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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 261INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID) PROGRAM--CONTRACTING
SUBCHAPTER GPROVIDER AGREEMENT SANCTIONS
RULE §261.266DADS Review of Inspection or Survey Findings

(a) DADS may impose a directed plan of correction (DPoC) on one or more of a program provider's facilities, a vendor hold on payments due under one or more of a program provider's agreements, or both if:

  (1) the program provider is determined as a result of an inspection or survey to not meet one or more of the federal ICF/IID standards of participation (SoPs) or conditions of participation (CoPs) and DADS determines that the program provider's failure to meet such SoPs or CoPs resulted in or may result in serious injury to or death of an individual residing in the program provider's facility;

  (2) the program provider is determined as a result of an inspection or survey to not meet one or more of the SoPs and DADS determines that the program provider's failure to meet such SoPs indicates a pervasive lack of active treatment;

  (3) the program provider is determined as a result of an inspection or survey to not meet one of more of the SoPs or CoPs or to not be compliant with one or more state rules applicable to the ICF/IID program and DADS determines, based on its review of previous inspection or survey findings related to the program provider, that the program provider's failure to meet the SoPs or CoPs or noncompliance with state rules indicates:

    (A) a pattern of error in a particular discipline, such as nursing or psychology; or

    (B) deficient program provider practices or procedures, such as inadequate staffing or insufficient staff training; or

  (4) it is determined:

    (A) during a follow-up certification review that the program provider failed to correct previous findings of the survey and did not meet one or more additional SoPs, CoPs, or state rules; and

    (B) that the program provider's continued failure to meet the SoPs, CoPs, or state rules indicates significant deficient practices that resulted in or may result in serious injury to or death of an individual residing in the program provider's facility.

(b) When making a determination in accordance with subsection (a) of this section, DADS reviews the inspection or survey reports documenting the program provider's failure to meet the SoPs, CoPs, or state rules, which may include a description of:

  (1) the situation or occurrence that led to the deficiency;

  (2) the program provider's response to the situation or occurrence; and

  (3) the program provider's practices at the time of the situation or occurrence.

(c) DADS imposes a DPoC or vendor hold in accordance with subsection (a) of this section only on a facility that has been determined to meet the criteria described in subsection (a)(1), (2), (3), or (4) of this section.


Source Note: The provisions of this §261.266 adopted to be effective January 1, 2001, 25 TexReg 12790; amended to be effective March 31, 2002, 27 TexReg 2475; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective November 4, 2013, 38 TexReg 7724; transferred effective October 1, 2020, as published in the Texas Register August 28, 2020, 45 TexReg 6127

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