New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS › Part 2 - ADJUDICATORY HEARINGS FOR LICENSED FACILITIES › Section 8.370.2.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
For purposes of this rule, the following shall apply.
A.
"Adjudicate"
means to decide,
				settle or determine a disputed action. The term applies to a determination of
				facts and the application of law and reason to the facts by an impartial
				decision maker.
B.
"Administrator"
means the person or manager in charge of the
				day-to-day operation of the facility or medicaid provider. The administrator
				may be the licensee or an authorized representative of the licensee.
C.
"Annual license"
is the
				legally required authority-issued license authorizing a facility to operate for
				the one year period of time noted on the face of the document and issued on an
				initial and renewal basis.
D.
"Appellant"
means the party seeking review in a court of competent
				jurisdiction of a final decision of the licensing authority.
E.
"Applicant"
means the
				individual responsible for the day-to-day operations of the facility, and who
				signs the license application. The applicant must be the individual. The
				applicant may be the same individual as the prospective licensee or may be an
				authorized representative of the prospective licensee.
F.
"Application"
means the
				forms, attachments and other writings and drawings required by the licensing
				authority, to be completed and submitted by the applicant for the licensing
				authority's review for granting or denying a license.
G.
"Burden of proof"
refers to
				the requirement of a party to produce an amount of evidence tending to prove a
				proposition.
H.
"Cease and
				desist order"
means a formal, enforceable order of the licensing
				authority issued to a facility, usually in instances where the facility is
				operating without a license.
I.
"Certification"
means the determination made by the licensing
				authority as to whether a health facility or agency complies with applicable
				federal regulations and the conditions of participation in the medicare or
				medicaid program. Certification of noncompliance may be the basis for denial or
				termination of provider participation in the medicare or medicaid programs, or
				the basis for the imposition of other sanctions including license
				revocation.
J.
"Denial of an
				application" and "denial of an annual license"
mean action by the
				licensing authority declining to grant an annual license on the basis of
				noncompliance with applicable laws and regulations.
K.
"Director"
means the director
				of the division of health improvement of the New Mexico health care authority.
L.
"Emergency suspension of
				license"
means the licensing authority's prohibition of operation of a
				facility for a stated period of time by temporary withdrawal of the license,
				prior to a hearing on the matter, when immediate action is required to protect
				human health and safety. The emergency suspension is carried out by personal
				service of an emergency suspension order and notice of a hearing. A hearing
				must be held within five working days of the effective date of suspension
				("five-day hearing"), as noticed in the emergency suspension order and notice
				of hearing, unless the right to a hearing is waived by the licensee or the
				right to a five-day hearing is waived and a hearing is requested at a later
				date by the licensee.
M.
"Facility"
means any health facility or health agency required to
				be licensed by the licensing authority pursuant to the authority of the Public
				Health Act, Sections 24-1-1 to 24-1-21 NMSA 1978, as amended, or required to be
				certified by the licensing authority in order to be eligible to receive and
				medicaid reimbursement for services provided to eligible recipients. This does
				not refer to community providers.
N.
"Final decision"
means the
				dispositive written document entered following a request for hearing under this
				rule, stating the final determination of the secretary made after review of the
				hearing officer's report and recommendation.
O.
"Five-day hearing"
means the
				hearing noticed in the emergency suspension order and notice of hearing. See
				the definition of "emergency suspension of license" in Subsection E of this
				section.
P.
"Hearing"
means a proceeding in which legal rights, duties or privileges of a party are
				at issue and which shall include an opportunity for the parties to present such
				testimony and evidence as the hearing officer deems relevant and material to
				the issues to be adjudicated.
Q.
"Hearing officer"
means an individual designated to conduct
				prehearing conferences and hearings and to make reports and recommendations,
				based on the evidence taken, to the secretary.
R.
"Initial applicant"
means the
				individual who signs the initial license application.
S.
"License"
means the document
				issued by the licensing authority which authorizes the lawful operation of a
				facility. The term "license" includes an annual license and a temporary
				license.
T.
"Licensee"
means the person in whose name a license for a facility has been issued and who
				is legally responsible for the facility's compliance with applicable laws and
				regulations.
U.
"Licensing
				authority"
means the division of health improvement of the New Mexico
				health care authority. The licensing authority is also the state survey agency
				authorized to perform survey and certification functions for the medicaid and
				medicare programs.
V.
"Official notice"
means administrative notice, the act by which
				the hearing officer, in conducting the hearing or framing their decision,
				recognizes the existence and truth of certain facts without the production of
				evidence by the parties.
W.
"Party" and "parties"
means the original persons, entities, or
				agencies to a hearing under this rule and such intervenors permitted to
				intervene by written order of the hearing officer.
X.
"Person"
means an individual,
				partnership, proprietorship, agency, corporation, company, association, tribal
				government or tribal organization, state or local government entity, or similar
				legal entity and the legal successor thereof.
Y.
"Prospective licensee"
means
				the person in whose name a license for operation of a facility is to be
				issued.
Z.
"Recipient"
means the individual who receives service of notice and, specifically includes
				the person who receives a cease and desist order issued by the licensing
				authority.
AA.
"Renewal
				applicant"
means the individual who signs the renewal license
				application.
BB.
"Revocation
				of license"
means the licensing authority's cancellation and withdrawal
				of a license on a permanent basis.
CC. "Secretary" means the secretary of the
				New Mexico health care authority and includes their authorized
				representative.
DD.
"Subpoena"
means a written command issued by the hearing officer,
				at the request of a party, directing the appearance by a person, at a
				designated time and place, to give testimony upon a certain matter. The
				subpoena may include a command to produce books, papers, documents and other
				things, in which case it is issued as a subpoena duces tecum.
EE.
"Suspension of license"
means the licensing authority's temporary cancellation and withdrawal of a
				license for a stated period of time.
FF.
"Taking of appearances"
means recording for the record the names of persons appearing at the hearing
				and their representatives, if any.
GG.
"Temporary license"
means,
				with respect to a health facility, an operating license issued for a stated
				period of time not to exceed 120 days. Not more than two consecutive temporary
				licenses may be granted by the licensing authority.
HH.
"Working days"
means, when
				determining compliance with various deadlines in this rule, Monday through
				Friday of each calendar week, excluding state observed
				holidays.