42 CFR § 488.434 - Civil money penalties: Notice of penalty.

---
identifier: "/us/cfr/t42/s488.434"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 488.434 - Civil money penalties: Notice of penalty."
title_number: 42
title_name: "Public Health"
section_number: "488.434"
section_name: "Civil money penalties: Notice of penalty."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "G"
subchapter_name: "STANDARDS AND CERTIFICATION"
part_number: "488"
part_name: "SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES"
positive_law: false
currency: "2026-03-24"
last_updated: "2026-03-24"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C 1302 and 1395hh."
regulatory_source: "53 FR 22859, June 17, 1988, unless otherwise noted."
cfr_part: "488"
---


# 488.434 Civil money penalties: Notice of penalty.

(a) *CMS notice of penalty.* (1) CMS sends a written notice of the penalty to the facility for all facilities except non-State operated NFs when the State is imposing the penalty.

(2) *Content of notice.* The notice that CMS sends includes—

(i) The nature of the noncompliance;

(ii) The statutory basis for the penalty;

(iii) Either the amount of penalty per day of noncompliance or the amount of the penalty per instance of noncompliance or both;

(iv) Any factors specified in § 488.438(f) that were considered when determining the amount of the penalty;

(v) The date(s) of the instance(s) of noncompliance or the date on which the penalty begins to accrue;

(vi) When the penalty stops accruing, if applicable;

(vii) When the penalty is collected; and

(viii) Instructions for responding to the notice, including a statement of the facility's right to a hearing, and the implication of waiving a hearing, as provided in § 488.436.

(b) *State notice of penalty.* (1) The State must notify the facility in accordance with State procedures for all non-State operated NFs when the State takes the action.

(2) The State's notice must—

(i) Be in writing; and

(ii) Include, at a minimum, the information specified in paragraph (a)(2) of this section.

[59 FR 56243, Nov. 10, 1994; 60 FR 50119, Sept. 28, 1995, as amended at 64 FR 13360, Mar. 18, 1999; 89 FR 64163, Aug. 6, 2024]