| (iii) §553.255 of this chapter (relating to All
Staff Policy for Residents with Alzheimer's Disease or a Related Disorder)
that occurs before the second anniversary of the date of a previous
violation of §553.255 of this chapter;
(E) that is written because of an inappropriately placed
resident, except as described in §553.259(e) of this chapter;
(F) that is a pattern of violation that results in
actual harm;
(G) that is widespread in scope and results in actual
harm;
(H) that is widespread in scope, constitutes a potential
for more than minimal harm, and relates to:
(i) resident assessment as described in §553.259(b)
of this chapter;
(ii) staffing, including staff training, as described
in §553.253 of this chapter (relating to Employee Qualifications
and Training);
(iii) medication administration as described in §553.261(a)
of this chapter (relating to Coordination of Care);
(iv) infection control as described in §553.261(f)
of this chapter;
(v) restraints as described in §553.261(g) of
this chapter; or
(vi) emergency preparedness and response as described
in §553.275 of this chapter (relating to Emergency Preparedness
and Response); or
(I) is an immediate threat to the health or safety
of a resident.
(3) Maintenance of violation correction.
(A) A license holder that corrects a violation must
maintain the correction. If the license holder fails to maintain the
correction until at least the first anniversary of the date the correction
was made, HHSC may assess and collect an administrative penalty for
the subsequent violation.
(B) An administrative penalty assessed under this paragraph
is equal to three times the amount of the original administrative
penalty that was assessed but not collected.
(C) HHSC is not required to offer the license holder
an opportunity to correct the subsequent violation.
(h) Hearing on an administrative penalty. If a license
holder timely requests an administrative hearing as described in subsection
(f)(3) or (7) of this section, the administrative hearing is held
in accordance with HHSC rules at 1 TAC Chapter 357, Subchapter I (relating
to Hearings under the Administrative Procedure Act).
(i) HHSC may charge interest on an administrative penalty.
The interest begins the day after the date the penalty becomes due
and ends on the date the penalty is paid in accordance with Texas
Health and Safety Code §247.0455(e).
(j) Amelioration of a violation.
(1) In lieu of demanding payment of an administrative
penalty, the commissioner may allow a license holder to use, under
HHSC supervision, any portion of the administrative penalty to ameliorate
the violation or to improve services, other than administrative services,
in the facility affected by the violation. Amelioration is an alternate
form of payment of an administrative penalty, not an appeal, and does
not remove a violation or an assessed administrative penalty from
a facility's history.
(2) A license holder cannot ameliorate a violation
that HHSC determines constitutes immediate jeopardy to the health
or safety of a resident.
(3) HHSC offers amelioration to a license holder not
later than 10 calendar days after the date a license holder receives
a final notification of the recommended assessment of an administrative
penalty that is sent to the license holder after an informal dispute
resolution process but before an administrative hearing.
(4) A license holder to whom amelioration has been
offered must:
(A) submit a plan for amelioration not later than 45
calendar days after the date the license holder receives the offer
of amelioration from HHSC; and
(B) agree to waive the license holder's right to an
administrative hearing if HHSC approves the plan for amelioration.
(5) A license holder's plan for amelioration must:
(A) propose changes to the management or operation
of the facility that will improve services to or quality of care of
residents;
(B) identify, through measurable outcomes, the ways
in which and the extent to which the proposed changes will improve
services to or quality of care of residents;
(C) establish clear goals to be achieved through the
proposed changes;
(D) establish a time line for implementing the proposed
changes; and
(E) identify specific actions the license holder will
take to implement the proposed changes.
(6) A license holder's plan for amelioration may include
proposed changes to:
(A) improve staff recruitment and retention;
(B) offer or improve dental services for residents;
and
(C) improve the overall quality of life for residents.
(7) HHSC may require that an amelioration plan propose
changes that would result in conditions that exceed the requirements
of this chapter.
(8) HHSC approves or denies a license holder's amelioration
plan not later than 45 calendar days after the date HHSC receives
the plan. If HHSC approves the amelioration plan, any pending request
the license holder has submitted for an administrative hearing must
be withdrawn by the license holder.
(9) HHSC does not offer amelioration to a license holder:
(A) more than three times in a two-year period; or
(B) more than one time in a two-year period for the
same or a similar violation.
|
