Enforcement is a process by which a sanction is proposed, and
if warranted, imposed on an applicant or licensee regulated by the
Texas Health and Human Services Commission (HHSC) for failure to comply
with applicable statutes, rules, and orders.
(1) Denial, suspension or revocation of a license or
imposition of an administrative penalty. HHSC has jurisdiction to
enforce violations of Texas Health and Safety Code (HSC) Chapters
571 through 578 or the rules adopted under these chapters. HHSC may
deny, suspend, or revoke a license or impose an administrative penalty
for:
(A) failure to comply with any applicable provision
of the HSC, including Chapters 161, 321, 322, and 571 through 578;
(B) failure to comply with any provision of this chapter
or any other applicable laws;
(C) the facility, or any of its employees, committing
an act which causes actual harm or risk of harm to the health or safety
of a patient;
(D) the facility, or any of its employees, materially
altering any license issued by HHSC;
(E) failure to comply with minimum standards for licensure;
(F) failure to provide a complete license application;
(G) failure to comply with an order of the executive
commissioner or another enforcement procedure under HSC Chapters 571
through 578;
(H) a history of failure to comply with the applicable
rules relating to patient environment, health, safety, and rights;
(I) the facility aiding, committing, abetting, or permitting
the commission of an illegal act;
(J) the facility, or any of its employees, committing
fraud, misrepresentation, or concealment of a material fact on any
documents required to be submitted to HHSC or required to be maintained
by the facility pursuant to HSC Chapters 571 through 578 and the provisions
of this chapter;
(K) failure to timely pay an assessed administrative
penalty as required by HHSC;
(L) failure to submit an acceptable plan of correction
for cited deficiencies within the timeframe required by HHSC;
(M) failure to timely implement plans of corrections
to deficiencies cited by HHSC within the dates designated in the plan
of correction;
(N) failure to comply with applicable requirements
within a designated probation period; or
(O) if the facility is participating under Title XVIII
of the Social Security Act, 42 United States Code (USC), §1395
et seq., the Centers for Medicare & Medicaid Services terminating
the facility's Medicare provider agreement.
(2) Denial of a license. HHSC has jurisdiction to enforce
violations of HSC Chapters 571 through 578 or the rules adopted under
this chapter. HHSC may deny a license if the applicant:
(A) fails to provide timely and sufficient information
required by HHSC that is directly related to the license application;
or
(B) has had the following actions taken against the
applicant within the two-year period preceding the license application:
(i) decertification or cancellation of its contract
under the Medicare or Medicaid program in any state;
(ii) federal Medicare or state Medicaid sanctions or
penalties;
(iii) unsatisfied federal or state tax liens;
(iv) unsatisfied final judgments;
(v) eviction involving any property or space used as
a hospital in any state;
(vi) unresolved federal Medicare or state Medicaid
audit exceptions;
(vii) denial, suspension, or revocation of a hospital
license, a private psychiatric hospital license, or a license for
any health care facility in any state; or
(viii) a court injunction prohibiting ownership or
operation of a facility.
(3) Order for immediate license suspension. HHSC may
suspend a license for 10 days pending a hearing if after an investigation
HHSC finds that there is an immediate threat to the health or safety
of the patients or employees of a licensed facility. HHSC may issue
necessary orders for the patients' welfare.
(4) Probation. In lieu of denying, suspending, or revoking
a license, HHSC may place a facility on probation for a period of
not less than 30 days, if HHSC finds that the facility is in repeated
non-compliance with this chapter or HSC Chapters 571 through 578 and
the facility's noncompliance does not endanger the public's health
and safety.
(A) HHSC shall provide notice to the facility of the
probation and of the items of noncompliance not later than the 10th
day before the date the probation period begins.
(B) During the probation period, the facility shall
correct the items of noncompliance and report the corrections to HHSC
for approval.
(5) Administrative penalty. HHSC has jurisdiction to
impose an administrative penalty against a person licensed or regulated
under this chapter for violations of applicable chapters of the HSC
or this chapter. The imposition of an administrative penalty shall
be in accordance with the provisions of HSC §571.025.
(6) Licensure of persons or entities with criminal
backgrounds. HHSC may deny a person or entity a license or suspend
or revoke an existing license on the grounds that the person or entity
has been convicted of a felony or misdemeanor that directly relates
to the duties and responsibilities of the ownership or operation of
a facility. HHSC shall apply the requirements of Texas Occupations
Code Chapter 53.
(A) HHSC is entitled under Texas Government Code Chapter
411 to obtain criminal history information maintained by the Texas
Department of Public Safety, the Federal Bureau of Investigation,
or any other law enforcement agency to investigate the eligibility
of an applicant for an initial or renewal license and to investigate
the continued eligibility of a licensee.
(B) In determining whether a criminal conviction directly
relates, HHSC shall apply the requirements and consider the provisions
of Texas Occupations Code Chapter 53 (relating to Consequences of
Criminal Conviction).
(C) The following felonies and misdemeanors directly
relate to the duties and responsibilities of the ownership or operation
of a health care facility because these criminal offenses indicate
an ability or a tendency for the person to be unable to own or operate
a facility:
(i) a misdemeanor violation of HSC Chapter 571;
(ii) a misdemeanor or felony involving moral turpitude;
(iii) a misdemeanor or felony relating to deceptive
business practices;
(iv) a misdemeanor or felony of practicing any health-related
profession without a required license;
(v) a misdemeanor or felony under any federal or state
law relating to drugs, dangerous drugs, or controlled substances;
(vi) a misdemeanor or felony under Texas Penal Code
(TPC), Title 5, involving a patient or a client of any health care
facility, a home and community support services agency, or a health
care professional; or
(vii) a misdemeanor or felony under TPC:
(I) Title 4;
(II) Title 5;
(III) Title 7;
(IV) Title 8;
(V) Title 9;
(VI) Title 10; or
(VII) Title 11.
(7) Offenses listed in paragraph (6)(C) of this section
are not exclusive in that HHSC may consider similar criminal convictions
from other state, federal, foreign or military jurisdictions that
indicate an inability or tendency for the person or entity to be unable
to own or operate a facility.
(8) HHSC shall revoke a license on the licensee's imprisonment
following a felony conviction, felony community supervision revocation,
revocation of parole, or revocation of mandatory supervision.
(9) Notice. If HHSC proposes to deny, suspend, or revoke
a license, or impose an administrative penalty, HHSC shall send a
notice of the proposed action by certified mail, return receipt requested,
at the address shown in the current records of HHSC or HHSC may personally
deliver the notice. The notice to deny, suspend, or revoke a license,
or impose an administrative penalty, shall state the alleged facts
or conduct to warrant the proposed action, provide an opportunity
to demonstrate or achieve compliance, and shall state that the applicant
or license holder has an opportunity for a hearing before taking the
action.
(10) Acceptance. Within 20 calendar days after receipt
of the notice described in paragraph (9) of this section, the applicant
or licensee shall notify HHSC, in writing, of acceptance of HHSC's
determination or request a hearing.
(11) Hearing request.
Cont'd... |
