La. Admin. Code tit. 48 § I-4611

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-4611 - General Provisions

A. Any health care facility found to be in violation of any state or federal statute, regulation, or any department rule, adopted in accordance with the APA, governing the administration and operation of the facility may be sanctioned as provided in this Chapter.

B. Unless otherwise prohibited by federal law or regulation, the department may impose one or more of the following sanctions:

1. civil fine(s);

2. denial of Medicaid payment with respect to any individual admitted to, or provided services by, a facility;

3. denial of new admissions into the facility or by the provider;

4. removal from the freedom of choice list;

5. transfer of clients receiving services;

6. suspension of license;

7. monitoring;

8. special staffing requirements;

9. temporary management;

10. revocation of license;

11. denial of license renewal; or

12. any and all sanctions allowed under federal or state law or regulations, including but not limited to:

a. sanctions authorized under the medical assistance programs integrity law (MAPIL), pursuant to R.S. 46:437.1 et seq.;

b. the surveillance and utilization review systems (SURS) rule, pursuant to LAC 50:I, Chapter 41; or

c. any successor statutes or rules.

C. Considerations. When determining whether to impose a sanction, the department may consider some or all of the following factors:

1. whether the violations pose an immediate threat to the health, safety, or welfare of the resident(s), patient(s), or client(s);

2. the duration of the violation(s);

3. whether the violation, or one that is substantially similar, has previously occurred during the last three consecutive surveys;

4. the facility's history of survey compliance;

5. the sanction most likely to cause the facility to come into compliance in the shortest amount of time;

6. the severity of the violation if it does not pose an immediate threat to health and safety;

7. the "good faith" exercised by the facility in attempting to stay in compliance;

8. the financial benefit to the facility of committing or continuing the violation;

9. whether the violation is a repeat violation;

10. whether the facility interfered or hindered the department's investigation or survey process;

11. whether the facility has the governance or institutional control to maintain compliance; and

12. such other factors as the department deems appropriate.

D. The department shall determine whether a violation is a repeat violation and sanction the provider accordingly.

E. The department reserves the right to issue more than one sanction for each violation committed by a facility.

F. Any facility sanctioned under this Rule and found to have a violation that poses a threat to the health, safety, or welfare of the resident(s), patient(s), or client(s) may have additional actions, such as criminal charges, brought against it under another applicable law, statute or regulation.

G. Unless otherwise provided for in state law or statute, if the secretary determines that the violations committed by the facility pose an imminent or immediate threat to the health, safety, or welfare of any resident(s), patient(s), or client(s) receiving services, the imposition of the sanction may be immediate and may be enforced during the pendency of the administrative appeal.

La. Admin. Code tit. 48, § I-4611

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 39:3078 (November 2013), Amended LR 491216 (7/1/2023).

AUTHORITY NOTE: Promulgated in accordance with R.S. 40:2009.11, 40:2009.23, 40:2199 and 40:2199.1.