SECTION 566.19. HHSC Surveys of a Program Provider

(a) A program provider must be in continuous compliance with the certification principles contained in this subchapter that apply to program providers.

(b) HHSC conducts the following surveys:

(1) an initial certification survey;

(2) a recertification survey;

(3) a follow-up survey; and

(4) an intermittent survey.

(c) HHSC conducts an initial certification survey within 120 calendar days after the date HHSC approves the enrollment or transfer of the first individual to receive TxHmL Program services from the program provider.

(d) HHSC may conduct an intermittent survey at any time during a certification period.

(e) HHSC may conduct a combination of two or more different types of surveys at the same time.

(f) If HHSC certifies a program provider after completion of an initial or a recertification survey, the certification period is for no more than 365 calendar days.

(g) HHSC may choose not to conduct a recertification survey of a program provider that has a standard contract if the program provider is not the program provider for one or more individuals for at least 60 consecutive calendar days during the period beginning the first day of the certification period to be surveyed through the 121st calendar day before the end of the certification period.

(h) During a survey, HHSC may:

(1) review the TxHmL Program services or CFC services provided to any individual to determine if a program provider is in compliance with the certification principles; and

(2) determine if a program provider has implemented an approved plan for amelioration as described in §9.586 of this subchapter (relating to Amelioration).

(i) HHSC conducts an exit conference at the end of a survey, at a time and location determined by HHSC. At the exit conference, HHSC informs a program provider of preliminary findings, in writing, including findings that may result in a critical violation.

(j) If HHSC identifies a finding that may be a critical violation not discussed during an exit conference, HHSC holds a new exit conference with a program provider to discuss the finding.

(k) Based on a survey, HHSC takes action as described in §9.587 of this subchapter (relating to Program Provider Compliance and Corrective Action).

(l) HHSC may evaluate the health and safety of an individual at any time. If HHSC identifies a concern from the evaluation, HHSC may conduct an intermittent survey.

Source Note: The provisions of this §566.19 adopted to be effective January 5, 2003, 27 TexReg 12254; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; amended to be effective March 1, 2007, 32 TexReg 544; amended to be effective September 1, 2014, 39 TexReg 6549; amended to be effective July 1, 2015, 40 TexReg 2760; amended to be effective March 20, 2016, 41 TexReg 1867; amended to be effective April 28, 2020, 45 TexReg 2704; transferred effective June 19, 2023, as published in the May 26, 2023 issue of the Texas Register, 48 TexReg2732