reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter U - INSPECTIONS, SURVEYS, AND VISITS › Section 554.2009 - Hearings on Complaints of Resident Neglect and Abuse, and Misappropriation of Resident Property in Medicaid-Certified Facilities

Current through Reg. 49, No. 28; July 12, 2024
Hearings required by 42 Code of Federal Regulations
					 §488.335 will be conducted in person or by telephone for the purpose of
					 determining whether sufficient grounds exist for a referral of an individual to
					 the appropriate licensure authority and the facility administrator. The
					 hearings referenced in this section are not applicable to information provided
					 by the Texas Department of Human Services pursuant to
					 42 CFR
					 §488.325(h) (referrals
					 for substandard quality of care).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter U - INSPECTIONS, SURVEYS, AND VISITS › Section 554.2010 - General Provisions

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Confidentiality. All reports, records, and working papers used or developed by
				  the Texas Department of Human Services (DHS) in an investigation are
				  confidential and may be released to the public only as provided below.
(1) Completed written investigation reports
				  are open to the public, provided the report is de-identified. The process of
				  de-identification means removing all names and other personally identifiable
				  data, including any information from witnesses and others furnished to DHS as
				  part of the investigation.
(2) If
				  DHS receives written authorization from a facility resident or the resident's
				  legal representative regarding an investigation of abuse or neglect involving
				  that resident, DHS will release the completed investigation report without
				  removing the resident's name. The authorization must:
(A) be signed and dated within six months of
				  the request or state a length of time the authorization is valid;
(B) detail the information to be
				  released;
(C) identify to whom the
				  information can be released; and
(D) release DHS from all liability for
				  complying with the authorization.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter U - INSPECTIONS, SURVEYS, AND VISITS › Section 554.2011 - Procedures for Inspection of Public Records

Current through Reg. 49, No. 28; July 12, 2024
(a) Procedures for inspection of public
				  records will be in accordance with the Texas Government Code, Chapter 552, and
				  as further described in this section.
(b) Long-Term Care-Regulatory, Texas
				  Department of Human Services (DHS), is responsible for the maintenance and
				  release of records on licensed facilities, and other related records.
(c) The application for inspection of public
				  records is subject to the following criteria:
(1) the application must be made to Long-Term
				  Care-Regulatory, Texas Department of Human Services, 701 West 51st Street,
				  Austin, Texas 78751 or P.O. Box 149030, Austin, Texas 78714-9030;
(2) the requestor must identify
				  himself;
(3) the requestor must
				  give reasonable prior notice of the time for inspection and/or copying of
				  records;
(4) the requestor must
				  specify the records requested;
(5)
				  on written applications, if DHS unable to ascertain the records being
				  requested, DHS may return the written application to the requestor for
				  clarification; and
(6) DHS will
				  provide the requested records as soon as possible; however, if the records are
				  in active use, or in storage, or time is needed for proper de-identification or
				  preparation of the records for inspection, DHS will so advise the requestor and
				  set an hour and date within a reasonable time when the records will be
				  available.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 1 - ENFORCEMENT GENERALLY › Section 554.2102 - Enforcement Generally

Current through Reg. 49, No. 28; July 12, 2024
The Texas Department of Human Services (DHS), as the
						state licensing agency and the survey and certification agency for the Medicaid
						program, may impose concurrently licensing remedies and Medicaid remedies on
						Medicaid-certified facilities.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 2 - LICENSING REMEDIES › Section 554.2103 - Warning Letter

Current through Reg. 49, No. 28; July 12, 2024
When Texas Department of Human Services (DHS) personnel
						determine that a facility is out of compliance with licensure rules to a degree
						that places the facility at risk of the imposition of licensing actions, DHS
						may send a warning letter to the facility. The warning letter notifies the
						facility that the violations of licensing rules must be
						corrected.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 2 - LICENSING REMEDIES › Section 554.2104 - Suspension of a License

Current through Reg. 49, No. 28; July 12, 2024
(a) The Texas
					 Department of Human Services (DHS) may suspend a facility's license when the
					 license holder, or any other person described in § 554.201(e) of Title 40
					 (relating to Criteria for Licensing), has:
(1) violated the requirements in either a
					 repeated or substantial manner; or
(2) committed any act described in §
					 554.2112(a)(2)-(6) of Title 40 (relating to Administrative
					 Penalties).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 2 - LICENSING REMEDIES › Section 554.2106 - Revocation of a License

Current through Reg. 49, No. 28; July 12, 2024
(a) DADS may
					 revoke a facility's license when the license holder, or any other person
					 described in § 554.201(f) of Title 40 (relating to Criteria for
					 Licensing), has:
(1) violated the
					 requirements of the Health and Safety Code, Chapter 242, or the rules adopted
					 under that chapter, in either a repeated or substantial manner;
(2) committed any act described in §
					 554.2112(a)(2) - (6) of Title 40 (relating to Administrative Penalties);
					 or
(3) failed to notify DADS of a
					 significant adverse change in financial condition, as required under §
					 554.1925(b) of Title 40 (relating to Financial Condition).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 2 - LICENSING REMEDIES › Section 554.2107 - Revocation of a License by the HHSC Executive Commissioner

Current through Reg. 49, No. 28; July 12, 2024
(a) In this section, "immediate threat to
					 health and safety," is defined as a condition in which immediate corrective
					 action is necessary because the facility's noncompliance with one or more
					 requirements has caused, or is likely to cause, serious injury, harm,
					 impairment, or death to a resident.
(b) Except as provided by subsection (d) of
					 this section, the executive commissioner revokes a license if DADS finds that:
(1) the license holder has committed three
					 violations in § 554.601(b) or (c) of this chapter (relating to Resident
					 Behavior and Facility Practice) that constitute an immediate threat to health
					 and safety related to abuse or neglect of a resident within a 24-month period
					 at the same facility; and
(2) each
					 of the violations is reported in connection with a separate survey, inspection,
					 or investigation visit that occurred on separate entrance and exit dates.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 2 - LICENSING REMEDIES › Section 554.2108 - Emergency Suspension and Closing Order

Current through Reg. 49, No. 28; July 12, 2024
(a) The Texas Department of Human Services
					 (DHS) will suspend a facility's license or order an immediate closing of part
					 of the facility if:
(1) DHS finds that the
					 facility is operating in violation of the licensure rules; and
(2) the violation creates an immediate threat
					 to the health and safety of a resident.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 2 - LICENSING REMEDIES › Section 554.2110 - Referral to the Attorney General

Current through Reg. 49, No. 28; July 12, 2024
In this section, "threatened violation" means a situation
						which, unless immediate steps are taken to correct, may cause injury or harm to
						a resident's health and safety. The Texas Department of Human Services (DHS)
						may refer a facility to the attorney general who may petition a district court
						for:
(1) a temporary restraining order
					 to restrain a person from a violation or threatened violation of the
					 requirements or any other law affecting residents if DHS reasonably believes
					 that the violation or threatened violation creates an immediate threat to the
					 health and safety of a resident;
(2) an injunction to restrain a person from a
					 violation or threatened violation of the requirements or any other law
					 affecting residents if DHS reasonably believes that the violation or threatened
					 violation creates a threat to the health and safety of a resident; or
(3) the assessment of civil penalties under
					 the Texas Health and Safety Code, §
											242.065, for a
					 violation that threatens the health and safety of a resident. DHS recognizes
					 the limited immunity from civil liability granted to volunteers serving as
					 officers, directors, or trustees of charitable organizations, under the
					 Charitable Immunity and Liability Act of 1987 (Texas Civil Practice and
					 Remedies Code, Chapter 84).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 2 - LICENSING REMEDIES › Section 554.2111 - Suspension of Admissions

Current through Reg. 49, No. 28; July 12, 2024
(a) If the
					 commissioner finds that a nursing facility has committed an act for which a
					 civil penalty may be imposed under §
											242.065, Health and
					 Safety Code, the commissioner may order the nursing facility to immediately
					 suspend admissions. For the purpose of this remedy, the Texas Department of
					 Human Services defines an admission as the entry into a facility of a new
					 resident or of a resident who has been absent from the facility for 24 or more
					 hours.
(1) A waiver to allow a resident to be
					 admitted may be considered by the commissioner or his designee.
(2) In determining whether to grant a waiver
					 under paragraph (1) of this subsection, factors that the commissioner or his or
					 her designee may consider include, but are not limited to:
(A) the reason(s) for which admissions at the
					 facility are suspended;
(B) the
					 facility's ability to correct the reasons for which admissions at the facility
					 are suspended;
(C) the relation
					 between the reasons for which admissions at the facility are suspended and the
					 health care needs of the resident who seeks to return to the
					 facility;
(D) whether the resident
					 who wants to return to the facility has a spouse or relative in the facility;
					 or
(E) the effect that barring the
					 resident's return to the facility or other alternative placement will have on
					 the ability of the resident to maintain contact with the resident's attending
					 physician, family, responsible party, and agent (if any) under a medical power
					 of attorney.
(3) A
					 facility, with regard to which admissions are suspended, must inform a resident
					 or his responsible party upon leaving that facility, that if he leaves for more
					 than 24 hours, he may not be able to return.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 2 - LICENSING REMEDIES › Section 554.2112 - Administrative Penalties

Current through Reg. 49, No. 28; July 12, 2024
(a) HHSC may
					 assess an administrative penalty against a person who:
(1) violates Chapter 242, Health and Safety
					 Code or a rule, standard or order adopted or license issued under Chapter
					 242;
(2) makes a false statement,
					 that the person knows or should know is false, of a material fact:
(A) on an application for issuance or renewal
					 of a license or in an attachment to the application; or
(B) with respect to a matter under
					 investigation by HHSC ;
(3) refuses to allow a representative of HHSC
					 to inspect:
(A) a book, record, or file
					 required to be maintained by a facility; or
(B) any portion of the premises of a
					 facility;
(4) willfully
					 interferes with the work of, or retaliates against, a representative of HHSC or
					 the enforcement of this chapter;
(5) willfully interferes or retaliates
					 against a representative of HHSC preserving evidence of a violation of a rule,
					 standard, or order adopted or license issued under Chapter 242, Health and
					 Safety Code;
(6) fails to pay a
					 penalty assessed by HHSC under Chapter 242, Health and Safety Code by the 10th
					 day after the date the assessment of the penalty becomes final;
(7) fails to notify HHSC of a change of
					 ownership before the effective date of the change of ownership;
(8) willfully interferes with the State
					 Ombudsman, a certified ombudsman, or an ombudsman intern performing the
					 functions of the Ombudsman Program as described in 26 TAC § 88.2(relating
					 to Definitions); or
(9) retaliates
					 against the State Ombudsman, a certified ombudsman, or an ombudsman intern:
(A) with respect to a resident, employee of a
					 facility, or other person filing a complaint with, providing information to, or
					 otherwise cooperating with the State Ombudsman, a certified ombudsman, or an
					 ombudsman intern; or
(B) for
					 performing the functions of the Ombudsman Program as described in 26 TAC
					 Chapter 88 (relating to State Long-Term Care Ombudsman Program).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 2 - LICENSING REMEDIES › Section 554.2113 - Criteria for the Executive Commissioner to Stay a License Revocation

Current through Reg. 49, No. 28; July 12, 2024
(a) A license
					 holder may request that the executive commissioner stay a license revocation
					 imposed in accordance with § 554.2107 of this chapter (relating to
					 Revocation of a License by the Executive Commissioner). The request must:
(1) be in writing;
(2) be submitted to the department within 10
					 working days after the license holder receives written notification of the
					 revocation;
(3) explain how the
					 license holder meets the applicable criteria described in subsection (b) of
					 this section;
(4) describe any
					 potential negative impact to residents that may occur if the request for stay
					 is denied;
(5) include any
					 documentation supporting the request; and
(6) be signed by an authorized representative
					 of the license holder.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 2 - LICENSING REMEDIES › Section 554.2114 - Right to Correct

Current through Reg. 49, No. 28; July 12, 2024
(a) HHSC may
					 not collect an administrative penalty if, not later than the 45th day after the
					 date the facility receives notice, the facility corrects the
					 violation.
(b) If the facility
					 reports to HHSC that the violation has been corrected, HHSC inspects the
					 facility for the correction or takes any other steps necessary to confirm that
					 the violation has been corrected and notifies the facility that:
(1) the correction is satisfactory and a
					 penalty is not assessed; or
(2) the
					 correction is not satisfactory and a penalty is recommended.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 2 - LICENSING REMEDIES › Section 554.2115 - Amelioration of Violation

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 In lieu of demanding payment of an administrative penalty, the commissioner may
					 allow the person to use, under supervision of the Texas Department of Human
					 Services (DHS), a portion of the penalty to ameliorate the violation or to
					 improve services, other than administrative services, in the nursing
					 facility.
(b) DHS will offer
					 amelioration to a person for a violation if DHS determines that the violation
					 does not constitute immediate jeopardy to the health and safety of an
					 institution resident. In this section, "immediate jeopardy to health and
					 safety" means a situation in which immediate corrective action is necessary
					 because the facility's noncompliance with one or more requirements has caused,
					 or is likely to cause, serious injury, harm, impairment, or death to a
					 resident.
(c) DHS will not offer
					 amelioration to a person if:
(1) the person
					 has been charged with a violation that is subject to the right-to-correct,
					 or
(2) DHS determines that the
					 violation constitutes immediate jeopardy to the health and safety of a
					 resident.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 2 - LICENSING REMEDIES › Section 554.2116 - Involuntary Appointment of a Trustee

Current through Reg. 49, No. 28; July 12, 2024
(a) The Texas Department of Human Services
					 (DHS) may petition a court of competent jurisdiction for the involuntary
					 appointment of a trustee to operate a facility if one or more of the following
					 conditions exist:
(1) the facility is
					 operating without a license;
(2)
					 the facility's license has been suspended or revoked;
(3) license suspension or revocation
					 procedures against a facility are pending and an imminent threat to the health
					 and safety of the residents exists;
(4) an emergency exists that presents an
					 immediate threat to the health and safety of the residents; and/or
(5) the facility is closing (whether
					 voluntarily or through an emergency closure order) and arrangements for
					 relocation of the residents to other licensed institutions have not been made
					 before closure.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 2 - LICENSING REMEDIES › Section 554.2118 - Appointment of a Trustee by Agreement

Current through Reg. 49, No. 28; July 12, 2024
(a) A person holding a controlling interest
					 in a facility may, at any time, request the Texas Department of Human Services
					 (DHS) to assume the operation of the facility through the appointment of a
					 trustee.
(b) If DHS believes that
					 the appointment of a trustee is desirable, DHS may enter into an agreement with
					 the person holding the controlling interest for appointment of the trustee to
					 take charge of the facility.
(c)
					 Any agreement entered into under this section must:
(1) specify all terms and conditions of the
					 trustee's appointment and authority; and
(2) preserve all rights of the residents as
					 granted by law.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 2 - LICENSING REMEDIES › Section 554.2119 - Open Hearing

Current through Reg. 49, No. 28; July 12, 2024
(a) HHSC holds an
					 open hearing in a facility if HHSC :
(1) has
					 taken a punitive action against the facility in the preceding 12 months;
					 or
(2) receives a complaint that
					 HHSC has reasonable cause to believe is valid from the State Ombudsman, a
					 certified ombudsman, an ombudsman intern, an advocate, a resident, or a
					 relative of a resident relating to a serious or potentially serious problem in
					 the facility.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 3 - REMEDIES IN MEDICAID-CERTIFIED FACILITIES › Section 554.2120 - Definitions Pertaining to Medicaid Remedies

Current through Reg. 49, No. 28; July 12, 2024
The following term, when used in this undesignated head,
						Remedies in Medicaid-Certified Facilities, shall have the following meaning,
						unless the context clearly indicates otherwise. Accountability period--A
						24-month period which begins each time the Texas Department of Human Services
						(DHS) imposes on a facility a required Category II or III remedy.
						Accountability periods may overlap.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 3 - REMEDIES IN MEDICAID-CERTIFIED FACILITIES › Section 554.2121 - General Provisions

Current through Reg. 49, No. 28; July 12, 2024
Enforcement actions in Medicaid-certified facilities are
						performed according to regulations found in 42 Code of Federal Regulations
						§§431.151, 431.153, 488.301, 488.325(g), 488.330, 488.331, 488.335,
						and 488.400-488.456.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 3 - REMEDIES IN MEDICAID-CERTIFIED FACILITIES › Section 554.2129 - Interest on Civil Money Penalties

Current through Reg. 49, No. 28; July 12, 2024
Interest on civil money penalties accrues at the rate of
						10% from the date specified in Code of Federal Regulations §488.442 until
						paid.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 3 - REMEDIES IN MEDICAID-CERTIFIED FACILITIES › Section 554.2144 - Procedures Following Termination of the Provider Agreement

Current through Reg. 49, No. 28; July 12, 2024
(a) The Texas
					 Department of Human Services (DHS) may continue payments for no more than 30
					 days from the date DHS cancels a facility's provider agreement if DHS
					 determines that:
(1) reasonable efforts are
					 being made to transfer the residents to another facility, to community care, or
					 to other alternate care; and
(2)
					 additional time is needed to effect an orderly transfer of the
					 residents.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 3 - REMEDIES IN MEDICAID-CERTIFIED FACILITIES › Section 554.2146 - Termination of Provider Agreement on the Basis of the Imposition of Enforcement Actions Three Times Within an Accountability Period

Current through Reg. 49, No. 28; July 12, 2024
(a) If DADS determines that DADS or CMS has
					 imposed a required Category II or III remedy (as defined in 42 Code of Federal
					 Regulations (CFR)) on a facility three times within an accountability period, a
					 recommendation is made to terminate the facility's provider agreement, unless
					 DADS waives termination after considering the factors described in subsection
					 (e) of this section.
(b) DADS
					 notifies a facility in writing of its intention to terminate the facility's
					 provider agreement. Notification occurs within:
(1) three calendar days after receipt of the
					 recommendation of remedies for a facility found in immediate jeopardy;
					 or
(2) 15 calendar days after
					 receipt of the recommendation of remedies for a facility not found in immediate
					 jeopardy.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 3 - REMEDIES IN MEDICAID-CERTIFIED FACILITIES › Section 554.2147 - Informal Dispute Resolution

Current through Reg. 49, No. 28; July 12, 2024
The Texas Department of Human Services (DHS) provides an
						informal dispute resolution process (IDR) in the central office, as
						follows:
(1) A written request, all
					 supporting documentation, and registration information as required under
					 paragraph (3) of this section, must be submitted to the Texas Department of
					 Human Services, Long Term Care-Regulatory, ATTN: IDR Coordinator, P.O. Box
					 149030 (MC-E-343), Austin, TX 78714-9030, no later than the 10th calendar day
					 after receipt of the official statement of deficiencies.
(2) DHS will complete the IDR process no
					 later than the 30th calendar day after receipt of the facility's written
					 request, all documentation, and required registration information.
(3) Any individual representing a facility in
					 an IDR must register with DHS and disclose the following:
(A) the individual's employment history
					 during the preceding five years, including employment in regulatory agencies of
					 this state and other states;
(B)
					 ownership, including the identity of the controlling person or persons, of the
					 facility the person is representing before DHS; and
(C) the identity of other entities the person
					 represents or has represented before the agency during the previous 24
					 months.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 3 - REMEDIES IN MEDICAID-CERTIFIED FACILITIES › Section 554.2148 - Arbitration

Current through Reg. 49, No. 28; July 12, 2024
A facility may elect arbitration as provided in 1 TAC
						Chapter 163 (concerning Arbitration Procedures for Certain Enforcement Actions
						of the Department of Human Resources).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 3 - REMEDIES IN MEDICAID-CERTIFIED FACILITIES › Section 554.2149 - Exclusions

Current through Reg. 49, No. 28; July 12, 2024
This undesignated head governs the cancellation of
						current Texas Department of Human Services (DHS) Medicaid contracts with
						nursing facilities; debarment of former or potential contractors is governed by
						§§ 69.275-69.279 of Title 40 (relating to Debarment and Suspension of
						Current and Potential Contractor's Rights, Causes for and Conditions of
						Debarment, Causes for and Conditions of Suspension, Proof Required for
						Debarment and Suspension, and Notice Requirements for Debarment and for
						Suspension).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 3 - REMEDIES IN MEDICAID-CERTIFIED FACILITIES › Section 554.2150 - Fraud Referral

Current through Reg. 49, No. 28; July 12, 2024
None of the options described in this undesignated head
						are intended to restrict the Texas Department of Human Services (DHS) from
						imposing, as necessary, appropriate remedies for program violations listed in
						§ 79.2105 of Title 40 (relating to Grounds for Fraud Referral and
						Administrative Sanction).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter V - ENFORCEMENT › Division 3 - REMEDIES IN MEDICAID-CERTIFIED FACILITIES › Section 554.2151 - Construction

Current through Reg. 49, No. 28; July 12, 2024
The remedies provided under this undesignated head are in
						addition to those otherwise available under state and federal law and are not
						to be construed as limiting any other remedies, including any remedy available
						to an individual at common law.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter W - CERTIFICATION OF FACILITIES FOR CARE OF PERSONS WITH ALZHEIMER'S DISEASE AND RELATED DISORDERS › Section 554.2204 - Voluntary Certification of Facilities for Care of Persons with Alzheimer's Disease

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility
				  may apply for certification as a facility that provides specialized care for
				  Alzheimer's disease and related disorders either at the time of the initial
				  application for a license or at any time subsequent to the issuance of a
				  license under this chapter.
(b)
				  Application must be made on forms prescribed by the Texas Department of Human
				  Services (DHS). The application fee must accompany the application as provided
				  in § 554.216(c) of Title 40 (relating to License Fees).
(c) A facility licensed under this chapter is
				  not required to apply for certification under this section in order to provide
				  care and treatment of persons with Alzheimer's disease and related
				  disorders.
(d) A facility may not
				  advertise or otherwise communicate that the facility is certified by DHS to
				  provide specialized care for persons with Alzheimer's disease or related
				  disorders unless the facility is certified under this subchapter.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter W - CERTIFICATION OF FACILITIES FOR CARE OF PERSONS WITH ALZHEIMER'S DISEASE AND RELATED DISORDERS › Section 554.2206 - General Requirements for a Certified Facility

Current through Reg. 49, No. 28; July 12, 2024
(a) Resident admission. The facility must
				  admit and retain only residents whose needs can be met through service from the
				  facility staff, or in cooperation with community resources or other providers
				  under contract.
(b) Allowable
				  number of residents. Each certificate must specify the maximum allowable number
				  of residents to be cared for at any one time in the certified area. No greater
				  number of residents must be kept in the certified area than is authorized by
				  the certificate.
(c) Nullification
				  of certificate. When a certificate becomes null and void, the facility must
				  remove the certificate from display and advertising, and the certificate must
				  be surrendered to DADS on request. A certificate is nontransferable and
				  nonassignable; therefore, a certificate existing at the time of change of
				  ownership becomes null and void.
(d) Display of certificate. A certificate
				  must be displayed in a prominent location for public view. The facility may
				  advertise as long as the certificate is in effect; however, the type of
				  advertising must be such that the advertising can be withdrawn if the
				  certificate becomes null and void. Upon removal of the certificate it is the
				  responsibility of the facility to inform interested persons of the revised
				  status. The certificate is the property of DADS.
(e) Cancellation of certificate. A
				  certificate must be canceled if DADS finds that the certified unit is not in
				  compliance with applicable laws and rules.
(f) Effective period of certificate. An
				  initial certificate that is based on an application submitted to DADS on or
				  after January 1, 2014, or a renewal certificate that has an effective date on
				  or after January 1, 2014, is valid for three years.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter X - REQUIREMENTS FOR MEDICAID-CERTIFIED FACILITIES › Section 554.2301 - Conditions for Participation as a Medicaid-Certified Facility

Current through Reg. 49, No. 28; July 12, 2024
(a) The facility
				  must meet the following conditions to be approved by the Texas Department of
				  Human Services (DHS) for participation in the Title XIX Texas Medical
				  Assistance program and receive state and federal reimbursement for services to
				  Title XIX residents:
(1) the facility has
				  been certified by DHS as meeting the conditions of participation, including the
				  requirement to have a license from DHS, in the Title XIX Texas Medical
				  Assistance program;
(2) the entity
				  licensed to operate the facility has filed a complete application with the
				  Provider Enrollment Section of DHS for participation as a nursing facility in
				  the Title XIX Texas Medical Assistance program; and
(3) the beds for which the facility wishes to
				  contract meet the requirements of § 554.2322 of Title 40 (relating to
				  Medicaid Bed Allocation Requirements).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter X - REQUIREMENTS FOR MEDICAID-CERTIFIED FACILITIES › Section 554.2302 - Requirements for a Contracted Medicaid Facility

Current through Reg. 49, No. 28; July 12, 2024
(a) This section applies to nursing
				  facilities (NFs) that have been licensed and certified as eligible for
				  participation under Title XIX.
(b)
				  Each nursing facility (NF) must comply with the state requirements for
				  participation and the facility's contract on a continuing basis.
(c) Each NF must comply with the Texas Health
				  and Human Services Commission's (HHSC's) utilization review requirements as
				  provided in 1 TAC §
										371.212(relating
				  to Minimum Data Set Assessments) and §371.214 (relating to Resource
				  Utilization Group Classification System).
(d) A facility may not participate in the
				  Texas Medical Assistance Program if it has restrictive policies or practices,
				  including:
(1) requiring the resident to make
				  a will, with the facility named as legatee or devisee;
(2) requiring the resident to assign his life
				  insurance to the facility;
(3)
				  requiring the resident to transfer property to the facility;
(4) requiring the resident to pay a lump sum
				  entrance fee or make any other payment or concession to the facility beyond the
				  recognized rate for board, room, and care as a condition for entry, departure,
				  or continued stay;
(5) controlling
				  or restricting the resident, the resident's guardian, or responsible party in
				  the use of the resident's personal needs allowance;
(6) restricting the resident from leaving the
				  facility at will except as provided by state law;
(7) restricting the resident from applying
				  for Medicaid for a specified period of time;
(8) denying appropriate care to an individual
				  on the basis of his race, religion, color, national origin, sex, age,
				  disability, marital status, or source of payment; and
(9) preventing terminally ill adult residents
				  from exercising their will in making written or unwritten directives to reject
				  life-sustaining procedures.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter X - REQUIREMENTS FOR MEDICAID-CERTIFIED FACILITIES › Section 554.2304 - Contract Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  The Texas Department of Human Services (DHS) may enter into contracts with the
				  facility.
(b) Nursing facilities
				  (NFs) must comply with all state and federal requirements for
				  participation.
(c) The contracting
				  nursing facility agrees to:
(1) comply with
				  Title VI of the Civil Rights Act of 1964 (Public Law 88-352), §504 of the
				  Rehabilitation Act of 1973 (Public Law 93-112), the Age Discrimination Act of
				  1975, the Americans with Disabilities Act of 1990 (Public Law
				  101-336), the Safe Medical Devices Act of 1990,
				  and all amendments to each, and all requirements imposed by the regulations
				  issued pursuant to these acts. In addition, the contractor agrees to comply
				  with Chapter 73 of Title 40 (relating to Civil Rights). These provide in part
				  that no persons in the United States shall, on the grounds of race, color,
				  national origin, sex, age, disability, political beliefs or religion be
				  excluded from participation in, or denied, any aid, care, service or other
				  benefits provided by federal and/or state funding, or otherwise be subjected to
				  discrimination;
(2) comply with
				  Texas Health and Safety Code, Chapter 85, Subchapter E (concerning workplace
				  and confidentiality guidelines regarding AIDS and HIV);
(3) comply with 42 Code of Federal
				  Regulations, Part 455, Program Integrity: Medicaid.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter X - REQUIREMENTS FOR MEDICAID-CERTIFIED FACILITIES › Section 554.2306 - Effective Dates of Provider Contracts

Current through Reg. 49, No. 28; July 12, 2024
(a) The effective date of the provider
				  contract for an initial certification is the date the on-site survey is
				  completed if the facility meets:
(1) all
				  federal health and safety standards; and
(2) any other requirements imposed by the
				  Texas Department of Human Services (DHS).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter X - REQUIREMENTS FOR MEDICAID-CERTIFIED FACILITIES › Section 554.2308 - Change of Ownership

Current through Reg. 49, No. 28; July 12, 2024
(a) Definition.
				  An ownership change is defined in § 554.210(c) of Title 40 (relating to
				  Temporary Change of Ownership). For purposes of this section, prior owner is
				  defined as the legal entity with a Medicaid contract for the facility before
				  the change of ownership. The new owner is the legal entity to which DADS has
				  assigned the contract (in accordance with
				  42 CFR
				  §442.14 and subsection (d) of this
				  section). The effective date of the ownership change is the effective date of
				  the new owner's license for the facility.
(b) Notice of ownership change. The prior
				  owner must give DADS written notice of a change of ownership at least 30 days
				  before the effective date of the change. If written notice of the change is not
				  received 30 days before the agreed change date, DADS is not responsible for
				  payments made to the prior owner or new owner that do not reflect the
				  established change date. DADS will not make a duplicate payment. It is the
				  responsibility of the prior and new owner to make arrangements between
				  themselves for such contingencies.
(c) Vendor holds based on a change of
				  ownership.
(1) Holds on payments due to a
				  prior owner.
(A) When DADS receives
				  information about a proposed or actual change of ownership, DADS may place
				  vendor payments to the prior owner on hold. Vendor payments will not be
				  released until the Texas Health and Human Services Commission notifies DADS
				  that the prior owner meets the final reporting requirements as specified in 1
				  TAC §
												355.306(relating
				  to Cost Finding Methodology) and 1 TAC §
												355.308(f)(1)(A)
				  (relating to Direct Care Staff Rate Component).
(B) Once the final reporting requirements in
				  subparagraph (A) of this paragraph are met, vendor payments may still be held
				  so that money owed to DADS can be recouped from the funds placed on hold.
				  Vendor payments will be released after:
(i)
				  completion of a billing and claims reconciliation, or the passing of a time
				  period of 12 months after the effective date of the change of ownership,
				  whichever is sooner; or
(ii) the
				  prior owner provides, at DADS' option, either of the following documents in a
				  format acceptable to DADS to cover possible liabilities of the prior owner:
(I) a surety bond or an irrevocable letter of
				  credit as described in § 554.2312(f)(1)(A) of Title 40 (relating to Surety
				  Bonds or Letters of Credit); or
(II) written authority by the prior owner to
				  withhold and retain funds normally due the prior owner from other Medicaid
				  contracts the prior owner may have with DADS.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter X - REQUIREMENTS FOR MEDICAID-CERTIFIED FACILITIES › Section 554.2310 - Nursing Facility Ceases to Participate

Current through Reg. 49, No. 28; July 12, 2024
A nursing facility may voluntarily terminate or be
					 involuntarily terminated from Medicaid participation. A facility must have
					 policies and procedures in place to ensure that the administrator's duties and
					 responsibilities include providing the appropriate notices in the event of a
					 Medicaid termination.
(1) If a
				  facility voluntarily closes and ceases providing nursing facility services, the
				  facility must comply with this paragraph.
(A)
				  The facility must close on the first day of a month.
(B) At least 75 days before closure, the
				  administrator must submit to the HHSC regional director a plan for relocation
				  of all residents. The plan must:
(i) provide
				  for the transfer and adequate relocation of the residents;
(ii) include assurances that residents are
				  Transferred to the most appropriate facility or other setting in terms of
				  quality, services, and location, taking into consideration the needs, choice,
				  and best interests of each resident; and
(iii) be revised as necessary to obtain HHSC
				  approval.
(C) At least
				  60 days before closure, the administrator must submit written notice of the
				  closure that includes the approved closure plan and the closure date to:
(i) the secretary or the secretary's
				  designee;
(ii) HHSC Regulatory
				  Services;
(iii) the State
				  Ombudsman;
(iv) each resident;
				  and
(v) each resident's legal
				  representative or responsible party.
(D) The notice to each resident and the
				  resident's legal representative or responsible party must include the
				  information required by § 554.502(f) of this chapter (relating to Transfer
				  and Discharge in Medicaid-certified Facilities).
(E) The facility must not admit any new
				  residents on or after the date the written notice is submitted.
(F) The facility must have the resources to
				  operate through the closure date.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter X - REQUIREMENTS FOR MEDICAID-CERTIFIED FACILITIES › Section 554.2314 - Financial Audits

Current through Reg. 49, No. 28; July 12, 2024
DADS may audit or monitor a facility, including the
					 facility's trust fund accounts, periodically or as a result of a complaint
					 investigation. DADS may also refer a facility to the Office of Inspector
					 General for an audit. A facility is notified of monitoring or audit plans and
					 is given a report of the final findings.