(a) In lieu of demanding payment of an administrative penalty assessed under § 242.066, the department may, in accordance with this section, allow the person to use, under the supervision of the department, any portion of the penalty to ameliorate the violation or to improve services, other than administrative services, in the institution affected by the violation.
(b) The department shall offer amelioration to a person for a charged violation if the department determines that the violation does not constitute immediate jeopardy to the health and safety of an institution resident.

(c) The department may not offer amelioration to a person if:
(1) the person has been charged with a violation which is subject to correction under § 242.0665; or
(2) the department determines that the charged violation constitutes immediate jeopardy to the health and safety of an institution resident.
(d) The department shall offer amelioration to a person under this section not later than the 10th day after the date the person receives from the department a final notification of assessment of administrative penalty that is sent to the person after an informal dispute resolution process but before an administrative hearing under § 242.068.
(e) A person to whom amelioration has been offered must file a plan for amelioration not later than the 45th day after the date the person receives the offer of amelioration from the department. In submitting the plan, the person must agree to waive the person’s right to an administrative hearing under § 242.068 if the department approves the plan.
(f) At a minimum, a plan for amelioration must:
(1) propose changes to the management or operation of the institution that will improve services to or quality of care of residents of the institution;
(2) identify, through measurable outcomes, the ways in which and the extent to which the proposed changes will improve services to or quality of care of residents of the institution;
(3) establish clear goals to be achieved through the proposed changes;
(4) establish a timeline for implementing the proposed changes; and
(5) identify specific actions necessary to implement the proposed changes.
(g) A plan for amelioration may include proposed changes to:
(1) improve staff recruitment and retention;
(2) offer or improve dental services for residents; and
(3) improve the overall quality of life for residents.
(h) The department may require that an amelioration plan propose changes that would result in conditions that exceed the requirements of this chapter or the rules adopted under this chapter.
(i) The department shall approve or deny an amelioration plan not later than the 45th day after the date the department receives the plan. On approval of a person’s plan, a pending request for a hearing submitted by the person under § 242.067(d) shall be denied.
(j) The department may not offer amelioration to a person:
(1) more than three times in a two-year period; or
(2) more than one time in a two-year period for the same or similar violation.
(k) In this section, “immediate jeopardy to health and safety” means a situation in which immediate corrective action is necessary because the institution’s noncompliance with one or more requirements has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident receiving care in the institution.