| (a) DADS may deny an initial license or refuse to renew
a license if any person described in §19.201(e) of this subchapter
(relating to Criteria for Licensing):
(1) is subject to denial or refusal as described in
Chapter 99 of this title (relating to Denial or Refusal of License)
during the time frames described in that chapter;
(2) does not have a satisfactory history of compliance
with state and federal nursing home regulations. In determining whether
there is a history of satisfactory compliance with federal or state
regulations, DADS at a minimum may consider:
(A) whether any violation resulted in significant harm
or a serious and immediate threat to the health, safety, or welfare
of any resident;
(B) whether the person promptly investigated the circumstances
surrounding any violation and took steps to correct and prevent a
recurrence of a violation;
(C) the history of surveys and complaint investigation
findings and any resulting enforcement actions;
(D) a repeated failure to comply with regulation;
(E) an inability to attain compliance with cited deficiencies
within an acceptable period of time as specified in the plan of correction
or credible allegation of compliance, whichever is appropriate;
(F) the number of violations relative to the number
of facilities the applicant or any other person named in §19.201(e)
of this subchapter has been affiliated with at any time; and
(G) any exculpatory information deemed relevant by
DADS;
(3) has committed any act described in §19.2112(a)(2)
- (7) of this chapter (relating to Administrative Penalties);
(4) violated Chapter 242 of the Texas Health and Safety
Code in either a repeated or substantial manner;
(5) aids, abets, or permits a substantial violation
described in paragraph (4) of this subsection about which the person
had or should have had knowledge;
(6) fails to provide the required information and facts
and/or references;
(7) fails to pay the following fees, taxes, and assessments
when due:
(A) licensing fees as described in §19.216 of
this subchapter (relating to License Fees);
(B) reimbursement of emergency assistance funds within
one year after the date on which the funds were received by the trustee
in accordance with the provisions of §19.2116(e) and (f) of this
chapter (relating to Involuntary Appointment of a Trustee); or
(C) franchise taxes;
(8) has a history of any of the following actions at
any time preceding the date of the application:
(A) operation of a facility that has been decertified
or had its contract canceled under the Medicare or Medicaid program
in any state or both;
(B) federal or state nursing facility sanctions or
penalties, including, but not limited to, monetary penalties, downgrading
the status of a facility license, proposals to decertify, directed
plans of correction or the denial of payment for new Medicaid admissions;
(C) unsatisfied final judgments;
(D) eviction involving any property or space used as
a facility in any state;
(E) suspension of a license to operate a health care
facility, long-term care facility, assisted living facility, or a
similar facility in any state;
(F) revocation of a license to operate a health care
facility, long-term care facility, assisted living facility, or similar
facility in any state;
(G) surrender of a license in lieu of revocation or
while a revocation hearing is pending; or
(H) expiration of a license while a revocation action
is pending and the license is surrendered without an appeal of the
revocation or an appeal is withdrawn;
(9) fails to meet minimum standards of financial condition
as described in §19.201(d)(1)(A) of this subchapter and §19.1925(a)
of this chapter (relating to Financial Condition); or
(10) fails to notify DADS of a significant adverse
change in financial condition as required under §19.1925 of this
chapter.
(b) DADS:
(1) denies a license to an applicant to operate a facility
if the applicant has on the date of the application:
(A) a debarment or exclusion from the Medicare or Medicaid
programs by the federal government or a state; or
(B) a court injunction prohibiting the applicant or
manager from operating a facility; or
(2) may deny a license to an applicant to operate a
new facility if the applicant has a history of any of the following
actions at any time preceding the date of the application:
(A) revocation of a license to operate a health care
facility, long-term care facility, assisted living facility, or similar
facility in any state;
(B) surrender of a license in lieu of revocation or
while a revocation hearing is pending;
(C) expiration of a license while a revocation action
is pending and the license is surrendered without an appeal of the
revocation or an appeal is withdrawn;
(D) debarment or exclusion from the Medicare or Medicaid
programs by the federal government or a state; or
(E) a court injunction prohibiting the applicant or
manager from operating a facility.
(c) Only final actions are considered for purposes
of subsections (a)(8) and (b) of this section. An action is final
when routine administrative and judicial remedies are exhausted. All
actions, whether pending or final, must be disclosed.
(d) If an applicant for a new license owns multiple
facilities, DADS examines the overall record of compliance in all
of the applicant's facilities. Denial of an application for a new
license will not preclude the renewal of licenses for the applicant's
other facilities with satisfactory records.
(e) If DADS denies a license or refuses to issue a
renewal of a license, the applicant or license holder may request
an administrative hearing. Administrative hearings are held under
the Health and Human Services Commission's hearing procedures in 1
TAC Chapter 357, Subchapter I (relating to Hearings Under the Administrative
Procedure Act), and Chapter 91 of this title (relating to Hearings
Under the Administrative Procedure Act).
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| Source Note: The provisions of this §554.214 adopted to be effective May 1, 1995, 20 TexReg 2054; amended to be effective March 1, 1998, 23 TexReg 1314; amended to be effective October 1, 1999, 24 TexReg 8314; amended to be effective April 1, 2001, 26 TexReg 1547; amended to be effective September 1, 2007, 32 TexReg 4231; amended to be effective May 4, 2008, 33 TexReg 3446; amended to be effective September 1, 2009, 34 TexReg 5138; amended to be effective January 18, 2012, 37 TexReg 125; amended to be effective December 2, 2012, 37 TexReg 9525;transferred effective January 15, 2021, as published in the Texas Register December 11, 2020, 45 TexReg 8871 |
