SECTION 559.231. Surveys and Visits

(a) The Texas Health and Human Services Commission (HHSC) may enter the premises of an individualized skills and socialization provider at reasonable times and perform a survey necessary to issue a license or renew a license. HHSC survey personnel will perform surveys, follow-up visits, complaint investigations, investigations of abuse or neglect, and other contact visits as required for carrying out the responsibilities of licensing.

(b) Generally, all surveys, complaint investigations, and other visits, whether routine or non-routine, made for the purpose of determining the appropriateness of care of individuals and day-to-day operations of an individualized skills and socialization provider will be unannounced. Any exceptions must be justified.

(c) HHSC may conduct any survey or investigation as a desk review, if appropriate, and at the discretion of HHSC, except for the on-site components of:

(1) an initial survey; and

(2) a complaint investigation.

(d) Any person may request a survey of an individualized skills and socialization provider by notifying HHSC Complaint and Incident Intake at 1-800-458-9858 of an alleged violation of a licensing requirement. HHSC performs an on-site survey as soon as feasible but no later than 30 days after receiving the complaint, unless after a preliminary investigation the complaint is found to be frivolous. HHSC will respond to the complainant in writing if the complainant provides a mailing address.

(e) HHSC receives and investigates anonymous complaints.

(f) The individualized skills and socialization provider must provide all its books, records, and other documents maintained by or on behalf of an individualized skills and socialization provider to HHSC upon request.

(1) HHSC is authorized to photocopy documents, photograph individuals, and use any other available recording devices to preserve all relevant evidence of conditions found during a survey, or investigation that HHSC reasonably believes threatens the health and safety of an individual.

(2) Examples of records and documents that may be requested and photocopied or otherwise reproduced are individual program plans, person-directed plans, and medication records.

(3) Upon request, an individualized skills and socialization provider must provide HHSC with a list of all individuals served by the individualized skills and socialization provider. The list must include the waiver program or funding source used by the individual to receive services from the individualized skills and socialization provider.

(4) The individualized skills and socialization provider may charge HHSC at a rate not to exceed the rate HHSC charges for copies. The procedure of copying is the responsibility of the administrator or designee. If copying requires that the records be removed from the individualized skills and socialization provider, a representative of the individualized skills and socialization provider is expected to accompany the records and assure their order and preservation.

(5) HHSC protects the copies for privacy and confidentiality in accordance with recognized standards of medical records practice, applicable state laws, and HHSC policy.

(g) The source of the complaint is not revealed.

(h) HHSC inspects an individualized skills and socialization provider at least once every two years after the initial survey.

Source Note: The provisions of this §559.231 adopted to be effective January 1, 2023, 47 TexReg 8709