26 Tex. Admin. Code § 509.83 - Complaint Investigations
(a) Upon initial
triage, a facility shall provide each patient and applicable legally authorized
representative with a written statement identifying the Texas Health and Human
Services Commission (HHSC) as the agency responsible for investigating
complaints against the facility.
(1) The
statement shall inform persons that they may direct a complaint to HHSC
Complaint and Incident Intake (CII) and include current CII contact
information, as specified by HHSC.
(2) The facility shall prominently and
conspicuously post this statement in patient common areas and in visitor's
areas and waiting rooms so that it is readily visible to patients, employees,
and visitors. The information shall be in English and in a second language
appropriate to the demographic makeup of the community served.
(b) HHSC evaluates all complaints.
A complaint must be submitted using HHSC's current CII contact information for
that purpose, as described in subsection (a) of this section.
(c) HHSC documents, evaluates, and
prioritizes complaints based on the seriousness of the alleged violation and
the level of risk to patients, personnel, and the public.
(1) Allegations determined to be within
HHSC's regulatory jurisdiction relating to freestanding emergency medical care
facilities may be investigated under this chapter.
(2) HHSC may refer complaints outside HHSC's
jurisdiction to an appropriate agency, as applicable.
(d) HHSC shall conduct investigations to
evaluate a facility's compliance following a complaint of abuse, neglect, or
exploitation; or a complaint related to the health and safety of
patients.
(e) HHSC may conduct an
unannounced, on-site investigation of a facility at any reasonable time,
including when treatment services are provided, to inspect or investigate:
(1) a facility's compliance with any
applicable statute or rule;
(2) a
facility's plan of correction;
(3)
a facility's compliance with an order of the executive commissioner or the
executive commissioner's designee;
(4) a facility's compliance with a court
order granting injunctive relief; or
(5) for other purposes relating to regulation
of the facility.
(f) An
applicant or licensee, by applying for or holding a license, consents to entry
and investigation of any of its facilities by HHSC.
(g) A facility shall cooperate with any HHSC
investigation and shall permit HHSC to examine the facility's grounds,
buildings, books, records, and other documents and information maintained by,
or on behalf of, the facility, unless prohibited by law.
(h) A facility shall permit HHSC access to
interview members of the governing body, personnel, and patients, including the
opportunity to request a written statement.
(i) HHSC shall maintain the confidentiality
of facility records as applicable under state and federal law.
(j) A facility shall permit HHSC to inspect
and copy any requested information, unless prohibited by law. If it is
necessary for HHSC to remove documents or other records from the facility, HHSC
provides a written description of the information being removed and when it is
expected to be returned. HHSC makes a reasonable effort, consistent with the
circumstances, to return any records removed in a timely manner.
(k) Upon entry, the HHSC representative holds
an entrance conference with the facility's designated representative to explain
the nature, scope, and estimated duration of the investigation.
(l) The HHSC representative holds an exit
conference with the facility representative to inform the facility
representative of any preliminary findings of the investigation. The facility
may provide any final documentation regarding compliance during the exit
conference.
(m) Once an
investigation is complete, HHSC reviews the evidence from the investigation to
evaluate whether there is a preponderance of evidence supporting the
allegations contained in the complaint.
Notes
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