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TITLE 40SOCIAL SERVICES AND ASSISTANCE
PART 1DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 96CERTIFICATION OF LONG-TERM CARE FACILITIES
RULE §96.7Appeals

(a) Informal reconsideration (IR) for intermediate care facilities for the mentally retarded. Prior to the effective date of any termination of certification, the Texas Department of Human Services (DHS) gives the facility an opportunity for an IR.

  (1) Elements of the informal reconsideration are as follows.

    (A) DHS gives the facility written notice of the proposed termination of certification and the findings upon which the action is based.

    (B) The facility will have the opportunity to refute DHS's findings in writing. If the facility does not respond during the specified period, the action will be taken. If there is no response by the facility, DHS is not required to take any other action on the appeals process prior to the proposed action.

    (C) If the facility does respond as required in subparagraph (B) of this paragraph, DHS will give the facility a written affirmation or reversal of the proposed action.

  (2) DHS will provide IRs for an immediate termination of certification as follows.

    (A) The facility must submit a written request for an IR and provide all supporting documentation within five calendar days after receipt of DHS's written notice of the proposed termination of certification. Long Term Care-Regulatory staff will provide a written response to the facility within seven calendar days after receipt of the request.

    (B) If, as a result of a credible allegation visit, the immediate termination is changed to a 90-day termination, an IR will be offered based on the findings of this visit. This second IR will follow the procedures in paragraph (4) of this subsection.

  (3) DHS will not provide an IR for an immediate termination of certification if, as a result of a credible allegation visit, DHS's proposal to immediately terminate the facility's certification is not changed.

  (4) DHS will provide IRs for a 90-day termination of certification as follows.

    (A) The facility must submit a written request for an IR and provide all supporting documentation within seven calendar days after receipt of DHS's written notice of the proposed termination of certification. Long Term Care-Regulatory staff will provide a written response to the facility within ten calendar days after receipt of the request.

    (B) After the 45-day visit, DHS will provide the following IRs for a 90-day termination of certification.

      (i) If DHS proposes to continue the 90-day termination based on new deficiencies, an IR will be offered on the new deficiencies only, following the procedure in paragraph (2)(A) of this subsection.

      (ii) If DHS proposes to continue the 90-day termination based only on uncorrected deficiencies, an IR will not be offered.

      (iii) If DHS proposes to change the 90-day termination to an immediate termination, an IR will be offered on the new deficiencies only, following the procedure in paragraph (2) of this subsection.

  (5) DHS will not provide an IR for a 90-day termination of certification if, as a result of a credible allegation visit, DHS's proposal to terminate the facility's certification in 90 days is not changed.

(b) Formal hearing for all facilities.

  (1) The facility will have the opportunity for a formal hearing after the effective date of the termination of certification, denial of certification, or other adverse certification recommendation.

  (2) A facility desiring a formal hearing must make a request to DHS, in writing, within 15 calendar days after the facility receives DHS's official notice of the action. Upon receipt of the request, DHS's Office of General Counsel will institute formal hearing procedures. Failure of the facility to request a formal hearing within 15 calendar days constitutes a waiver of the right to a hearing.

  (3) The formal hearing will be conducted in accordance with DHS's formal hearing procedures in Chapter 79 of this title (relating to Legal Services).


Source Note: The provisions of this §96.7 adopted to be effective August 31, 1993, 18 TexReg 2725; transferred effective September 1, 1993, as published in the Texas Register September 3, 1993, 18 TexReg 5885; amended to be effective September 1, 1994, 19 TexReg 5736; amended to be effective March 1, 1995, 20 TexReg 353; amended to be effective July 31, 1995, 20 TexReg 5261.

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