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TITLE 40SOCIAL SERVICES AND ASSISTANCE
PART 1DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 9INTELLECTUAL DISABILITY SERVICES--MEDICAID STATE OPERATING AGENCY RESPONSIBILITIES
SUBCHAPTER DHOME AND COMMUNITY-BASED SERVICES (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
RULE §9.171HHSC Surveys and Residential Visits of a Program Provider

(a) A program provider must be in continuous compliance with the certification principles contained in this subchapter that apply to program providers.

(b) HHSC conducts the following surveys:

  (1) an initial certification survey;

  (2) a recertification survey;

  (3) a follow-up survey; and

  (4) an intermittent survey.

(c) HHSC conducts an initial certification survey within 120 calendar days after the date HHSC approves the enrollment or transfer of the first individual to receive HCS Program services from the program provider.

(d) HHSC may conduct an intermittent survey at any time during a certification period.

(e) HHSC may conduct a combination of two or more different types of surveys at the same time.

(f) If HHSC certifies a program provider after completion of an initial or a recertification survey, the certification period is for no more than 365 calendar days.

(g) HHSC may choose not to conduct a recertification survey of a program provider that has a standard contract if the program provider is not the program provider for one or more individuals for at least 60 consecutive calendar days during the period beginning the first day of the certification period to be surveyed through the 121st calendar day before the end of the certification period.

(h) During a survey, HHSC may:

  (1) review the HCS Program services or CFC services provided to any individual to determine if a program provider is in compliance with the certification principles; and

  (2) determine if a program provider has implemented an approved plan for amelioration as described in §9.182 of this subchapter (relating to Amelioration).

(i) HHSC conducts an exit conference at the end of a survey, at a time and location determined by HHSC. At the exit conference, HHSC informs a program provider of preliminary findings, in writing, including findings that may result in a critical violation.

(j) If HHSC identifies a finding that may be a critical violation not discussed during an exit conference, HHSC holds a new exit conference with a program provider to discuss the finding.

(k) In addition to the surveys described in this section, HHSC conducts, at least annually, a visit of each residence in which host home/companion care, residential support, or supervised living is provided to determine if the residence provides a safe and comfortable environment that complies with the certification principles.

  (1) HHSC conducts an unannounced visit of each residence in which residential support or supervised living is provided.

  (2) HHSC may conduct an unannounced visit of each residence in which host home/companion care is provided.

(l) Based on the information obtained from a visit described in subsection (k) of this section, HHSC may:

  (1) require the program provider to complete corrective action before the residential visit ends;

  (2) require the program provider to submit, before the residential visit ends, a written plan describing how the safety of the individuals will be protected until corrective action is completed;

  (3) require the program provider to submit evidence of corrective action within a time period determined by HHSC; or

  (4) conduct an intermittent survey of the program provider.

(m) Based on a survey, HHSC takes action as described in §9.183 of this subchapter (relating to Program Provider Compliance and Corrective Action).

(n) HHSC may evaluate the health and safety of an individual at any time. If HHSC identifies a concern from the evaluation, HHSC may conduct an intermittent survey.


Source Note: The provisions of this §9.171 adopted to be effective March 1, 2000, 25 TexReg 1649; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective June 1, 2006, 31 TexReg 4442; amended to be effective June 1, 2010, 35 TexReg 4441; amended to be effective September 1, 2014, 39 TexReg 6516; amended to be effective July 1, 2015, 40 TexReg 2760; amended to be effective November 15, 2015, 40 TexReg 7827; amendedtobe effective March 20, 2016, 41 TexReg 1867; amended to be effective April 28, 2020, 45 TexReg 2704

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