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Regulatory Services Annual Report Fiscal Year 2016

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Regulatory Services Annual Report Fiscal Year 2016 Regulatory Services Fiscal Year 2016 Annual Report February 2017 Texas Department of Aging and Disability Services Contents General Information 1 General Information 3 Texas Department of Aging and Disability Services (DADS) . 3 Long-Term Care Regulation: Regulatory Services . 4 Provider Descriptions . 5 Home and Community Support Services Agencies . 6. Fiscal Year (FY) 2016 Information and Trends 10 DADS Regions in Texas . 10 DADS Waiver Contract Areas . 12. Regulated Facilities . 14. Changes in Regulated Facilities . 16. Regulated Home and Community Support Services Agencies . 20. Changes in Regulated Home and Community Support Services Agencies . 23 Regulated Waiver Programs . 24. Changes in Waiver Programs . 26 . Comparisons to Other States . 28 Credentialing Programs . .28 . Overview of Enforcement Activities . 31 Top 10 Rankings 34 Deficiencies . 34 . Principles . 45 Assisted Living and Unlicensed Facilities 49 Assisted Living Facility and Unlicensed Facility Actions 51 Administrative Penalties . 51 . Injunctive/Other Relief and Civil Penalty Referrals . 52 . Amelioration of Violations . 52 Trusteeships . 52 . Emergency Suspension and Closing Orders . 53. Denial of License . 53 . Revocation of License . 53 Assisted Living Facility Actions by Region for FY 2016 . 54 Unlicensed Facility Actions by Region for FY 2016 . 55 . i Assisted Living and Unlicensed Facility Complaint and Incident Intakes 65 Complaints . 65 Incidents . 65. Priority Assignment . 65 Assisted Living and Unlicensed Facility Actions Compared Over Multiple Fiscal Years 69 Day Activity and Health Services 73 Day Activity and Health Services Facility Actions 75 Administrative Penalties . 75 . Injunctive or Other Relief Referrals to the Office of the Attorney General . .76 . Emergency Suspension and Closing Orders . 76. Denial of License . 76 . Revocation of License . 77 Day Activity and Health Services Facility Actions by Region for FY 2016 . 77. Day Activity and Health Services Facility Complaint and Incident Intakes 81 Complaints . 81 Incidents . 81. Priority Assignment . 81 Day Activity and Health Services Facility Actions Compared Over Multiple Fiscal Years 84 Home and Community Support Services Agencies 87 Home and Community Support Services Agency Actions 89 Administrative Penalties . 89 . Civil Penalties . .89 . Denials of License Application . 90 Denials of License Renewal . 90. Expirations of License (in Lieu of Enforcement Actions) . 90 Immediate Suspensions . 90 Surrenders of License (in Lieu of Enforcement Actions) . 90. License Revocations . 90 Home Health Agency Actions by Region for FY 2016 . 91 Hospice Agency Actions by Region for FY 2016 . 92 ii Home and Community Support Services Agency Complaint and Incident Intakes 134 Complaints . 134 Incidents . 134 . Priority Assignment . 134 Home and Community Support Services Agency Actions Compared Over Multiple Fiscal Years 139 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions 145 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions Actions 147 Administrative Penalties . .147 . Injunctive/Other Relief and Civil Penalties . 148 Amelioration of Violations . 148 Trusteeships . 148. Emergency Suspension and Closing Orders . 148 . Denials of License . 149 Revocations of License . 149. Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition Actions by Region for FY 2016 . 150. Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions Complaint and Incident Intakes 154 Complaints . 154 Incidents . 154 . Priority Assignment . 154 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions Actions Compared Over Multiple Fiscal Years 158 Nursing Facilities 161 Nursing Facility Actions 163 Administrative Penalties . .163 . Injunctive/Other Relief and Civil Penalties . 164 Amelioration of Violations . 165 Trusteeships . 165. Emergency Suspension and Closing Orders . 165 . Suspension of Admissions . .165 . iii Denial of Payment for New Admissions . 165 . Denial of License . .166 . Revocation of License . 166 Civil Money Penalties . 167 Nursing Facility Actions by Region for FY 2016 . 168 . Nursing Facility Complaint and Incident Intakes 195 Complaints . 195 Incidents . 195 . Priority Assignment . 195 Nursing Facility Actions Compared Over Multiple Fiscal Years 199 Home and Community-based Services and Texas Home Living Contracts 203 Home and Community-based Services and Texas Home Living Contracts 205 Vendor Hold . 205 . Denial of Certification . 205 . Home and Community-based Services Actions by Contract Area for FY 2016 . 205. Texas Home Living Actions by Contract Area for FY 2016 . 205 Home and Community-based Services and Texas Home Living Complaints and Referrals 207 Complaints . 207 Waiver Contract Actions Compared Over Multiple Fiscal Years 208 Glossary 209 iv General Information 1 2 DADS Regulatory Services FY 2016 Annual Report General Information Texas Department of Aging and Disability Services (DADS) Vision Aging Texans and individuals with disabilities will be supported by a comprehensive and cost-effective service delivery system that promotes and enhances individual well-being, dignity and choice . Mission To provide a comprehensive array of aging and disability services, supports and opportunities that are easily accessed in local communities . Our key responsibilities to the residents of Texas include: • Working in partnership with consumers, caregivers, service providers and other stakeholders . • Developing and improving service options that are responsive to individual needs and preferences . • Ensuring and protecting self-determination, consumer rights and safety . Goal 1: Long-term Services and Supports To enable aging and disabled Texans to live dignified, independent, and productive lives in a safe living environment through an accessible, locally based, comprehensive and coordinated continuum of services and opportunities; to provide appropriate services and supports based on individual needs ranging from in-home and community based services for the aging and people with disabilities who request assistance in maintaining their independence and increasing their quality of life, to institutional services for those who require that level of support, seeking to ensure health and safety and to maintain maximum independence for the individual while providing the services and supports required . Goal 2: Regulation, Certification and Outreach Provide licensing, certification, contract enrollment services, financial monitoring and complaint investigation to ensure that residential facilities, home and community support services agencies and people providing services in facilities or home settings comply with state and federal standards, and that people receive high-quality services and are protected from abuse, neglect and exploitation . General Information 3 Goal 3: Indirect Administration Assure the efficient, quality, and effective administration of services provided to the aging and people with disabilities . Long-Term Care Regulation: Regulatory Services Regulatory Services Mission Consumers of long-term care receive competent and compassionate care in a cooperative environment meeting their unique needs and preferences . DADS Regulatory Services regulates long-term care facilities, agencies, programs and individual providers of long-term care services through: • Inspections, surveys and plan reviews • Follow-up visits • Complaint and incident investigations • Other contacts required for carrying out state and federal licensure or certification responsibilities, such as telephone monitoring The following long-term care facilities, agencies and programs must be licensed or, if exempt from licensure, certified by DADS and comply with licensure rules (or certification requirements) to operate in Texas: • Day activity and health services • Assisted living facilities • Home and community support services agencies • Intermediate care facilities for individuals with an intellectual disability or related conditions • Nursing facilities • Home and Community-based Services waiver providers [certified, exempt from licensure] • Texas Home Living waiver providers [certified, exempt from licensure] Regulatory Services enrolls providers and manages the Medicaid provider contract agreements for the nursing facilities and intermediate care facilities for individuals with an intellectual disability or related conditions programs to ensure that provider applicants and providers meet the Medicaid provider participation requirements and are eligible to receive Medicaid reimbursement for long-term care services provided to residents of nursing facilities and intermediate care facilities for individuals with an intellectual disability or related conditions . These enrollment activities include initial provider contract enrollment, contract renewals, contract amendments, changes of ownership, facility relocations and contract monitoring . 4 DADS Regulatory Services FY 2016 Annual Report DADS also licenses, certifies, permits and/or monitors the following people and programs for the purpose of employability in facilities and agencies providing services to people with long-term care needs: • Direct care personnel • Medication aides • Nurse aides • Nursing facility administrators • The Nurse Aide Training and Competency Evaluation Program Provider Descriptions Day Activity and Health Services Facilities
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