When the Department determines that there is a deficiency in a nursing home, the Department may appoint an independent monitor to oversee efforts made by the nursing home to achieve compliance with State and federal regulations governing nursing homes that participate in the Medicare and Medicaid programs. The appointment of a State monitor is an intermediate sanction that may be in addition to or in lieu of other sanctions. The State monitor’s duties may include: Periodic inspections of a nursing home for the purpose of assessing the nursing home’s compliance with State and federal regulations; and Reporting to the Department and the nursing home its findings. The State monitor may not be an employee of the Department. A nursing home shall be responsible for the costs associated with the appointment of a State monitor to the nursing home.