La. Admin. Code tit. 48 § I-8523

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

Section I-8523 - Notice and Appeal of License Denial, Revocation or Non-Renewal

A. Notice of a license denial, license revocation, or license non-renewal (i.e. denial of license renewal) shall be given to the provider in writing.

B. The ICF/DD has the right to an informal reconsideration of the license denial, license revocation, or license non-renewal. There is no right to an informal reconsideration of a voluntary non-renewal or surrender of a license by the provider.

1. The ICF/DD provider shall request the informal reconsideration within 15 calendar days of the receipt of the notice of the license denial, license revocation, or license non-renewal. The request for informal reconsideration shall be in writing and shall be forwarded to the department's Health Standards Section. The request for informal reconsideration shall be considered timely if received by DHH Health Standards within 15 days from the provider's receipt of the notice.

2. The request for informal reconsideration shall include any documentation that demonstrates that the determination was made in error.

3. If a timely request for an informal reconsideration is received by the Health Standards Section, an informal reconsideration shall be scheduled and the provider will receive written notification of the date of the informal reconsideration.

4. The provider shall have the right to appear in person at the informal reconsideration and may be represented by counsel.

5. Correction of a violation of a deficiency which is the basis for the denial, revocation or non-renewal, shall not be a basis for reconsideration.

6. The informal reconsideration process is not in lieu of the administrative appeals process.

7. The provider will be notified in writing of the results of the informal reconsideration.

C. The ICF/DD provider has a right to an administrative appeal of the license denial, license revocation, or license non-renewal. There is no right to an administrative appeal of a voluntary non-renewal or surrender of a license by a provider.

1. The ICF/DD provider shall request the administrative appeal within 30 calendar days of the receipt of the result of the informal reconsideration. The ICF/DD may forgo its rights to an informal reconsideration, and if so, the ICF/DD shall request the administrative appeal within 30 calendar days of the recipient of the notice of license denial, license revocation, or license non-renewal. The request for administrative appeal shall be in writing and shall be submitted to the department's Division of Administrative Law or its successor.

2. The request for administrative appeal shall include any documentation that demonstrates that the determination was made in error and shall include the basis and specific reasons for the appeal.

3. If a timely request for an administrative appeal is received by the Division of Administrative Law or its successor, the administrative appeal of the license revocation or license non-renewal shall be suspensive, and the provider shall be allowed to continue to operate and provide services until such time as the department issues a final administrative decision. If the department denied an initial license application, the ICF/DD shall discharge any and all individuals receiving services.

a. Notwithstanding the provisions of Paragraph §8523. C.3 above, if the secretary of the department determines that the violations of the facility pose an imminent or immediate threat to the health, welfare, or safety of a participant or individual receiving services, then the imposition of the license revocation or license non-renewal may be immediate and may be enforced during the pendency of the administrative appeal.

b. If the secretary of the department makes such a determination, the facility shall be notified in writing of such determination.

4. Correction of a violation or a deficiency which is the basis for the denial, revocation, or non-renewal, shall not be a basis for the administrative appeal.

D. If an existing ICF/DD provider has been issued a notice of license revocation and the provider's license is due for annual renewal, the department shall deny the license renewal application. The denial of the license renewal application does not affect in any manner the license revocation.

E. If a timely administrative appeal has been filed by the provider on a license denial, license non-renewal, or license revocation, the department's Division of Administrative Law or its successor shall conduct the hearing within 90 days of docketing of the administrative appeal. One extension, not to exceed 90 days, may be granted by the Division of Administrative Law or its successor upon good cause shown.

1. If the final agency action is to reverse the license denial, the license non-renewal, or the license revocation, the provider's license will be re-instated or granted upon the payment of any licensing or other fees due to the department and the payment of any outstanding sanctions due to the department.

2. If the final agency action is to affirm the license non-renewal or the license revocation, the provider shall discharge any and all individuals receiving services according to the provisions of this Rule. Within 10 days of the final agency decision, the provider must notify the department's licensing section in writing of the secure and confidential location of where client records will be stored.

F. There is no right to an informal reconsideration or an administrative appeal of the issuance of a provisional initial license to a new ICF/DD or the issuance of a provisional license to an existing ICF/DD. A provider who has been issued a provisional license is licensed and operational for the term of the provisional license. The issuance of a provisional license to an existing ICF/DD is not considered to be a denial of license, a denial of license nonrenewal, or a license revocation.

1. If a provisional license is issued, the provider shall submit a plan of correction to DHH for approval, and shall be required to correct all noncompliance or deficiencies prior to the expiration of the provisional license.

2. The department shall conduct a follow-up survey, either on-site or by desk review, of the ICF/DD provider prior to the expiration of the provisional license.

3. If the follow-up survey determines that the ICF/DD provider has corrected the deficient practices and has maintained compliance during the period of the provisional license, the department may issue a full license for the remainder of the year until the anniversary date of the ICF/DD provider.

4. If the follow-up survey determines that all noncompliance or deficiencies have not been corrected, or if new deficiencies that are a threat to the health, safety, or welfare of individuals receiving services are cited on the follow-up survey, the provisional initial license or provisional license shall expire on the date specified on the provisional license. However, at the sole discretion of the department, the provisional license may be extended for an additional period not to exceed 90 days in order for the ICF/DD facility to correct the non-compliance or deficiencies.

5. The department shall issue written notice to the provider of the results of the follow-up survey.

6. A provider with a provisional initial license or an existing provider with a provisional license that expires due to noncompliance or deficiencies cited at the follow-up survey shall have the right to an informal reconsideration and the right to an administrative appeal as to the deficiencies cited in the follow-up survey.

a. The correction of a violation, noncompliance, or deficiency after the follow-up survey shall not be the basis for the informal reconsideration or the administrative appeal.

b. The informal reconsideration and the administrative appeal are limited to whether the deficiencies were properly cited at the follow-up survey.

c. The provider shall request the informal reconsideration in writing to the DHH Health Standards Section within five calendar days of receipt of the notice of the results of the follow-up survey from the department. The informal reconsideration request shall be considered timely if received by the Health Standards Section within five days from provider's receipt of the notice.

d. The provider must request an administrative appeal within five calendar days of receipt of the notice of the results of the informal reconsideration. The facility may forgo its right to an informal reconsideration, and if so, the facility shall request an administrative appeal within five calendar days of receipt of the notice of the results of the follow-up survey. The request for an administrative appeal shall be in writing and shall be submitted to the department's Division of Administrative Law or its successor.

e. A provider with a provisional initial license or an existing provider with a provisional license that expires under the provisions of this section shall cease providing services and discharge clients unless the Division of Administrative Law or its successor issues a stay of the expiration. The stay may be granted by the Division of Administrative Law or its successor upon application by the provider at the time the administrative appeal is filed and only after a contradictory hearing, and only upon a showing that there is no potential harm to the client being served by the provider.

f. If a timely administrative appeal has been filed by a provider with a provisional license that has expired or by an existing provider whose provisional license has expired under the provision of this section, the Division of Administrative Law or its successor shall conduct the hearing within 90 days of the docketing of the administrative appeal. One extension, not to exceed 90 days, may be granted by the Division of Administrative Law or its successor upon good cause shown.

i. If the final agency decision is to remove all deficiencies, the provider's license will be reinstated upon the payment of any licensing or other fees due to the department and the payment of any outstanding sanctions due to the department

ii. If the final agency decision is to uphold the deficiencies and affirm the expiration of the provisional license, the provider shall discharge any and all individuals receiving services. Within 10 days of the final agency decision, the provider must notify the department's licensing section in writing of the secure and confidential location of where client records will be stored.

G. Representation at Hearings. An ICF/DD shall, when allowed by law, have a representative present at all judicial, educational, or administrative hearings which address the status of an individual in the care of the ICF/DD.

La. Admin. Code tit. 48, § I-8523

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 38:3188 (December 2012).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and R.S. 40:2180-2180.5.