Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part II - Nursing Facilities › Subpart 3 - Standards for Payment › Chapter 101 - Standards for Payment for Nursing Facilities › Subchapter L - Sanctions and Appeal Procedures › Section II-10167 - General Provisions

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Authority and Scope. Any person or entity found to be in violation of any
					 provision of
					 R.S.
					 40:2009.1 through 40:2009.11 or any other
					 state or federal statute, regulation, or any Department of Health and
					 Hospitals' rule adopted pursuant to the Administrative Procedure Act governing
					 the administration of nursing facility care may be sanctioned by one or more of
					 the following remedies:
1. plan of
					 correction;
2.
					 monitoring;
3. special staffing
					 requirements;
4. civil money
					 penalties (fines);
5. denial of
					 payment for new admissions;
6.
					 withholding of vendor payments;
7.
					 temporary management;
8.
					 termination of certification; and
9. revocation of license;
NOTE: The Secretary or his designee may impose any of the
						above cited sanctions separately or in combination. In addition to the
						foregoing administrative remedies, the Secretary may have recourse to any
						judicial remedies provided by law;
a.
					 Considerations. The secretary shall impose the sanction(s) which will bring the
					 facility into compliance in the most efficient and effective manner with the
					 care and well-being of the residents being the paramount consideration. The
					 secretary's decision shall be based on an assessment of some or all of the
					 following factors:
i. whether the violations
					 pose an immediate threat to the health or safety of the residents;
ii. the duration of the violations;
iii. whether the violation (or one that is
					 substantially similar) has previously occurred during the last three
					 consecutive surveys;
iv. the
					 facility's history of compliance during the last three consecutive
					 surveys;
v. what sanction is most
					 likely to cause the facility to come into compliance in the shortest amount of
					 time;
vi. the severity of the
					 violation if it does not pose an immediate threat to health or
					 safety;
vii. the logistical
					 feasibility of implementing the sanction;
viii. the "good faith" exercised by the
					 facility in attempting to stay in compliance;
ix. the financial benefit to the facility of
					 committing or continuing the violation; and
x. such other factors as the secretary deems
					 appropriate.
b. Repeated
					 Findings of Substandard Care. Where the facility has been found to have
					 provided substandard quality of care on three consecutive standard surveys, the
					 secretary shall (regardless of what other remedies are provided):
i. deny payment under the state plan with
					 respect to any individual admitted to the nursing facility involved after
					 notice to the public and to the facility as may be provided for by
					 law;
ii. monitor the facility on
					 site, until the facility has demonstrated, to the satisfaction of the
					 Department, that it is in compliance with all requirements and that it will
					 remain in compliance with such requirements;
c. Immediate Jeopardy. Where the department
					 determines that a facility no longer meets the requirements of certification
					 and further finds that the facility's deficiencies immediately jeopardize the
					 health or safety of its residents, the department shall:
i. take immediate action to remove the
					 jeopardy and correct the deficiencies through the appointment of temporary
					 management; or
ii. terminate the
					 facility's participation under the state plan and may provide, in addition, any
					 other remedies the department deems appropriate.
d. Non-immediate Jeopardy. If the facility's
					 deficiencies do not immediately jeopardize the health or safety of its
					 residents, the department may:
i. terminate
					 the facility's participation under the state plan;
ii. provide for one or more of the remedies
					 described in Authority and Scope of this Subchapter §10167; or
iii. do both.