The Texas Health and Human Services Commission (HHSC) adopts, on behalf of the Department of Aging and Disability Services (DADS), new §92.22 and amendments to §92.51 and §92.551, in Chapter 92, Licensing Standards for Assisted Living Facilities. New §92.22 is adopted with changes to the proposed text published in the October 28, 2016, issue of the Texas Register (41 TexReg 8556). The amendments §92.51 and §92.551 are adopted without changes to the proposed text published in the October 28, 2016, issue of the Texas Register (41 TexReg 8556).

BACKGROUND AND PURPOSE

The amendments and new section set forth requirements for an applicant for an initial assisted living facility (facility) license to obtain Alzheimer's certification for the facility or a distinct unit of the facility and allow an applicant in good standing to request that DADS issue Alzheimer's certification for the facility or unit before DADS conducts an on-site health inspection. The new section sets forth the criteria for good standing by requiring an applicant, or a controlling person of the applicant, to have operated a certified facility in Texas or a facility in Texas with a certified unit for six consecutive years preceding the request for certification. In addition, each licensed facility operated by the applicant or controlling person must not have a history of certain licensure violations or sanctions imposed as specified in the new section. Before issuing certification, the applicant must submit for approval policies and procedures, verification of employee background checks, and employee credentials. DADS will conduct a health inspection that includes observation of resident care not later than 90 days after the date DADS certifies the facility or unit. The amendments allow DADS to impose an administrative penalty if a facility fails to disclose to residents and prospective residents that it has not met the requirements of an on-site health inspection. The amendments also clarify the process for a license holder of a Type B facility to obtain Alzheimer's certification for the facility or a unit of the facility.

COMMENTS

DADS received written comments from a representative from the Area Agency on Aging Houston-Galveston Area and a representative from Ochiltree General Hospital.

Comment: Both commenters asked for confirmation that, in addition to the process described in the proposed rules, an applicant has the option to apply for Alzheimer’s certification using the current process.

Response: The agency responds that an applicant may apply for Alzheimer’s certification using the current process. No changes were made in response to the comments.

DADS made changes to §92.22(d)(1) to clarify that an applicant or controlling person of the applicant must have operated a certified facility in Texas or a facility in Texas with a certified unit for six consecutive years preceding the request for certification. DADS will not accept operation of an assisted living facility outside of Texas to satisfy this requirement. DADS also made changes to §92.22(f)(2) to require that an applicant to submit documentation demonstrating that it is complying with §92.123, in addition to §92.53. This change is intended to ensure that the applicant verifies the employability of employees before hire and during the term of the employment.

STATUTORY AUTHORITY

The new section is adopted under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; and Texas Health and Safety Code, §247.029, which provides that the HHSC executive commissioner shall adopt rules that govern facilities that provide personal care services to residents who have Alzheimer's disease or related disorders.

The new section implements Texas Government Code, §531.0055 and Texas Health and Safety Code, §247.029.