(a) The Texas Health and Human Services Commission
(HHSC) receives and investigates referrals and complaints.
(b) Persons wanting to file a complaint against a licensee
may contact HHSC by:
(1) calling HHSC at the telephone numbers on the HHSC
website;
(2) emailing the complaint to HHSC using the email
address on the HHSC website;
(3) faxing the complaint to HHSC using the fax number
on the HHSC website; or
(4) mailing the complaint to HHSC at the mailing address
on the HHSC website.
(c) HHSC sends HHSC Form 5521-NFA, Complaints, to persons
wanting to file a complaint. HHSC Form 5521-NFA, Complaints, is also
available on the HHSC web page. The complainant must complete, sign,
and return the form to HHSC.
(d) If a referral or complaint is received, HHSC notifies
the licensee and, if applicable, the person filing the complaint of
the:
(1) alleged rule violation;
(2) assigned case number; and
(3) investigator contact information.
(e) HHSC investigates referrals and complaints by first
determining if a complaint is within HHSC's authority to investigate
and, if it is, by engaging in one or more of the following investigative
activities:
(1) reviewing pertinent documentation maintained by
the facility, including financial and resident medical records;
(2) gathering additional evidence, including licensee
and witness statements;
(3) determining licensee culpability for survey or
investigative findings; and
(4) utilizing the services of a private investigator
when special circumstances exist.
(f) HHSC keeps records confidential in accordance with
state and federal law.
(g) HHSC prioritizes complaints as follows.
(1) Priority one complaints allege physical abuse,
sexual abuse, neglect, serious injury, death, or immediate jeopardy
to resident health or safety. Investigations are initiated within
24 hours of receipt or by the next working day.
(2) Priority two complaints allege all other types
of misconduct by the licensee. Investigations are initiated within
30 days after receipt.
(h) After the investigation is complete, a final report
with supporting documentation is given to the Nursing Facility Administrators
Advisory Committee (NFAAC) for review and a recommendation on the
appropriate action.
(i) After evaluating the NFAAC's recommendation, HHSC
decides to:
(1) impose a sanction;
(2) collect additional information; or
(3) dismiss the case.
(j) HHSC notifies the licensee and, if applicable,
the person filing a complaint of the status and final outcome of a
complaint or referral.
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Source Note: The provisions of this §555.51 adopted to be effective June 1, 2004, 29 TexReg 4233; amended to be effective June 1, 2009, 34 TexReg 2795; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1880; amended to be effective November 14, 2021, 46 TexReg 7791; amended to be effective September 18, 2024, 49 TexReg 7339 |