La. Admin. Code tit. 48 § I-8521

Current through Register Vol. 50, No. 9, September 20, 2024

Section I-8521 - Denial of License, Revocation of License, or Denial of License Renewal

A. The department may deny an application for a license, may deny a license renewal, or may revoke a license in accordance with the provisions of the Administrative Procedure Act.

B. Denial of an Initial License

1. The department shall deny an initial license in the event that the initial licensing survey finds that the ICF/DD facility is non-compliant with any licensing laws or regulations or with any other required statute, laws, ordinances, Rules or regulations that present a potential threat to the health, safety, or welfare of the individuals receiving services.

2. The department shall deny an initial license for any of the reasons a license may be revoked or non-renewed pursuant to these licensing regulations.

C. Voluntary Non-Renewal of a License

1. If a provider fails to timely renew its license, the license expires on its face and is considered voluntarily surrendered. There are no appeal rights for such surrender or non-renewal of the license, as this is a voluntary action on the part of the provider.

2. If an ICF/DD fails to timely renew its license, the provider shall immediately cease and desist providing services, unless the provider has individuals in the ICF/DD facility. In which case, the provider shall comply with the following requirements:

a. shall immediately provide written notice to the department of the number of individuals receiving services in the ICF/DD facility;

b. shall immediately provide written notice to the individual, parent, legal guardian, or legal representative of the following:

i. notice of voluntary non-renewal;

ii. notice of closure; and

iii. plans for orderly transition of the individuals receiving services;

c. shall discharge and transition each individual within 15 calendar days of voluntary non-renewal; and

d. shall notify the department of where records will be stored and the contact person for those records.

3. If an ICF/DD provider fails to follow these procedures, the owners, managers, officers, directors, and administrators may be prohibited from opening, managing, directing, operating or owning an ICF/DD facility for a period of two years.

D. Revocation of License or Denial of License Renewal. An ICF/DD's license may be denied renewal or may be revoked for any of the following reasons, including but not limited to:

1. failure to be in substantial compliance with the ICF/DD licensing laws, rules and regulations or with other required statutes, laws, ordinances, rules or regulations;

2. failure to comply with the terms and provisions of a settlement agreement or education letter with or from the department, the Attorney General's office, any regulatory agency, or any law enforcement agency;

3. failure to uphold resident rights whereby deficient practices may result in harm or injury or death of an individual receiving services;

4. negligent or harmful failure to protect an individual receiving services from a harmful act of an employee or other individual receiving services including, but not limited to:

a. mental or physical abuse, neglect, exploitation, or extortion;

b. an action posing a threat to an individual's health and safety;

c. coercion;

d. threat or intimidation;

e. harassment; or

d. criminal activity;

5. failure to notify the proper authorities, as required by federal or state law or Rule or regulations, of all suspected cases of:

a. mental or physical abuse, neglect, exploitation, or extortion;

b. an action posing a threat to an individual's health and safety;

c. coercion;

d. threat or intimidation;

e. harassment; or

f. criminal activity;

6. knowingly making a false statement in any of the following areas, including but not limited to:

a. application for initial license or renewal of license;

b. data forms;

c. clinical records, client records, or provider records;

d. matters under investigation by the department or the Office of the Attorney General; or

e. information submitted for reimbursement from any payment source;

7. knowingly making a false statement or providing false, forged, or altered information or documentation to DHH employees or to law enforcement agencies;

8. the use of false, fraudulent or misleading advertising;

9. fraudulent operation of an ICF/DD facility by the owner, administrator, manager, member, officer, or director;

10. an owner, officer, member, manager, administrator, director, or person designated to mange or supervise an individual receiving services has plead guilty or nolo contendere to a felony, or has been convicted of a felony, as documented by a certified copy of the record of the court. For purposes of this paragraph, conviction of a felony means:

a. any felony relating to the violence, abuse, or negligence of a person;

b. any felony relating to the misappropriation of property belonging to another person;

c. any felony relating to cruelty of the infirmed, exploitation of the infirmed, or sexual battery of the infirmed;

d. any felony relating to a drug offense;

e. any felony relating to crimes of sexual nature;

f. any felony relating to a firearm or deadly weapon;

g. any felony relating to Medicare or Medicaid fraud; or

h. any felony relating to fraud or misappropriation of federal or state funds;

11. failure to comply with all reporting requirements in a timely manner as required by the department;

12. bribery, harassment, intimidation, or solicitation of any client designed to cause that client to use or retain the services of any particular ICF/DD;

13. cessation of business or non-operational status;

14. failure to allow or refusal to allow the department to conduct an investigation or survey or to interview provider staff or individuals;

15. interference with the survey process, including but not limited to, harassment, intimidation, or threats against the survey staff;

16. failure to allow or refusal to allow access to provider, facility or client records by authorized departmental personnel;

17. failure to repay an identified overpayment to the department or failure to enter into a payment agreement to repay such overpayment; or

18. failure to timely pay outstanding fees, fines, sanctions or other debts owed to the department.

E. In the event an ICF/DD's license is revoked or renewal is denied, (other than for cessation of business or non-operational status) any owner, officer, member, director, manager, or administrator of such ICF/DD facility may be prohibited from opening, managing, directing, operating, or owning another ICF/DD facility for a period of two years from the date of the final disposition of the revocation or denial action.

La. Admin. Code tit. 48, § I-8521

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 38:3187 (December 2012).

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