| (a) HHSC may deny an initial license or refuse to renew
a license if any person described in §559.11(e) of this subchapter
(relating to Criteria for Licensing):
(1) is subject to denial or refusal as described in
Chapter 560 of this title (relating to Denial or Refusal of License)
during the time frames described in that chapter;
(2) substantially fails to comply with the requirements
described in §559.42 of this chapter (relating to Safety), §559.43
of this chapter (relating to Sanitation), and Subchapter D of this
chapter (relating to Standards for Licensure), including:
(A) noncompliance that poses a serious threat to health
and safety; or
(B) failure to maintain compliance on a continuous
basis;
(3) aids, abets, or permits a substantial violation
described in paragraph (2) of this subsection about which the person
had or should have had knowledge;
(4) fails to provide the required information, facts,
or references;
(5) knowingly provides false or fraudulent information
by:
(A) submitting false or intentionally misleading statements
to HHSC;
(B) using subterfuge or other evasive means of filing;
(C) engaging in subterfuge or other evasive means of
filing on behalf of another who is unqualified for licensure;
(D) knowingly concealing a material fact; or
(E) being responsible for fraud;
(6) fails to pay when due:
(A) licensing fees as described in §559.37 of
this subchapter (relating to Fees); and
(B) franchise taxes, if applicable; or
(7) has a history of any of the following actions during
the five-year period preceding the date of the application:
(A) received a sanction for operating a facility that
has been decertified or had its contract canceled under the Medicare
or Medicaid program in any state;
(B) being assessed federal or state Medicare or Medicaid
sanctions or penalties;
(C) received unsatisfied final judgments;
(D) was evicted from any property or space used as
a facility in any state; or
(E) received a suspension of a license to operate a
health facility, long-term care facility, assisted living facility,
or a similar facility in any state.
(b) Concerning subsection (a)(7) of this section, HHSC
may consider exculpatory information provided by any person described
in §559.11(e) of this subchapter and grant a license if HHSC
finds that person able to comply with the rules in this chapter.
(c) HHSC does not issue a license to an applicant to
operate a new facility if the applicant has a history of any of the
following actions during the five-year period preceding the date of
the application:
(1) revocation of a license to operate a health care
facility, nursing facility, assisted living facility, or similar facility
in any state;
(2) debarment or exclusion from the Medicare or Medicaid
programs by the federal government or a state; or
(3) a court injunction prohibiting any person described
in §559.11(e) of this subchapter from operating a facility.
(d) Only final actions are considered for purposes
of subsection (a)(7) of this section and subsection (c) of this section.
An action is final when routine administrative and judicial remedies
are exhausted. All actions, whether pending or final, must be disclosed.
(e) If an applicant owns multiple facilities, the overall
record of compliance in all the facilities is examined. An overall
record poor enough to deny issuing a new license does not preclude
renewing licenses of individual facilities with satisfactory records.
(f) If HHSC denies a license or refuses to issue a
license renewal, the applicant or license holder may request a hearing
by following HHSC rules in 1 TAC Chapter 357, Subchapter I (relating
to Hearings Under the Administrative Procedure Act). An administrative
hearing is conducted in accordance with Texas Government Code, Chapter
2001, and 1 TAC Chapter 357, Subchapter I.
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