N.H. Code Admin. R. He-E 807.14

Current through Register No. 25, June 20, 2024
Section He-E 807.14 - Administrative Hearings
(a) A NF may appeal the finding of non-compliance resulting in the imposition of a remedy specified in 42 CFR 488.406 or resulting in the notice of termination of the provider agreement as referenced in He-E 807.03(d) and (e) (2) and He-E 807.08(k) by requesting an administrative hearing in accordance with He-C 200.
(b) An administrative hearing shall not delay the imposing of a remedy or remedies except in the case of a CMP pursuant to 42 CFR 431.153(f) (2) .
(c) A NF may appeal the level of non-compliance in CMP situations only if it would affect the amount of CMPs which could be collected pursuant to 42 CFR 488.438.
(d) When the remedy of the termination of a provider's agreement has been imposed:
(1) The termination shall result in the provider's loss of certification as a nursing facility under Title XIX of the Social Security Act and constitute immediate suspension of its license in accordance with RSA 151:5-b and RSA 541-A:30, III; and
(2) An administrative hearing, pursuant to He-C 200, on the immediate suspension shall be held no later than 10 business days after the notice is sent. If the immediate suspension is upheld, the termination shall take effect without further proceedings.
(e) The choice of remedy to be imposed on the NF shall not be appealed pursuant to 42 CFR 488.408(g) (2) .
(f) A hearings officer, at the administrative hearing, shall:
(1) Hear the testimony of both the survey agency and the NF regarding the survey results; and
(2) Determine, based on the evidence presented at the hearing and in accordance with He-E 807:
a. In the case of CMP appeals, whether the amount of the CMP was correctly set pursuant to 42 CFR 488.438; and
b. In all appeals, whether the deficiency or deficiencies were correctly cited.
(g) Pursuant to 42 CFR 488.438(e) , when a hearing officer finds that the basis for imposing a CMP exists, he/she shall not:
(1) Set a penalty of zero or reduce a penalty to zero;
(2) Review the exercise of discretion by the survey agency or the state medicaid agency to impose a CMP; and
(3) Consider any factors in reviewing the amount of the penalty other than those described in 42 CFR 488.438(f) .
(h) If a NF is upheld at the administrative hearing, then:
(1) The deficiency(ies) shall be removed from the Form CMS-2567; and
(2) Any enforcement action(s) imposed as a result of deficiencies shall be rescinded.
(i) If the finding(s) of non-compliance is upheld at the administrative hearing, then:
(1) The deficiency(ies) shall remain as cited on the Form CMS-2567; and
(2) Any enforcement action(s) imposed as a result of those deficiencies shall continue or, in the case of a CMP, be imposed.

N.H. Code Admin. R. He-E 807.14

#8177, eff 9-23-04