Texas Register, Volume 17, Number 95, Pages 8985-9056, December 22, 1992 Page: 9,044
8985-9056 p. ; 28 cm.View a full description of this periodical.
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ginning with the date of the on-site visit exit
conference by the state survey agency;
(-b-) with a scope
of up to and including 20% results in mone-
tary penalties of $5.00 per day per certified
Medicaid bed{ for every day the facility is
out of compliance, for a minimum of 15
days beginning with the date of the on-site
visit exit conference by the state survey
agency.
(II) A severity of "po-
tential for harm," with a scope of more than
20% results in monetary penalties of $5.00
per day per certified Medicaid bed, for ev-
ery day the facility is out of compliance, for
a minimum of 15 days beginning with the
date of the on-site visit exit conference by
the state survey agency.
(2) Duration and payment of
monetary penalties.
(A) Unless the penalties are
appealed, payment of assessed monetary
penalties must be received in full by DHS
within 20 days of receipt of a certified letter
from DHS to the facility stipulating the
amount of monetary penalties.
(B) Unless the facility ap-
peals as specified in 19.2209 of this title
(relating to Appeals Process for Resident-
Related. Contract Violations), interest on the
monetary penalties accrues from the 21st
day of receipt of the certified letter until
paid, and at the rate of interest in effect
during the interest period for judgments of
the courts of Texas, as provided in Texas
Civil Statutes, Article 5069-1.05, 2.
(C) Monetary penalties cease
the slmne Jate as decertification or contract
cancellation.
(D) Unless the facility is
decertified or its contract is canceled, mone-
tary penalties continue for a minimum of 15
days or until the survey agency is assured
that the contract violation is corrected,
whichever is later. The state survey agency
may be notified in writing by the facility
that the contract violation was corrected.
The state survey agency staff must find on a
subsequent visit that the contract violation
was in fact corrected.
(i) Monetary penalties as
described in this section will cease on the
16th day or the date of notification to the
state survey agency, whichever is later, if:
(I) the state surveyors
are unable to revisit the facility within five
days after the date that the facility provided
notification that the contract violation was
corrected; and(II) the contract viola-
tion is later shown to be corrected based
upon observation by the state survey agency
and/or written documentation by the facil-
ity.
(ii) If, on a subsequent
visit, the state survey agency determines
that the contract violation was in fact not
corrected, the state survey agency notifies
DHS, and DHS will double the most recent
assessment of monetary penalties, effective
the date the contract violation was errone-
ously reported corrected, and DHS will con-
tinue the assessment until the contract
violation is corrected.
(E) DHS applies all funds
collected, as a result'of monetary penalties,
to the protection of the health and property
of residents of nursing facilities that DHS or
the, Health Care Financing Administration
(HCFA) finds deficient. Funds may be used
for the cost of relocating residents to other
facilities, for maintenance or operation of a
facility pending correction of a contract vio-
lation or closure, and for reimbursement of
residents for lost personal funds.
19.2207. Administrative Contract Viola-
tions. If a facility has been cited in writing
by the Texas Department of Human Ser-
vices (DHS) for failure to meet nonresident-
related requirements, other applicable
agency rules, or contractual provisions,
DHS takes the following action.
(1) DHS grants the facility a
compliance period of no more than 30 days
to correct a contract violation. At the end of
the compliance period, if DHS determines
that a contract violation is not corrected, but
determines that the facility has made sub-
stantial progress toward correcting the con-
tract violation, DHS may grant an
additional one-time extension period of up
to 15 days.
(2) If the contract violation is
not corrected within the compliance period,
DHS imposes vendor hold on state Medic-
aid payments to the facility.
(3) If a contract violation is not
corrected within 60 days from the date the
facility is placed on vendor hold, DHS can-
cels the facility's contract on the 61st day.
A facility may request an informal reconsid-
eration and/or an appeal hearing. A request
for an informal reconsideration must be
submitted in writing to Provider Services,
Texas Department of Human Services, P.O.
Box 149030, Austin, Texas 78714-9030.
Regulations governing these appeals are
specified in 79.1605(a) of this title (relat-
ing to Request for a Hearing). If the facility
appeals the contract cancellation by DHS
and the adverse action is sustained by anadministrative law judge or judicial pro-
ceedilig, the effective date of the contract
cancellation is the date the administrative
law judge's decision becomes final. Unless
otherwise provided for in this section, DHS
makes no payment for services provided by
the facility after the effective date of the
facility's contract cancellation. DHS may
continue payments for no more than 30
days from the date DHS cancels or fails to
renew a facility's contract if the state survey
agency notifies DHS in writing, or DHS
determines, that:
(A) reasonable efforts are be-
ing made to transfer the residents to another
facility or to alternate care; and
(B) additional time is needed
to effect an orderly transfer of the residents.
192208. Contract Cancellation for
Resident-Related Contract Violations.
(a) The Texas Department of Hu-
man Services (DHS) notifies the facility in
writing of its intention to cancel the facili-
ty's contract when either of the following
situations occur.
(1) The state survey agency ter-
minates the facility's certification. DHS
makes no payment for services provided by
the facility after the effective date of the
termination of a facility's certification.
(2) The facility has received
three notifications within an accountability
period of resident-related contract violations
and recommendations for or imposition of
remedies, excluding 'facility-developed
plans of correction or compliance letters.
(A) If the contract cancella-
tion is not appealed, the contract is canceled
on the 20th day after the facility receives
notice of DHS's decilon to cancel the con-
tract.
(B) If the contract cancella-
tion is appealed, the contract will be can-
celed on the date the administrative law
judge's decision upholding the cancellation
becomes final.
(b) DHS may continue payments
for no more than 30 days from the date
DHS cancels a facility's contract if the state
survey agency notifies DHS in writing that:
(1) reasonable efforts are being
made to transfer .the residents to another
facility, to community care, or to other al-
ternate care; and
(2) additional time is needed to
effect an orderly transfer of the residents.
(c) When a facility's contract is
canceled by DHS under the provisions of17 TexReg 9044 December 22, 1992 .Texas Register +
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Texas. Secretary of State. Texas Register, Volume 17, Number 95, Pages 8985-9056, December 22, 1992, periodical, December 22, 1992; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth190841/m1/60/: accessed July 18, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.