| (a) If the Texas Health and Human Services Commission
(HHSC) determines from a survey that a program provider complies with
the certification standards, HHSC:
(1) sends the program provider a final survey report
stating that the program provider complies with the certification
standards;
(2) does not require any action by the program provider;
and
(3) if the survey is an initial or a recertification
survey, certifies the program provider as described in §565.41(f)
of this subchapter (relating to HHSC Surveys of a Program Provider).
(b) If HHSC determines from a survey that a program
provider is not in compliance with a certification standard and the
violation is an immediate threat, HHSC notifies the program provider
of the determination. The program provider must immediately provide
HHSC with a plan of removal.
(c) In a plan of removal provided in accordance with
subsection (b) of this section, a program provider must specify the
time by which the program provider will remove the immediate threat.
HHSC approves or disapproves the plan of removal and monitors to ensure
the immediate threat is removed.
(d) If a program provider that is required to provide
a plan of removal does not provide a plan of removal, HHSC does not
approve the program provider's plan of removal, or the program provider
does not implement the plan of removal approved by HHSC, HHSC:
(1) denies or terminates certification of the program
provider; and
(2) coordinates with the local intellectual and developmental
disability authorities (LIDDAs) the immediate provision of alternative
services for the individuals.
(e) If HHSC determines from a survey that a program
provider is not in compliance with a certification standard, HHSC
sends to the program provider, within 10 business days after the date
of the exit conference:
(1) a final survey report with a list of violations;
(2) a letter notifying the program provider that the
program provider may request an informal dispute resolution to dispute
a violation in the final survey report; and
(3) if HHSC imposes an administrative penalty in accordance
with §565.45 of this subchapter (relating to Administrative Penalties),
a written notice of the administrative penalty as described in 40
TAC §49.535(b) (relating to Administrative Penalties in the HCS
and TxHmL Programs).
(f) If HHSC determines from an initial certification
survey, recertification survey, or intermittent survey that a program
provider is not in compliance with a certification standard, the program
provider must submit to HHSC, within 14 calendar days after the date
the program provider receives the final survey report, a plan of correction
for each violation identified by HHSC in the final survey report.
The program provider must submit a plan of correction in accordance
with this subsection even if the program provider disagrees with the
violation or requests an informal dispute resolution.
(g) In a plan of correction submitted in accordance
with subsection (f) of this section, a program provider must specify
a date by which the program provider will complete corrective action
for each violation and such date must:
(1) for a critical violation, be no later than 30 calendar
days after the date of the survey exit conference; and
(2) for a violation that is not a critical violation,
be no later than 45 calendar days after the date of the survey exit
conference.
(h) After HHSC receives the plan of correction required
by subsection (f) of this section, HHSC notifies the program provider
whether the plan is approved or not approved.
(i) If HHSC does not approve a plan of correction required
by subsection (f) of this section, the program provider must submit
a revised plan of correction within five business days after the date
of HHSC's notice that the plan of correction was not approved. After
HHSC receives the revised plan of correction, HHSC notifies the program
provider whether the revised plan is approved or not approved.
(j) If the program provider does not submit a plan
of correction required by subsection (f) of this section or a revised
plan of correction required by subsection (i) of this section, or
if HHSC notifies the program provider that a revised plan of correction
is not approved, HHSC:
(1) imposes a vendor hold against the program provider
until HHSC approves a plan of correction submitted by the program
provider; or
(2) denies or terminates certification of the program
provider.
(k) If HHSC approves a plan of correction, HHSC takes
the following actions to determine if a program provider has completed
its corrective action:
(1) requests that the program provider submit evidence
of correction to HHSC; and
(2) conducts:
(A) for a critical violation, a follow-up survey after
the date specified in the plan of correction for correcting the violation
but within 45 calendar days after the survey exit conference, unless
HHSC conducts an earlier follow-up survey as described in subsection
(l) of this section; or
(B) for a violation that is not critical, a post 45-day
follow-up survey, unless HHSC conducts an earlier follow-up survey
as described in subsection (l) of this section.
(l) At the request of a program provider, HHSC may
conduct a follow-up survey earlier than the timeframes described in
subsection (k)(2) of this section.
(1) If HHSC determines from the earlier follow-up survey
that corrective action has been completed and the program provider
has not yet submitted a plan of correction to HHSC in accordance with
subsection (f) of this section, the program provider must include
the corrective action taken on the plan of correction that is submitted.
(2) If HHSC determines from the earlier follow-up survey
that corrective action has not been completed for a violation that
is not critical, HHSC conducts the post 45-day follow-up survey.
(m) If HHSC determines from a follow-up survey described
in subsections (k)(2)(A) or (l) of this section that the program provider
has completed corrective action for a critical violation, the administrative
penalty stops accruing on the date corrective action was completed,
as determined by HHSC. HHSC sends the program provider a written notice
as described in 40 TAC §49.535(c).
(n) If HHSC determines from a follow-up survey described
in subsections (k)(2)(A) or (l) of this section that the program provider
has not completed the corrective action for a critical violation,
HHSC:
(1) continues the administrative penalty and conducts
another follow-up survey to determine if the program provider completed
the corrective action;
(2) imposes a vendor hold against the program provider;
or
(3) denies or terminates certification of the program
provider.
(o) HHSC takes the actions described in this subsection
regarding a follow-up survey described in subsection (n)(1) of this
section.
(1) If HHSC determines from the survey that the program
provider has completed the corrective action, the administrative penalty
stops accruing on the date corrective action was completed, as determined
by HHSC. HHSC sends the program provider a written notice as described
in 40 TAC §49.535(c).
(2) If HHSC determines from the survey that the program
provider has not completed the corrective action, the administrative
penalty stops accruing and HHSC:
(A) imposes a vendor hold against the program provider;
or
(B) denies or terminates certification of the program
provider.
(p) If HHSC determines from a post 45-day follow-up
survey or an earlier survey described in subsection (l) of this section
that a program provider has completed corrective action for a violation
that is not critical, HHSC does not impose an administrative penalty
for the non-critical violation.
(q) If HHSC determines from a post 45-day follow-up
survey that a program provider has not completed corrective action
for a violation that is not critical, HHSC:
(1) imposes an administrative penalty for the non-critical
violation in accordance with §565.45 of this subchapter;
(2) notifies the program provider of the administrative
penalty, as described in 40 TAC §49.535(b); and
(3) conducts a survey:
(A) at least 31 calendar days after the date of the
post 45-day exit conference of the follow-up survey; or
Cont'd... |
