remove the notation from the registry if the
substantiated complaint finding is a one-time occurrence and there is no pattern of neglect
or misappropriation of property.
Sec. C-3. 22 MRSA §1812-G, sub-§4, as amended by PL 2023, c. 241, §10 and
c. 309, §25, is repealed and the following enacted in its place:
4. Department verification of credentials and training. The department may verify
the credentials and training of certified nursing assistants listed on the registry.
Sec. C-4. 22 MRSA §1812-G, sub-§4-A, as amended by PL 2023, c. 241, §11 and
c. 309, §26, is repealed and the following enacted in its place:
4-A. Provider verification fee. The department may establish a provider verification
fee not to exceed $25 annually per provider for verification of a certified nursing assistant's
credentials and training. Providers may not pass the cost on to the individual certified
nursing assistant. Provider verification fees collected by the department must be placed in
a special revenue account to be used by the department to operate the registry, including
but not limited to the cost of criminal history record checks. The department may adopt
rules necessary to implement this subsection. Rules adopted pursuant to this subsection are
routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.
Sec. C-5. 22 MRSA §1812-G, sub-§6, as amended by PL 2023, c. 241, §13 and
c. 309, §27, is repealed and the following enacted in its place:
6. Prohibited employment based on disqualifying offenses. An individual with a
disqualifying offense, including a substantiated finding or a disqualifying criminal
conviction, may not work as a certified nursing assistant, a direct care worker or an
immediate supervisor, and an employer is subject to penalties for employing a disqualified
or otherwise ineligible person in accordance with applicable federal or state laws.
Sec. C-6. 22 MRSA §1812-G, sub-§6-A, as amended by PL 2023, c. 241, §14 and
c. 309, §28, is repealed and the following enacted in its place:
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 6-A. Background check. Certified nursing assistants, direct care workers and
immediate supervisors are subject to a background check as defined by rules adopted by
the department and according to the following:
A. A training program for certified nursing assistants or direct care workers must
secure or pay for a background check on each individual who applies for enrollment.
The individual's current name and all previous names are