TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 1. TEXAS DEPARTMENT OF HUMAN SERVICES

Chapter 19. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION

Subchapter V. ENFORCEMENT

2. LICENSING REMEDIES

40 TAC §19.2111

The Texas Department of Human Services (DHS) proposes an amendment to §19.2111, concerning suspension of admissions, in its Nursing Facility Requirements for Licensure and Medicaid Certification chapter. The purpose of the amendment is to define an admission as a means of a more consistent application of the optional state remedy, suspension of admissions. When the remedy to suspend admissions is imposed, the facility is ordered not to admit residents, regardless of funding source, effective on the date the provider receives notice of the commissioner's order. The proposal states that, for the purpose of imposing this remedy, an admission is the entry into a facility of a new resident or of a resident who has been absent from the facility for 24 or more hours. A waiver to allow a resident to be admitted may be considered by the commissioner or his designee.

Eric M. Bost, Commissioner, has determined that for the first five-year period the section is in effect there will be no fiscal implications for state or 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 protection of resident health and safety. When a suspension of admissions is imposed, there is a threat to the health and safety of residents. To allow an individual to return to that environment could place them at risk. There will be no effect on large, small, or micro businesses, because there is no effect on a facility that complies with the requirements. However, if facility conditions are so egregious that they pose a threat to resident health and safety and a suspension of admissions is the remedy imposed, a facility may experience an adverse economic effect. A one-year synopsis indicates that twenty-nine suspensions were imposed, nineteen were resolved, one was not implemented, four were overturned, and five were in active status. Based upon this data, the department does not anticipate that a significant number of facilities would experience a suspension of admissions, as defined by this rule. The financial impact on a specific facility where a suspension of admissions has been imposed would be dependant on the length of time the suspension is in effect and how many, if any, admissions were denied during that time frame.

Questions about the content of this proposal may be directed to Linda Williams at (512) 438-3167 in DHS's Long Term Care Policy Section. Written comments on the proposal may be submitted to Supervisor, Rules and Handbooks Unit-250, 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 Health and Safety Code, Chapter 242, which authorizes the department to license and regulate nursing facilities.

The amendment implements the Health and Safety Code, §242.001-242.268.

§19.2111.Suspension of Admissions.

(a)

If the commissioner finds that a nursing facility has committed an act for which a civil penalty may be imposed under §242.065, Health and Safety Code, the commissioner may order the nursing facility to immediately suspend admissions. For the purpose of this remedy, the Texas Department of Human Services defines an admission as the entry into a facility of a new resident or of a resident who has been absent from the facility for 24 or more hours. A waiver to allow a resident to be admitted may be considered by the commissioner or his designee.

(b)-(d)

(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 June 29, 2000.

TRD-200004539

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Earliest possible date of adoption: August 13, 2000

For further information, please call: (512) 438-3108