Part 1.
TEXAS DEPARTMENT OF HUMAN SERVICES
Chapter 15.
MEDICAID ELIGIBILITY
The Texas Department of Human Services (DHS) proposes amendments to §15.435,
concerning liquid resources, §15.605, concerning medical effective date,
and §15.610, concerning Medicaid coverage, in its Medicaid Eligibility
chapter. The purpose of the amendments is to simplify the medical effective
date policy for clients in institutional settings, clarify that parents of
a deceased child of any age can file for benefits on his behalf, and address
the treatment of funds in the "Texas Tomorrow" program as a resource.
The medical effective date is currently the first day on which all eligibility
criteria are met. The proposed medical effective date for an individual filing
a Medicaid application in the month of facility entry would be the first day
of that month if all eligibility criteria are met during that month.
The current rule language on parental rights to apply for Medicaid benefits
for a deceased child caused confusion because it seems to limit the right
to file only to parents of minor children. The amendment will ensure that
parents of a deceased child of any age can file for Medicaid benefits on his
behalf.
The "Texas Tomorrow" program allows parent/grandparents to purchase a prepaid
college education for a child/grandchild. If the funds can be withdrawn from
the program, they are a countable resource to the purchaser. If the right
to withdraw funds has been irrevocably waived, the funds are not countable
and there is no transfer of assets.
Eric M. Bost, commissioner, has determined that for the first five-year
period the proposed sections will be in effect there will be no fiscal implications
for state or local governments as a result of enforcing or administering the
sections.
Mr. Bost also has determined that for each year of the first five years
the sections are in effect the public benefit anticipated as a result of enforcing
the sections will be that policy will be applied correctly and consistently
statewide. There will be no effect on large, small, or micro businesses as
a result of enforcing or administering the sections because it applies only
to the client's financial eligibility for Medicaid benefits, not to the operation
of business. There is no anticipated economic cost to persons who are required
to comply with the proposed amendments.
Questions about the content of this proposal may be directed to Judy Coker
at (512) 438-3227 in DHS's Long Term Care section. Written comments on the
proposal may be submitted to Supervisor, Rules and Handbooks Unit-132, Texas
Department of Human Services E-205, P.O. Box 149030, Austin, Texas 78714-9030,
within 30 days of publication in the
Texas Register
.
Under §2007.003(b) of the Texas Government Code, the department has
determined that Chapter 2007 of the Government Code does not apply to these
rules. Accordingly, the department is not required to complete a takings impact
assessment regarding these rules.
Subchapter D. RESOURCES
40 TAC §15.435
The amendment is proposed under the Human Resources Code,
Title 2, Chapters 22 and 32, which authorizes the department to administer
public and medical assistance programs and under Texas Government Code §531.021,
which provides the Health and Human Services Commission with the authority
to administer federal medical assistance funds.
The amendment implements the Human Resources Code, §§22.001 -
22.030 and §§32.001 - 32.042.
§15.435.Liquid Resources.
(a)-(t)
(No change.)
(u)
"Texas Tomorrow" funds which can be withdrawn
with approval of the Texas Prepaid Higher Education Tuition Board are a countable
resource to the purchaser. If the purchaser irrevocably waives any right to
revoke the contract and receive a refund of monies invested, the funds are
no longer a countable resource. Irrevocably waiving the right to withdraw
"Texas Tomorrow" funds is not a transfer of assets.
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State on February 4, 2000.
TRD-200000810
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Earliest possible date of adoption: March 19, 2000
For further information, please call: (512) 438-3108
40 TAC §15.605, §15.610
The amendments are proposed under the Human Resources Code,
Title 2, Chapters 22 and 32, which authorizes the department to administer
public and medical assistance programs and under Texas Government Code §531.021,
which provides the Health and Human Services Commission with the authority
to administer federal medical assistance funds.
The amendments implement the Human Resources Code, §§22.001 -
22.030 and §§32.001 - 32.042.
§15.605.Medical Effective Date.
The effective date for medical assistance is
(1)
(No change.)
(2)
the first day of the month of nursing
facility, intermediate care facility for the mentally retarded (ICF/MR) facility,
or state school entry if the applicant filed a Medicaid application during
that month and met all eligibility criteria.
(3)
[
(4)
[
(5)
[
§15.610.Medicaid Coverage.
(a)-(c)
(No change.)
(d)
SSI-MAO eligibility requirements.
(1)-(3)
(No change.)
(4)
Prior coverage for deceased individuals.
(A)-(B)
(No change.)
(C)
If a bona fide agent was not appointed during the individual's
lifetime, then only the individual's spouse, children, sibling or half-sibling,
parent[
This agency hereby certifies that the proposal
has been reviewed by legal counsel and found to be within the agency's legal
authority to adopt.
Filed
with the Office of the Secretary of State on February 4, 2000.
TRD-200000811
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Earliest possible date of adoption: March 19, 2000
For further information, please call: (512) 438-3108
Subchapter T. ADMINISTRATIVE FRAUD DISQUALIFICATION HEARINGS
40 TAC §79.1906
The Texas Department of Human Services (DHS) proposes an
amendment to §79.1906 to eliminate duplicative advance notice of hearing,
in its Legal Services chapter. The purpose of the amendment is to delete the
requirement of "certified mail, return-receipt requested" for simplification
and as a cost savings for DHS. It will retain the requirement of notice by
first-class mail.
Eric M. Bost, commissioner, has determined that for the first five- year
period the section is in effect there will be fiscal implications for state
government as a result of enforcing or administering the section. The effect
on state government for the first five-year period the sections will be in
effect is an estimated reduction in cost of $6,072 in fiscal year (FY) 2000;
$18,215 in FY 2001; $18,215 in FY 2002; $18,215 in FY 2003; and $18,215 in
FY 2004. There will be no fiscal implications for local government as a result
of enforcing or administering the section.
Mr. Bost also has determined that for each year of the first five years
the section is in effect the public benefit anticipated as a result of enforcing
the section will be a cost savings for DHS and, therefore, more efficient
use of state resources. There will be no effect on large, small, or micro
businesses, because the change is internal to DHS. There is no anticipated
economic cost to persons who are required to comply with the proposed section.
Questions about the content of this proposal may be directed to Barbara
Stegall at (512) 438-4878 in DHS's Hearings Department. Written comments on
the proposal may be submitted to Supervisor, Rules and Handbooks Unit-131,
Texas Department of Human Services E-205, P.O. Box 149030, Austin, Texas 78714-9030,
within 30 days of publication in the
Texas Register
.
Under §2007.003(b) of the Texas Government Code, the department has
determined that Chapter 2007 of the Government Code does not apply to these
rules. Accordingly, the department is not required to complete a takings impact
assessment regarding these rules.
The amendment is proposed under the Human Resources Code, Title
2, Chapters 22 and 31, which authorizes the department to administer public
and financial assistance programs.
The amendment implements the Human Resources Code, §§22.001 -
22.030 and §§31.001 - 31.0325.
§79.1906.Advance Notice of Hearing.
(a)
The hearing officer sends the household member an advance
notice of the hearing in sufficient time to allow receipt at least 30 calendar
days before the scheduled hearing date. The notice is sent first class [
(b)
Advance notice requirements are met when the notice is
mailed to the most current mailing address available to any division within
the department whether or not the [
(1)-(2)
(No change.)
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on February 4, 2000.
TRD-200000778
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Earliest possible date of adoption: March 19, 2000
For further information, please call: (512) 438-3108
The Texas Department of Human Services (DHS) proposes the repeal of §97.13,
concerning change of ownership or services; proposes amendments to §97.1,
concerning purpose; §97.2, concerning definitions; §97.3, concerning
licensing fees; §97.11, concerning application and issuance of initial
license; §97.12, concerning issuance and renewal of license; §97.14,
concerning application and issuance of a branch office license; §97.15,
concerning application and issuance of an alternate delivery site license; §97.16,
concerning time periods for processing and issuing a license; §97.21,
concerning licensure requirements and standards for agencies providing licensed
home health, licensed and certified home health, or hospice services; §97.51,
concerning survey procedures; and §97.52, concerning enforcement action;
and proposes new §97.13, concerning change of ownership or services,
in its Home and Community Support Services Agencies chapter. The purpose of
the repeal, amendments, and new section is to implement recent legislation
from the 76th Legislative Session, which amended Health and Safety Code, Chapter
142, relating to licensing and regulation of home and community support services
agencies (HCSSA).
In addition, the sections concerning license application processes have
been amended and the sections on change of ownership/services have been rewritten
to address licensure problems that have been identified by DHS. The timelines
for applying for a license have been changed to expedite the application process.
The definition of change of ownership has been amended. The application procedures
for change of ownership include new time periods for applying for a license
and include a late fee for not complying with the time periods. The time periods
for notifying DHS of specific service changes have been changed to reflect
more realistic expectations. Also, a process for informal reconsideration
of proposed enforcement actions has been added to the enforcement section
in compliance with Government Code, §2001.054.
House Bill (HB) 2914, 76th Legislature, requires agencies to provide a
written statement describing the agencies policy for drug testing of employees
who have direct contact with clients to certain individuals. Senate Bill (SB)
94, 76th Legislature, requires DHS to adopt minimum standards for acceptable
quality of care; adds the concept of a controlling person and adds a definition
for controlling person; amends the requirements for disposal of special or
medical waste; adds requirements regarding the reporting of abuse, neglect,
and exploitation; and adds requirements prohibiting retaliation. HB 2037 establishes
a late renewal fee for licenses that have been expired for 90 days or less.
Senate Bill 1260 requires additional language relating to advance directives
policy. The policy must include a clear and precise statement of any procedure
the agency is unwilling to provide or withhold. This statement must be shared
with clients. Failure to comply will result in an administrative penalty.
In addition, DHS has made technical changes to the sections which facilitate
the transfer from the Texas Department of Health to DHS.
Eric M. Bost, commissioner, has determined that for the first five- year
period the sections are in effect there will be no fiscal implications for
state or local government as a result of enforcing or administering the sections.
Mr. Bost also has determined that for each year of the first five years
the sections are in effect the public benefit anticipated as a result of enforcing
the sections will be stronger HCSSA rules, particularly the sections which
require agencies to provide a written statement describing the agency's policy
for drug testing of employees who have direct contact with clients to certain
individuals; require agencies to dispose of special or medical waste generated
in the home in the same manner as they do at the agency; require agencies
to report abuse, exploitation, and neglect; prohibits retaliation against
a person for filing a complaint or presenting a grievance; and require agencies
to inform residents of policies regarding advance directives and establishes
a $500 administrative penalty for failure to do so. Also the sections on application
procedures and change of ownership have been strengthened to expedite the
application process for licensing of HCSSAs. There will be some effect on
large, small, or micro businesses, because HCSSAs will be required to dispose
of special or medical waste generated in a client's home in the same manner
as they do at the agency, as required by statute. Cost will vary depending
on the current method of disposal and on the number of clients served. The
rules establish a renewal fee for licenses that have been expired for 90 days
or less. The fee is one and one-half times the normal renewal license fee.
If an agency renews its license 90 days or less after the expiration date
of the license, the agency will incur the higher fee. The rules relating to
change of ownership include a $250 late fee for applications submitted postmarked
29 days or less prior to the date of the change of ownership and prior to
the expiration date, unless there is a valid emergency. There is no anticipated
economic cost to persons who are required to comply with the proposed sections.
Questions about the content of this proposal may be directed to Linda Kotek
at (512) 438-3158 in DHS's Long Term Care Section. Written comments on the
proposal may be submitted to Supervisor, Rules and Handbooks Unit-100, Texas
Department of Human Services E-205, P.O. Box 149030, Austin, Texas 78714-9030,
within 30 days of publication in the Texas Register.
Under §2007.003(b) of the Texas Government Code, the department has
determined that Chapter 2007 of the Government Code does not apply to these
rules. Accordingly, the department is not required to complete a takings impact
assessment regarding these rules.
Subchapter A. GENERAL PROVISIONS
40 TAC §§97.1 - 97.3
The amendments are proposed under the Health and Safety Code,
Chapter 142, which provides the department with the authority to adopt rules
for the licensing and regulation of home and community support services agencies.
The amendments implement the Health and Safety Code, Chapter 142.001 -
142.030.
§97.1. Purpose.
(a)
(No change.)
(b)
These sections provide minimum standards for
acceptable
quality of care, which include the following components:
(1)
client independence and self-determination;
(2)
humane treatment;
(3)
continuity of care;
(4)
coordination of services;
(5)
professionalism of service providers;
(6)
quality of life; and
(7)
client satisfaction with services.
[
(c)
(No change.)
§97.2.Definitions.
The following words and terms, when used in these sections, shall have
the following meanings, unless the context clearly indicates otherwise.
(1)-(21)
(No change.)
(22)
Controlling person -
A person with the ability, acting alone or in concert with others, to directly
or indirectly, influence, direct, or cause the direction of the management,
expenditure of money, or policies of an agency or other person.
(A)
A controlling person includes:
(i)
a management company, landlord, or other business
entity that operates or contracts with others for the operation of an agency;
(ii)
any person who is a controlling person of a
management company or other business entity that operates an agency or that
contracts with another person for the operation of an agency;
(iii)
any other individual who, because of a personal,
familial, or other relationship with the owner, manager, landlord, tenant,
or provider of an agency, is in a position of actual control or authority
with respect to the agency, without regard to whether the individual is formally
named as an owner, manager, director, officer, provider, consultant, contractor,
or employee of the agency.
(B)
A controlling person, as described by subparagraph
(A)(iii) of this paragraph, does not include an employee, lender, secured
creditor, or landlord, or other person who does not exercise formal or actual
influence or control over the operation of an agency.
(23)
[
(24)
[
(25)
[
(26)
[
(27)
[
(28)
[
(29)
[
(30)
[
(31)
[
(32)
[
(33)
[
(34)
[
(A)
nursing;
(B)
physical, occupational, speech, or respiratory therapy;
(C)
medical social service;
(D)
intravenous therapy;
(E)
dialysis;
(F)
service provided by unlicensed personnel under the delegation
of a licensed health professional;
(G)
the furnishing of medical equipment and supplies, excluding
drugs and medicines; or
(H)
nutritional counseling.
(35)
[
(36)
[
(A)
are available 24 hours a day, seven days a week, during
the last stages of illness, during death, and during bereavement;
(B)
are provided by a medically directed interdisciplinary
team; and
(C)
may be provided in a residence, nursing facility, residential
unit, independent living environment, or inpatient unit according to need.
These services do not include inpatient care normally provided in a licensed
hospital to a terminally ill person who has not elected to be a hospice client.
(37)
[
(38)
[
(39)
[
(40)
[
(A)
for home dialysis designation, the physician, the registered
nurse, the dietitian, and the qualified social worker responsible for planning
the care delivered to the home staff-assisted dialysis patient; or
(B)
a group of individuals who work together in a coordinated
manner to provide hospice services and must include a physician, registered
nurse, social worker, and counselor.
(41)
[
(42)
[
(43)
[
(44)
[
(45)
[
(46)
[
(47)
[
(48)
[
(A)
dialogue with the client to discuss current eating habits,
exercise habits, food budget and problems with food preparation;
(B)
discussion of dietary needs to help the client understand
why certain foods should be included or excluded from the client's diet and
to help with adjustment to the new or revised or existing diet plan;
(C)
a personalized written diet plan as ordered by the client's
physician or practitioner, to include instructions for implementation;
(D)
providing the client with motivation to help him or her
understand and appreciate the importance of the diet plan in getting and staying
healthy; or
(E)
working with the client or the client's family members
by recommending ideas for meal planning, food budget planning, and appropriate
food gifts.
(49)
[
(50)
[
(A)
a corporation;
(B)
a limited liability company;
(C)
an individual;
(D)
a partnership if a partnership name is stated in a written
partnership agreement or an assumed name certificate;
(E)
all partners in a partnership if a partnership name is
not stated in a written partnership agreement or an assumed name certificate;
or
(F)
all co-owners under any other business arrangement.
(51)
[
(52)
[
(53)
[
(54)
[
(55)
[
(56)
[
(57)
[
(58)
[
(59)
[
(60)
[
(61)
[
(62)
[
(63)
[
(64)
[
(65)
[
(A)
assessment of alterations in mental status or evidence
of suicide ideations or tendencies;
(B)
teaching coping mechanisms or skills;
(C)
counseling activities; or
(D)
evaluation of the plan of care.
(66)
[
(67)
[
(68)
[
(69)
[
(70)
[
(71)
[
(72)
[
(73)
[
(74)
[
(A)
registered nurse;
(B)
licensed vocational nurse;
(C)
physical, occupational, or respiratory therapist;
(D)
speech-language pathologist;
(E)
audiologist;
(F)
social worker; or
(G)
dietitian.
(75)
[
(76)
[
(77)
[
(78)
[
(79)
[
(80)
[
(81)
[
(82)
[
(83)
[
(84)
[
§97.3.Licensing Fees.
(a)
The schedule of fees for licensure of an agency authorized
to provide one or more services is as follows:
(1)
initial
(includes change of ownership)
license
fee--$875;
(2)
(No change.)
(3)
initial
(includes change of ownership)
branch office license fee--$875;
(4)
(No change.)
(5)
initial
(includes change of ownership)
alternate delivery site license fee--$500; and
(6)
(No change.)
(b)
If an applicant for an initial license,
based on a change of ownership, makes late application for a license to the
Texas Department of Human Services (DHS) in accordance with §97.13(b)(2)(C)(iii)
of this title (relating to Change of Ownership and Services), the applicant
shall submit the appropriate initial license fee as set out in subsection
(a) of this section plus an additional late fee of $250.
(c)
[
(d)
[
(e)
[
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State, on February 7, 2000.
TRD-200000934
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Earliest possible date of adoption: March 19, 2000
For further information, please call: (512) 438-3108
40 TAC §§97.11 - 97.16
The new section and amendments are proposed under the Health
and Safety Code, Chapter 142, which authorizes the department to adopt rules
for the licensing and regulation of home and community support services agencies.
The new section and amendments implement the Health and Safety Code, Chapter
142.001 - 142.030.
§97.11.Application and Issuance of Initial License.
(a)
All first-time applications for a license are applications
for an initial license.
An application for a license when there is a
change of ownership is considered to be a first-time application for an initial
license.
(b)
Upon written request, the Texas Department of
Human
Services (DHS)
[
(c)
If the applicant is an individual, the applicant
must
[
(d)
The applicant
must
[
(e)-(f)
(No change.)
(g)
The applicant
must
[
(1)
(No change.)
(2)
All applications for a
license must be made on forms prescribed by and available from DHS.
(A)
The application must be completed in accordance
with DHS instructions, and it must contain original signatures and be notarized.
(B)
The address provided on the application must
be the address from which the agency will be operating and providing services.
(C)
The address for the agency's place of business
to be licensed must be located in the State of Texas.
[
[
(3)
The following items must accompany
the application form and must be originals or notarized copies:
(A)
[
(i)
§97.21(a)(7)
[
(ii)
§97.26(b) of this title (relating to
Standards for Personal Assistance Services) for agencies with the category
of personal assistance services;
(B)
[
(C)
[
(D)
the name of any controlling person and
documentation relating to any controlling person, if requested by DHS and
relevant to the controlling person's compliance with any applicable licensing
standard;
(E)-(J)
(No change.)
(K)
for a parent agency:
(i)-(ii)
(No change.)
(iii)
its organizational structure, a list of management personnel
(including names and titles), and a job description of each administrative
and supervisory position. The job description must contain at a minimum the
job title, qualifications including required education and training, and job
responsibilities
;
[
(iv)
[
(v)
[
(I)
§97.21(b)(3)(B) of this title for agencies
providing licensed home health, licensed and certified home health, or hospice
services; or
(II)
§97.26(g) of this title for agencies
providing personal assistance services; and
(vi)
[
(L)-(S)
(No change.)
(T)
notice that the agency has attended a presurvey conference
at the office designated by
DHS
[
(i)
(No change.)
(ii)
The administrator and supervising nurse (if applicable)
must
[
(iii)
The designated survey office
must
[
(U)
information relating to compliance by
the applicant or a controlling person with respect to the applicant with regulatory
requirements in any other state in which the applicant or controlling person
operates or operated a home and community support services agency.
(V)
any other document or information that
DHS requests that is relevant to the application process.
(4)
[
(A)
DHS will review the materials
[
(B)
If an agency receives a notice from
DHS
[
(i)
An agency which fails to submit the required information
within
30 calendar days
[
(ii)
An agency which has withdrawn its application must reapply
for a license in accordance with this section, if it wishes to continue the
application process. A new license fee is required.
(C)
Information received by the department relating to the
competence and financial resources of the applicant is confidential and may
not be disclosed to the public.
(5)
[
[
on the last day of the preceding
month of the next year if issued on the first day of a month; or]
[
on the last day of the month
of issuance of the next year if issued on the second or any subsequent day
of a month.]
(6)
[
(h)
(No change.)
(i)
The agency
must
[
(1)
Upon admitting the first client, the agency
must
[
(2)
The agency is not required to admit a client(s) under
each category authorized under the license in order to be surveyed by
DHS
[
(j)
A
DHS
[
(1)
Upon receiving an agency request for an initial survey,
the designated survey office
will
[
(2)
An initial survey
will
[
(3)
(No change.)
(4)
At the time of the initial survey, the agency
must
[
(A)-(B)
(No change.)
(5)
DHS
[
(6)
By applying for or holding a license, an agency consents
to entry and survey by
DHS
[
(k)
A person who has requested the category of licensed and
certified home health services on the initial license application
must
[
(1)
Pending approval by the USDHHS Health Care Financing Administration
(HCFA), the person:
(A)
(No change.)
(B)
must
[
(2)
Upon becoming certified by HCFA to participate
in the Medicare program during the initial licensing period,
DHS will
[
(3)
If HCFA denies certification to the person or if the
person withdraws application for participation in the Medicare program, the
person will retain the category of licensed home health services. An agency's
retention of the licensed home health services category does not preclude
DHS
[
(l)
Continuing compliance with the minimum standards and the
provisions of this chapter for the services authorized to be provided under
the license is required during the initial licensing period in order for a
first renewal license to be issued.
(1)
An agency authorized under the license to provide licensed
home health, licensed and certified home health, or hospice services
must
[
(2)
An agency authorized under the license to provide
licensed home health services
must
[
(3)
An agency authorized under the license to provide
licensed and certified home health services
must
[
(4)
An agency authorized under the license to provide
home dialysis
must
[
(5)
An agency authorized under the license to provide
hospice services
must
[
(6)
An agency which holds a license with the category
of personal assistance services
must
[
(m)
If
DHS
[
(n)
If an applicant decides not to continue the application
process for an initial license, the application may be withdrawn. If a license
has been issued, the applicant
must
[
(o)
(No change.)
§97.12.Issuance and Renewal of License.
(a)
Eligibility for license renewal.
(1)
An agency
must
[
(2)
The renewal license
is valid for one year
[
(3)-(5)
(No change.)
(6)
An agency license will not be renewed with the category
of licensed and certified home health services if the agency withdraws from
or is terminated (voluntarily or involuntarily) from participation in the
Medicare program. However, if continued compliance with the requirements for
licensed home health services is demonstrated, the license
will
[
(7)-(9)
(No change.)
(b)
Renewal application.
(1)
DHS
[
(2)
The agency
must
[
(A)
a complete and correct application renewal form which includes
updated information as required by
§97.11(g)(3)(C)-(J))
[
(B)
a description of the agency's service area. The service
area
must
[
(C)-(E)
(No change.)
(F)
if certified by or contracting with another state agency
to deliver services for which a license is required under this chapter, documentation
from the certifying state agency(ies) confirming the certification or contract;
[
(G)
if an applicant is a corporation, a current letter from
the state comptroller's office stating the corporation is in good standing
or a notarized certification that the tax owed to the state under the Tax
Code, Chapter 171, is not delinquent or that the corporation is exempt from
the payment of the tax and is not subject to the Tax Code, Chapter 171
; and
[
(H)
information relating to compliance by the
license holder or a controlling person with respect to the license holder
with regulatory requirements in any other state in which the license holder
or controlling person operates or operated a home and community support services
agency.
(I)
any other document or information
that DHS requests that is relevant to the application process.
(3)
All documents submitted with the renewal application
must
[
(c)
Timely application required. [
(1)
An agency whose license has been expired
for 90 days or less may renew the license by paying the DHS renewal fee that
is 1 and 1/2 times the normally required renewal fee established in §97.3
of this title (relating to Licensing Fees).
(2)
An agency whose license has been
expired for more than 90 days must apply for an initial license in accordance
with §97.11 of this title (relating to Application and Issuance of Initial
License.
(d)
Active military duty exception. If a licensee fails to
timely renew his or her license on or after August 1, 1990, because the licensee
is or was on active duty with the armed forces of the United States of America
serving outside the State of Texas, the licensee may renew the license pursuant
to this subsection.
(1)
Renewal of the license may be requested by the licensee,
the licensee's spouse, or an individual having power of attorney from the
licensee. The renewal form
must
[
(2)
(No change.)
(3)
A copy of the official orders or other official military
documentation showing that the licensee is or was on active military duty
serving outside the State of Texas
must
[
(4)
A copy of the power of attorney from the licensee
must
[
(5)
A licensee renewing under this subsection
must
[
(6)-(7)
(No change.)
(e)
Withdrawal of application. If an agency decides not to
continue the application process for the renewal of a license, the application
may be withdrawn. If a license has been issued, the applicant
must
[
§97.13.Change of Ownership or Services.
(a)
Change of ownership.
(1)
A license may not be transferred.
(2)
A change of ownership occurs when there is:
(A)
a change of 50% or more in the ownership of the business
organization or sole proprietorship that is licensed to operate the agency;
or
(B)
a change in the federal tax payer identification number.
(3)
A change of ownership for a parent agency is
a change of ownership for the parent agency's branch office(s) or alternate
delivery site(s) and requires the submittal of a new initial application(s)
and fee(s) for the branch office(s) or alternate delivery site(s).
(4)
A change of ownership does not include when the licensee
is a business entity who is simply amending its official documents to revise
its name.
(b)
Agency procedures for change of ownership.
(1)
An application for a change of ownership must be requested
at least 60 calendar days prior to the effective date of the change of ownership.
(2)
To avoid a gap in the license period, the prospective
new owner must submit to the Texas Department of Human Services (DHS) a complete
application for a license, along with the appropriate license fee at least
30 days before the anticipated date of sale or other transfer of ownership
and prior to expiration date of the license.
(A)
The application must be completed, as applicable, in accordance
with §97.11 of this title (relating to Application and Issuance of Initial
License), §97.14 of this title (relating to Application and Issuance
of a Branch Office License) or §97.15 of this title (relating to Application
and Issuance of an Alternate Delivery Site License). In addition, the application
packet must include:
(i)
the effective date of the change of ownership;
(ii)
a notarized affidavit signed by the previous owner acknowledging
agreement with the change of ownership;
(iii)
if the applicant is a corporation, a copy of the applicant's
articles of incorporation; and
(iv)
if the applicant is a business entity other than a corporation,
a copy of the sales agreement.
(B)
The applicant must meet all requirements for a license.
(C)
If the applicant has submitted a timely and sufficient
application packet and license fee for a license and otherwise meets all requirements
for a license, DHS will issue the applicant a license effective on the date
of the transfer of ownership. DHS considers an applicant to have filed a timely
and sufficient application for a license if the applicant submits:
(i)
a complete application packet and license fee to DHS, and
the application packet and license fee are received by DHS postmarked at least
30 calendar days before the anticipated date of sale or other transfer of
ownership and prior to the expiration date of the license;
(ii)
an incomplete application packet and license fee to DHS
with a letter explaining the circumstances which prevented the inclusion of
the missing information, and the application packet, license fee, and letter
are received by DHS postmarked at least 30 calendar days before the anticipated
date of sale or other transfer of ownership and prior to the expiration date
of the license, and the explanation is found to be acceptable to DHS. The
missing information must be submitted to DHS within 30 calendar days from
the date of the letter;
(iii)
a complete application packet and license fee to DHS,
and the application packet and license fee are received by DHS postmarked
29 calendar days or less before the anticipated date of sale or other transfer
of ownership and prior to the expiration date of the license, and the applicant
pays a late fee as set out in §97.3(b) of this title (relating to Licensing
Fees); or
(iv)
a complete application packet and license fee to DHS,
and the application packet and license fee are received by DHS by the date
of sale or other transfer of ownership and prior to the expiration date of
the license, and the applicant proves to DHS's satisfaction that the health
and safety of the agency's clients required an emergency change of ownership.
(3)
If an application and license fee are timely
filed, but DHS determines that the application is incomplete and a letter
explaining the circumstances which prevented the inclusion of the missing
information was not filed with the application, the application is considered
to be timely filed but insufficient.
(A)
DHS will provide the applicant with written notification
of the missing information required to complete the application and may assess
a late fee as set out in §97.3(b) of this title (relating to Licensing
Fees) for failure to comply with paragraph (2) of this section.
(B)
The applicant must submit the required information and
late fee, if assessed, no later than 30 calendar days from the date of the
notice.
(i)
An applicant which fails to submit the required information
within 30 calendar days from the notice date is considered to have withdrawn
the application for an initial agency license. The license fee will not be
refunded.
(ii)
An applicant which has withdrawn the application must
reapply for a license in accordance with this section, if wishing to continue
the application process. A new license fee is required.
(4)
Failure to comply with the application procedures
set out in this section may result in an enforcement action(s) under §97.52
of this title (relating to Enforcement Action).
(5)
The initial license issued to the new owner is valid
for one year from the date of issuance.
(6)
The previous owner's license is void on the effective
date of the new initial license and must be surrendered to DHS.
(7)
DHS may deny issuance of a license for any of the
reasons specified in §97.52(a) of this title (relating to Enforcement
Action).
(8)
DHS may waive the on-site survey required by §97.11(i)
of this title (relating to Application and Issuance of Initial License).
(c)
Federal law or regulations.The requirements of this section
are in addition to any applicable federal law or regulation relating to change
of ownership or control.
(d)
Notification procedures for agency name change.
(1)
If an agency changes the agency's name (legal entity or
doing business as), but does not undergo a change of ownership as defined
in subsection (a)(2) of this section, the agency must provide:
(A)
written notification to DHS within five business days prior
the effective date of change;
(B)
a copy of a certificate of amendment from the Secretary
of State's office or other governmental authority(ies), e.g., an assumed name
certificate, reflecting the name change to DHS within 30 days of receipt of
the certificate; and
(C)
a copy of the agency's current federal tax payer identification
number.
(2)
On receipt and verification of the certificate
of amendment and the current federal tax payor identification number, DHS
will provide the agency with a notification of change in the agency's new
name.
(e)
Service change/agency closure procedures.
(1)
An agency must provide written notification to DHS within
five calendar days of the agency's receipt of notice of change in state or
federal certification or accreditation status. The licensee must include a
copy of the notice of change with its written notice to DHS.
(2)
An agency must notify DHS in writing within five calendar
days prior to the cessation of operation of the agency, branch office, or
alternate delivery site.
(A)
The agency must include in the written notice the reason
for closure, the location of the client records, and the name and address
of the client record custodian.
(B)
If the agency closes with an active client roster, the
agency must transfer a copy of the active client record with the client to
the receiving agency in order to assure continuity of care and services to
the client.
(C)
The agency must mail or return the initial license or renewal
license to DHS at the end of the day services were terminated.
(D)
Continuing to operate after the closure date specified
in the notice may result in enforcement action.
(f)
Procedures for adding or deleting a category to the license.To
add or delete a category to the license, the agency must provide written notification
to DHS at least 30 calendar days prior to the addition or deletion of the
category.
(1)
DHS will approve or disapprove the addition of a category.
(A)
At the discretion of DHS, an agency must attend a presurvey
conference at the designated survey office prior to DHS approving the addition
of a category.
(B)
If disapproved, DHS will inform the agency of the reason
for disapproval.
(2)
At the discretion of DHS, an on-site survey may
be conducted following the approval of a category.
(3)
DHS's receipt of an agency request to delete a category
from the license does not preclude DHS from taking enforcement action as appropriate
in accordance with §97.52 of this title (relating to Enforcement Action).
§97.14.Application and Issuance of a Branch Office License.
(a)
The Texas Department of
Human Services (DHS)
[
(1)-(2)
(No change.)
(b)
Upon written request,
DHS will
[
(c)
The parent agency applicant
must
[
(1)-(5)
(No change.)
(d)
The applicant
must
[
(e)
DHS will
[
(1)
The time frames for review
will
[
(2)
An agency which fails to respond to the department's
notice of an incomplete application for a branch office license described
in §97.16(b) of this title within
30 calendar days
[
(3)
(No change.)
(f)
DHS will
[
(g)
The designated survey office will conduct a review of the
applicant's request to establish a branch office. The survey office will recommend
to approve or disapprove the branch office request. At the discretion of
DHS
[
(h)
DHS
[
(i)
Upon approval of the branch office license application,
DHS
[
(j)
At the discretion of
DHS
[
(k)
DHS
[
(l)
The branch office
must
[
§97.15.Application and Issuance of an Alternate Delivery Site License.
(a)
The
Texas Department of Human Services (DHS)
[
(1)-(2)
(No change.)
(b)
Upon written request,
DHS will
[
(c)
The hospice
must
[
(1)-(5)
(No change.)
(d)
The hospice
must
[
(e)
DHS will
[
(1)
The time frames for review
will
[
(2)
An agency which fails to respond to
DHS's
[
(3)
(No change.)
(f)
DHS will
[
(g)
The designated survey office
will
[
(h)
DHS
[
(i)
Upon approval of the alternate delivery site application,
the department will issue the alternate delivery site a license, which
will
[
(j)
The alternate delivery site
must
[
(k)
If the designated survey office recommends that the licensed
alternate delivery site seek a license as a hospice, a written report supporting
the recommendation
must
[
§97.16.Time Periods for Processing and Issuing a License.
(a)
General.
(1)
The date a license application is received is the date
the application reaches the
Home and Community Support Services Agency
Division
[
(2)
An application for an initial license is complete
when
DHS
[
(3)
An application for a renewal license is complete when
DHS
[
(4)
An application for a change of ownership license is
complete when
DHS
[
(b)
Time periods. An application from an agency for an initial
license, renewal license, or change of ownership license
will
[
(1)
The first time period begins on the date the division receives
the application and ends on the date the license is issued, or if the application
is received incomplete, the period ends on the date the facility is issued
a written notice that the application is incomplete. The written notice
must
[
(2)
(No change.)
(c)
Reimbursement of fees.
(1)
In the event the application is not processed in the time
periods stated in subsection (b) of this section, the applicant has the right
to request that
DHS
[
(2)
(No change.)
(d)
Appeal. If the request for reimbursement as authorized
by subsection (c) of this section is denied, the applicant may then appeal
to the commissioner of
DHS
[
[
Hearings. If a hearing is
proposed during the processing of the application, the time periods in §1.34
of this title (relating to Time Periods for Conducting Contested Case Hearing)
are applicable.]
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed
with the Office of the Secretary of State, on February 7, 2000.
TRD-200000936
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Earliest possible date of adoption: March 19, 2000
For further information, please call: (512) 438-3108
40 TAC §97.13
(Editor's note: The text of the following section proposed for
repeal will not be published. The section may be examined in the offices of
the Texas Department of Human Services or in the Texas Register office, Room
245, James Earl Rudder Building, 1019 Brazos Street, Austin.)
The repeal is proposed under the Health and Safety
Code, Chapter 142, which authorizes the department to adopt rules for the
licensing and regulation of home and community support services agencies.
The repeal implements the Health and Safety Code, Chapter 142.001 - 142.030.
§97.13.Change of Ownership or Services.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed
with the Office of the Secretary of State, on February 7, 2000.
TRD-200000935
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Earliest possible date of adoption: March 19, 2000
For further information, please call: (512) 438-3108
Subchapter G. APPLICATION FOR MEDICAID
(2)
] the earliest date in
the month of application on which the applicant met all eligibility criteria;
(3)
] the date on which the
applicant subsequently met all eligibility criteria, if not eligible in the
month of application; or
(4)
] the day after the effective
date of denial (under Type Program 13), for individuals transferred from SSI
assistance to MAO (excluding qualified Medicare beneficiaries).
(in the case of a minor child)
], or court-appointed estate
representative may file for benefits on behalf of the deceased individual.
Chapter 79.
LEGAL SERVICES
and certified mail, return-receipt requested,
] and marked "return service
requested" to the address where the household member last received benefits.
Delivery is not restricted to the addressee. The notice specifies the charges
against the household member and a summary of the evidence (including how
and where it may be examined). If the notice is returned showing a new address,
it will be resent and the normal due process rules will be reapplied.
certified or
] first class mail
is returned. The hearing will be conducted.
Chapter 97.
HOME AND COMMUNITY SUPPORT SERVICES AGENCIES
home and community support services which may include licensed
home health services, licensed and certified home health services, home dialysis
designation, hospice services or personal assistance services, procedures
for granting, denying, suspending, and revoking a license, requirements for
permitting home health medication aides, approving home health medication
aide programs, home health aide training programs, and criminal history checks.
]
(22)
] Counselor--An
individual qualified under Medicare standards to provide counseling services,
including bereavement, dietary, spiritual, and other counseling services to
both the client and the family.
(23)
] Department--The Texas
Department of
Human Services (DHS)
[
Health
].
(24)
] Dialysis treatment
record--For home dialysis designation, a dated and signed written notation
by the person providing dialysis treatment which contains a description of
signs and symptoms, machine parameters and pressure settings, type of dialyzer
and dialysate, actual pre- and post-treatment weight, medications administered
as part of the treatment, and the client's response to treatment.
(25)
] Dietitian--A person
who is currently licensed under the laws of this state to use the title of
licensed dietitian or provisional licensed dietitian, or who is a registered
dietitian.
(26)
] Director--The director
of the
Home and Community Support Services Agencies
[
Health
Facility Licensing Division
] of the Texas Department of
Human Services
[
Health
] or his or her designee.
(27)
] End stage renal disease
(ESRD)--For home dialysis designation, the stage of renal impairment that
appears irreversible and permanent and requires a regular course of dialysis
or kidney transplantation to maintain life.
(28)
] Freestanding hospice--An
agency that provides hospice services to clients of the agency who are residing
at the agency's physical location including inpatient and respite care.
(29)
] Functional need--Needs
of the individual which require services without regard to diagnosis or label.
(30)
] Health assessment--A
determination of a client's physical and mental status through inventory of
systems.
(31)
] Home and community
support services agency--A person who provides home health, hospice, or personal
assistance services for pay or other consideration in a client's residence,
an independent living environment, or another appropriate location.
(32)
] Home health medication
aide--A person permitted under the Health and Safety Code, Chapter 142, Subchapter
B.
(33)
] Home health service--The
provision of one or more of the following health services required by an individual
in a residence or independent living environment:
(34)
] Hospice--A person
licensed under this chapter to provide hospice services, including a person
who owns or operates a residential unit or an inpatient unit.
(35)
] Hospice services--Services,
including services provided by unlicensed personnel under the delegation of
a registered nurse or physical therapist, provided to a client or a client's
family as part of a coordinated program consistent with the standards and
rules adopted under this chapter. These services include palliative care for
terminally ill clients and support services for clients and their families
that:
(36)
] Independent living
environment--A client's individual residence, which may include a group home
or foster home, or other settings where a client participates in activities,
including school, work, or church.
(37)
] Individual/family choice
and control--Individuals and families who express preferences and make choices
about how their support service needs are met.
(38)
] Inpatient unit--A facility
that provides a continuum of medical or nursing care and other hospice services
to clients admitted into the unit and that is in compliance with the conditions
of participation for inpatient units adopted under Social Security Act, Title
XVIII (42 United States Code §1395 et seq.) and standards adopted under
this chapter.
(39)
] Interdisciplinary team--
(40)
] Licensed vocational
nurse--A person who is currently licensed under Texas Civil Statutes, Article
4528c, as a licensed vocational nurse.
(41)
] Long-term program--For
home dialysis designation, the written documentation of the selection of a
suitable treatment modality and dialysis setting which has been selected by
the client and the interdisciplinary team.
(42)
] Manager--A person having
a contractual relationship to provide management services to a home and community
support services agency for the overall operation of a home and community
support services agency including administration, staffing, or delivery of
services. Examples of contracts for services that will not be considered to
be contracts for management services shall include contracts solely for maintenance,
laundry, or food services.
(43)
] Medication administration
record--A record used to document the administration of a client's medications.
(44)
] Medication list--A list
of a client's medications that includes the recommended dosage and the frequency
and method of administration. The medication list is used to identify possible
ineffective drug therapy or adverse reactions, significant side effects, drug
allergies, and contraindications. The medication list does not include a medication
profile.
(45)
] Notarized copy--A sworn
affidavit stating that attached copies are true and correct copies of the
original documents.
(46)
] Nursing facility--An
institution licensed as a nursing home under the Health and Safety Code, Chapter
242.
(47)
] Nutritional counseling--Advising
and assisting individuals or families on appropriate nutritional intake by
integrating information from the nutrition assessment with information on
food and other sources of nutrients and meal preparation consistent with cultural
background and socioeconomic status, with the goal being health promotion,
disease prevention, and nutrition education. Nutritional counseling may include,
but is not limited to, the following:
(48)
] Occupational therapist--A
person who is currently licensed under the Occupational Therapy Practice Act,
Texas Civil Statutes, Article 8851, as an occupational therapist.
(49)
] Owner--One of the following
persons which will hold or does hold a license issued under the statute in
the person's name or the person's assumed name:
(50)
] Palliative care--Intervention
services that focus primarily on the reduction or abatement of physical, psychosocial,
and spiritual symptoms of a terminal illness.
(51)
] Parent agency--The agency
that develops and maintains administrative controls and provides supervision
of branch offices and alternate delivery sites.
(52)
] Parent company--A person,
other than an individual, who has a direct 100% ownership interest in the
owner of an agency.
(53)
] Person--An individual,
corporation, or association.
(54)
] Personal assistance
services--Routine ongoing care or services required by an individual in a
residence or independent living environment that enable the individual to
engage in the activities of daily living or to perform the physical functions
required for independent living, including respite services. The term includes
health-related services performed under circumstances that are defined as
not constituting the practice of professional nursing by the Board of Nurse
Examiners through a memorandum of understanding with
DHS
[
the department
] in accordance with Health and Safety Code, §167
142.016, and health-related tasks provided by unlicensed personnel under the
delegation of a registered nurse or physician.
(55)
] Physical therapist--A
person who is currently licensed under Texas Civil Statutes, Article 4512e,
as a physical therapist.
(56)
] Physician--A person
who is currently licensed under the laws of a state within the United States
and in which the person practices medicine and who holds a doctor of medicine
or doctor of osteopathy degree.
(57)
] Physician assistant--A
person who is licensed under the Physician Assistant Licensing Act, Texas
Civil Statutes, Article 4495-1, as a physician assistant.
(58)
] Physician delegated
tasks--Tasks performed in accordance with the Medical Practice Act, Texas
Civil Statutes, Article 4495d, §3.06, including orders signed by a physician
which specify the delegated task(s), the individual to whom the task(s) is
delegated, and the client's name.
(59)
] Place of business--An
office of a home and community support services agency that maintains client
records or directs home health, hospice, or personal assistance services.
The term does not include an administrative support site.
(60)
] Plan of care--The written
orders of a practitioner for a client who requires skilled services.
(61)
] Practitioner--A person
who is currently licensed in a state in which the person practices as a physician,
dentist, podiatrist, or a physician assistant, or a person who is a registered
nurse registered with the Board of Nurse Examiners for the State of Texas
as an advanced practice nurse.
(62)
] Presurvey conference--A
conference held with department staff and the applicant or his or her representatives
to review licensure standards and survey documents and provide consultation
prior to the on-site licensure survey.
(63)
] Progress note--A dated
and signed written notation by agency personnel summarizing facts about care
and the client's response during a given period of time.
(64)
] Psychoactive treatment--The
provision of a skilled nursing visit to a client with a psychiatric diagnosis
under the direction of a physician that includes one or more of the following:
(65)
] Registered nurse
(RN)--A person who is currently licensed under the Nursing Practice Act, Texas
Civil Statutes, Article 4513 et seq. as a registered nurse.
(66)
] Registered nurse delegation--Delegation
by a registered nurse in accordance with 22 TAC §§218.1-218.11
(Delegation of Selected Nursing Tasks by Registered Professional Nurses to
Unlicensed Personnel).
(67)
] Residence--A place where
a person resides and includes a home, a nursing facility, a convalescent home,
an independent living environment, or a residential unit. A residence includes
a group or a foster home.
(68)
] Residential unit--A
facility that provides living quarters and hospice services to clients admitted
into the unit and that is in compliance with standards adopted under the Texas
Special Care Facility Licensing Act, Health and Safety Code, Chapter 248.
(69)
] Respiratory therapist--A
person who is currently licensed under Texas Civil Statutes, Article 4512l,
as a respiratory care practitioner.
(70)
] Respite services--Support
options that are provided temporarily for the purpose of relief for a primary
caregiver in providing care to individuals of all ages with disabilities or
at risk of abuse or neglect. Respite services may be provided under home health,
hospice, or personal assistance services depending on the needs of the client.
(71)
] Sections--Chapter 97
of this title (Home and Community Support Services Agency).
(72)
] Service area--The geographic
area(s) established by an agency in which all or some of the agency's services
are available.
(73)
] Skilled services--Services
in accordance with a plan of care that require the skills of a:
(74)
] Social worker--A
person who is currently licensed as a social worker under Human Resource Code,
Chapter 50.
(75)
] Speech-language pathologist--A
person who is currently licensed under the Texas Civil Statutes, Article 4512j,
as a speech-language pathologist.
(76)
] Statute--The Health
and Safety Code, Chapter 142.
(77)
] Supervising nurse--The
person responsible for supervising skilled services provided by an agency
and who has the qualifications described in §97.21(b)(3)(C) of this title
(relating to Licensure Requirements and Standards for Agencies Providing Licensed
Home Health, Licensed and Certified Home Health, or Hospice Services). This
person may also be known as the director of nursing or similar title.
(78)
] Supervision--Authoritative
procedural guidance by a qualified person for the accomplishment of a function
or activity with initial direction and periodic inspection of the actual act
of accomplishing the function or activity.
(79)
] Support services--Social,
spiritual, and emotional care provided to a client and a client's family by
a hospice.
(80)
] Survey--An inspection
or investigation conducted by a representative of the department to determine
if a licensee is in compliance with the statute and this chapter. A survey
may be conducted onsite, by mail, by telephone or by electronic communication
methods.
(81)
] Terminal illness--An
illness for which there is a limited prognosis if the illness runs its usual
course.
(82)
] Unlicensed person--An
individual who is not licensed as a health care professional. The term includes,
but is not limited to, home health aides, medication aides permitted by the
department, and other individuals providing personal care or assistance in
health services.
(83)
] Volunteer--An individual
who provides assistance to a home and community support services agency without
compensation other than reimbursement for actual expenses. A volunteer
must
[
shall
] meet the same requirements and standards in
this chapter as apply to an employee of the agency doing the same activities
unless the volunteer is exempt under this chapter from certain requirements
or standards.
(b)
]
DHS
[
The Texas
Department of Health
] will not consider an application as officially
submitted until the applicant pays the licensing fee. The fee must accompany
the application form.
(c)
] Fees paid to
DHS
[
the department
] are not refundable,
except as provided by §97.16
of this title (relating to Time Periods for Processing and Issuing a License)
.
(d)
] Any remittance submitted to
DHS
[
the department
] in payment of a required fee must be
in the form of a certified check, money order, or personal check made out
to the Texas Department of
Human Services
[
Health
].
Subchapter B. APPLICATION AND ISSUANCE OF A LICENSE
Health (department)
] will furnish a person
with an application packet for an agency license.
shall
] be at least 18 years of age.
shall
] retain
a copy of all documentation that is submitted to
DHS
[
the
department
].
shall
] apply
for a license in accordance with this subsection.
(2)
The applicant for a license
shall submit the information listed in subparagraphs (A)-(T) of this paragraph
to the department within six months from the date the department mails the
application packet to the applicant. If the department does not receive the
information listed in subparagraphs (A)-(T) of this paragraph within six months
from the mailing date, the applicant must request a new application packet.
The following documents must be submitted with the original application form
and shall be originals or notarized copies:
]
(A)
an accurate and complete application form
which contains original signatures. The address provided on the application
must be the address from which the agency will be operating and providing
services. The address for its place of business to be licensed by the department
must be located in the State of Texas;
]
(B)
] a description of the agency's
service area. The service area
must
[
shall
] be established
in accordance with
§97.21(a)(6)
] of this title (relating to Licensure Requirements and Standards for
Agencies Providing Licensed Home Health, Licensed and Certified Home Health,
or Hospice Services) for agencies providing licensed home health, licensed
and certified home health, or hospice services; or
(C)
] a nonrefundable license fee;
(D)
] the name of the applicant
and identifying information relating to the owner(s), administrator, and chief
financial officer (if applicable) on a form provided by the department to
enable
DHS
[
the department
] to conduct criminal background
checks;
.
]
The applicant must submit
] a plan
to provide annual continuing education and training for management personnel;
(iv)
] the resume or curriculum
vitae of the agency administrator. The resume or curriculum vitae
must
[
shall
] reflect that the administrator has the qualifications
described in:
(v)
] the resume or curriculum
vitae of the agency supervising nurse (if applicable). The resume or curriculum
vitae
must
[
shall
] reflect that the supervising nurse
has the qualifications described in §97.21(b)(3)(C) of this title;
the department
], or
that the designated survey office has waived the presurvey conference. [
The application is not considered complete and correct unless the department
has received this notice.
]
shall
] attend the presurvey conference.
shall
] verify compliance with the applicable provisions of this chapter and
recommend that the agency be issued an initial license or that the application
be denied pursuant to §97.52 of this title (relating to Enforcement Action)
; and
[
.
]
(3)
] Upon
DHS's
[
the department's
] receipt of the application form, the
required information described in paragraph
(3)
[
(2)
]
of this subsection, and the fee from an applicant,
DHS will
[
the department shall
] review the material to determine whether it is
complete and correct.
The time
periods for reviewing the material shall be
] in accordance with
time periods established in
§97.16 of this title (relating to Time
Periods for Processing and Issuing a License).
the department
] that some or all of the information required under
paragraphs (2) and (3)
[
paragraph (2)
] of this subsection
is deficient, the agency
must
[
shall
] submit the required
information no later than
30 calendar days
[
six months
]
from the date of the notice.
six months
] from the notice
date is considered to have withdrawn its application for an initial agency
license. The license fee will not be refunded.
(4)
] Once
DHS
[
the department
] has determined that the application form, the
information described in paragraph
(3)
[
(2)
] of this
subsection required to accompany the application form, and the license fee
are complete and correct,
and that the applicant meets the requirements
for the license, DHS will
[
the department shall
] issue the
initial license. The initial license
is valid for one year from the date
of issuance.
[
shall expire
]:
(A)
(B)
(5)
]
DHS will
[
The department shall
] mail the initial license certificate to
the licensee. The license certificate will designate the category(ies) of
service the agency is authorized to provide at or from the designated place
of business.
shall
] admit at
least one client and initiate services during the initial license period.
shall
] inform the designated survey office of the admission
and the name of the client and request that an initial survey be conducted.
the department
].
department
] surveyor
will
[
shall
] conduct an onsite survey of the agency after
the issuance of the initial license.
shall
] schedule the
survey of the agency and
will
[
shall
] inform the agency
of the survey date and time.
shall
]
not be required if the agency has received
notification of
accreditation
from
[
by
] the Community Health Accreditation Program or the
Joint Commission on Accreditation for Healthcare Organizations since the issuance
of the initial license.
shall
]:
The department
] will
not renew the license unless the designated survey office has conducted an
initial survey of the agency.
the department
] or a representative
of
DHS
[
the department
] to verify compliance with the
statute or this chapter. The agency
must
[
shall
] provide
a
DHS
[
department
] representative entry to the agency
and access to documents in accordance with §97.51(a) of this title (relating
to Survey Procedures).
shall
] also make application for certification by the United
States Department of Health and Human Services (USDHHS) as a Medicare certified
agency under the Social Security Act, Title XVIII.
shall
] comply with the Medicare
conditions of participation for home health agencies in 42 Code of Federal
Regulations, Part 484, as if the person were duly certified.
the department shall
] send notice to the agency that the
category of licensed and certified home health services has been added to
the license. The agency
must
[
shall
] submit a written
request for deletion or retention of the licensed home health services category.
the department
] from taking enforcement action, as appropriate,
under §97.52 of this title
(relating to Enforcement Action)
.
shall
] comply with §97.21 of this title.
shall
] comply with §97.22
of this title (relating to Standards for Licensed Home Health Services).
shall
]
comply with §97.23 of this title (relating to Standards for Licensed
and Certified Home Health Services).
shall
] comply with §97.24 of
this title (relating to Standards for Home Dialysis Designation).
shall
] comply with §97.25
of this title (relating to Standards for Hospice Services).
shall
] comply
with §97.26 of this title (relating to Standards for Personal Assistance
Services).
the department
] determines
that compliance with the minimum standards and the provisions of this chapter
is not substantiated after the issuance of the initial license, the department
may propose to revoke the initial license and deny the first renewal license
and
must
[
shall
] notify the applicant of a license revocation
and denial as provided in §97.52 of this title
(relating to Enforcement
Action)
.
shall
] cease providing
services and return the license to the department with its written request
to withdraw.
DHS will
[
The department shall
] acknowledge
receipt of the request to withdraw. The license fee will not be refunded.
shall
] renew a license
annually. The Texas Department of
Human Services (DHS) will
[
Health (department) shall
] issue a renewal license to an agency which
meets the minimum standards for a license.
shall expire 12 months
] from the date of issuance. For each annual
license period, the agency
must
[
shall
] provide services
to one or more clients and document the provision of services. The agency
must show proof that services have been provided under the license within
the previous 12 months. Such documentation
must
[
shall
]
be available for review by a
DHS
[
department
] surveyor.
shall
] be renewed with the category of licensed home health services.
The department
] will send notice
of expiration to an agency at least 60 calendar days before the expiration
date of the license. If the agency has not received notice of expiration from
DHS
[
the department
] 45 calendar days prior to the expiration
date, it is the duty of the agency to notify
DHS
[
the department
] and request a renewal application for a license.
shall
] submit
to
DHS
[
the department
] postmarked
at least 30
days
prior to the expiration date of the license:
§97.11(g)(2)(D)-(J)
],
§97.11(g)(3)(K)(iii)-(vi)
[
§97.11(g)(2)(K)(iii)-(v)
], and
§97.11(g)(3)(R)
and (S)
[
§97.11(g)(2)(R) and (S)
] of this title;
shall
] be established in accordance with §97.21(a)(7)
of this title (relating to Licensure Requirements and Standards for Agencies
Providing Licensed Home Health, Licensed and Certified Home Health, or Hospice
Services) for agencies providing licensed home health, licensed and certified
home health, or hospice services; or §97.26(b) of this title (relating
to Standards for Personal Assistance Services) for agencies with the category
of personal assistance services;
and
]
.
]
shall
] be notarized copies or originals. The time periods
for processing an application
must
[
shall
] be in accordance
with §97.16 of this title (relating to Time Periods for Processing and
Issuing a License).
An agency which fails
to make timely and sufficient application for renewal of its license shall
not provide home health, hospice, or personal assistance services after the
expiration date of the license.
] If an agency fails to make timely and
sufficient application for renewal of a license
at least 30 days
prior to the expiration date of the license, the agency must cease operation
upon expiration of the license. [
In order to resume operations, the agency
must apply for an initial license in accordance with §97.11 of this title.
]
shall
] include a current
address and telephone number for the individual requesting the renewal.
shall
] be filed
with
DHS
[
the department
] along with the renewal form.
shall
] be filed with
DHS
[
the department
] along with the renewal form if the individual having the power of
attorney executes any of the documents required in this section.
shall
] pay the applicable renewal fee.
shall
] return the license to the department with its written request
to withdraw and cease providing services.
DHS will
[
The department
shall
] acknowledge receipt of the request to withdraw.
Health (department)
] may issue a branch office license to a person
who holds a current agency license to provide home health or personal assistance
services. A person who holds a current agency license is eligible to apply
for a branch office license:
the department
shall
] furnish a license holder with an application for a branch office
license.
shall
] submit to
DHS
[
the department
]:
shall
] retain
a copy of all documentation that is submitted to
DHS
[
the
department
].
The department shall
] review
the application and accompanying material to determine whether it is complete
and correct.
shall
] be in accordance with §97.16 of this title (relating to Time
Periods for Processing and Issuing a License).
six months
] from the date of the notice is considered to have withdrawn
the application for a branch office license. The branch office license fee
will not be refunded.
The department shall
] notify
the designated survey office of the agency's request to establish a branch
office.
the department
], the designated survey office may conduct
an onsite survey of the branch office prior to recommending approval or disapproval
of the branch office request.
The department
] may propose
denial of the application according to §97.52 of this title (relating
to Enforcement Action) after consideration of the designated survey office's
recommendation.
the department
] will issue the branch office a license,
which
will
[
shall
] expire on the same expiration date
as the parent agency's license and
will
[
shall
] be renewed
with the parent agency's license.
the department
], an onsite survey of the branch office may be conducted after issuance
of the license to determine compliance with the statute and this chapter.
The department
] will mail the
branch office license to the licensee. The branch office license
must
[
shall
] be posted in a conspicuous place on the licensed
branch office premises.
shall
] comply
with §97.27 of this title
(relating to Standards for Branch Offices
and the standards relating to the category(ies) authorized under the
license.
department
] may issue an alternate delivery site license to a
person who holds a current agency license to provide hospice services. A person
who holds a current agency license to provide hospice services is eligible
to apply for an alternate delivery site license:
the department
shall
] furnish a hospice license holder with an application for an alternate
delivery site license.
shall
] submit to
DHS
[
the department
]:
shall
] retain a
copy of all documentation that is submitted to
DHS
[
the department
].
The department shall
] review
the application and accompanying material to determine whether it is complete
and correct.
shall
] be in accordance with §97.16 of this title (relating to Time
Periods for Processing and Issuing a License).
the department's
] notice of an incomplete application for an alternate
delivery site license described in §97.16(b) of this title within
30 calendar days
[
six months
] from the date of the notice
is considered to have withdrawn the application for an alternate delivery
site license. The alternate delivery site license fee will not be refunded.
The department shall
] notify
the designated survey office of the hospice's request to establish an alternate
delivery site.
shall
] conduct a review of the hospice's request to establish an alternate
delivery site. The survey office will recommend to approve or disapprove the
alternate delivery site request. At the discretion of
DHS
[
the department
], the designated survey office may conduct an onsite
survey of the alternate delivery site prior to recommending approval or disapproval
of the alternate delivery site request.
The department
] may propose
denial of the application according to §97.52 of this title after consideration
of the designated survey office's recommendation.
shall
] expire on the same expiration date as the hospice's
license, and
will
[
shall
] be renewed with the hospice's
license. The alternate delivery site license
must
[
shall
]
be posted in a conspicuous place on the licensed alternate delivery site premises.
shall
] comply with §97.25 of this title (relating to Standards for Hospice
Services) and §97.28 of this title. The designated survey office will
conduct an on-site survey after a license has been issued to verify compliance
with §97.25 of this title
(relating to Standards for Hospice Services)
and §97.28 of this title
(relating to Standards for Alternate
Delivery Sites)
.
shall
] be submitted to
DHS
[
the department
] for review.
Health Facility Licensing Division (division)
],
Texas Department of
Human Services (DHS)
[
Health (department)
].
the department
] has received, reviewed, and
found acceptable the information described in §97.11 of this title (relating
to Application and Issuance of Initial License).
the department
] has received, reviewed and found acceptable
the information described in §97.12 of this title (relating to Issuance
and Renewal of License).
the department
] has received, reviewed,
and found acceptable the information described in §97.13 of this title
(relating to Change of Ownership or Services).
shall
] be processed in accordance with the following time periods.
shall
] describe the specific information that is required
before the application is considered complete. The first time period is 45
days.
the department
] reimburse in full
the fee paid in that particular application process. If
DHS
[
the department
] does not agree that the established periods have been
violated or finds that good cause existed for exceeding the established periods,
the request will be denied.
health
] for a resolution
of the dispute. The applicant
must
[
shall
] give written
notice to the commissioner requesting reimbursement of the fee paid because
the application was not processed within the established time period.
DHS will
[
The department shall
] submit a written report of
the facts related to the processing of the application and good cause for
exceeding the established time periods. The commissioner will make the final
decision and provide written notification of the decision to the applicant
and the director.
(e)
Subchapter C. SERVICE STANDARDS