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From 2020 to 2022, Maine’s state health department cited residential care facilities for elder abuse in the form of dozens of resident rights violations and hundreds of other deficiencies. However, it imposed only one fine in response. The article highlights a case at Woodlands Memory Care of Rockland where a resident with a severe peanut allergy died after being served a peanut butter sandwich. The health department cited the facility for two resident rights violations but did not impose a fine, opting instead for a plan of correction. The investigation suggests that the health department rarely imposes fines or strict sanctions against Level IV residential care facilities in Maine, raising concerns about oversight and accountability for the well-being of vulnerable residents. Comparisons with other states, like Massachusetts, show a stark difference in regulatory approaches. Advocates argue for stronger enforcement measures to ensure resident safety and address recurring problems in these facilities.