25 Tex. Admin. Code § 135.63 - Complaint Investigations
(a) An
ambulatory surgical center (ASC) shall provide each patient and applicable
legally authorized representative at the time of admission with a written
statement identifying the Texas Health and Human Services Commission (HHSC) as
the agency responsible for investigating complaints against the ASC.
(1) The statement shall inform persons that
they may direct a complaint to HHSC Complaint and Incident Intake (CII) and
include current CII contact information, as specified by HHSC.
(2) The ASC shall prominently and
conspicuously post this statement in patient common areas and in visitor's
areas and waiting rooms so that it is readily visible to patients, employees,
and visitors. The information shall be in English and in a second language
appropriate to the demographic makeup of the community
served.
(b) HHSC
evaluates all complaints. A complaint must be submitted using HHSC's current
CII contact information for that purpose, as described in subsection (a) of
this section.
(c) HHSC documents,
evaluates, and prioritizes complaints directed to HHSC CII based on the
seriousness of the alleged violation and the level of risk to patients,
personnel, and the public.
(1) Allegations
determined to be within HHSC's regulatory jurisdiction relating to health care
facilities may be investigated under this chapter.
(2) HHSC may refer complaints outside HHSC's
jurisdiction to an appropriate agency, as applicable.
(d) HHSC conducts investigations to evaluate
an ASC's compliance following a complaint of abuse, neglect, or exploitation;
or a complaint related to the health and safety of patients.
(e) HHSC may conduct an unannounced, on-site
investigation of an ASC at any reasonable time, including when treatment
services are provided, to inspect or investigate:
(1) an ASC's compliance with any applicable
statute or rule;
(2) an ASC's plan
of correction;
(3) an ASC's
compliance with an order of the HHSC executive commissioner or the executive
commissioner's designee;
(4) an
ASC's compliance with a court order granting injunctive relief; or
(5) for other purposes relating to regulation
of the ASC.
(f) An
applicant or licensee, by applying for or holding a license, consents to entry
and investigation of any of its ASCs by HHSC.
(g) An ASC shall cooperate with any HHSC
investigation and shall permit HHSC to examine the ASC's grounds, buildings,
books, records, video surveillance, and other documents and information
maintained by, or on behalf of, the ASC, unless prohibited by law.
(h) An ASC shall permit HHSC access to
interview members of the governing body, personnel, and patients, including the
opportunity to request a written statement.
(i) HHSC shall maintain the confidentiality
of ASC records as applicable under state and federal law.
(j) An ASC shall permit HHSC to inspect and
copy any requested information, unless prohibited by law. If it is necessary
for HHSC to remove documents or other records from the ASC, HHSC provides a
written description of the information being removed and when it is expected to
be returned. HHSC makes a reasonable effort, consistent with the circumstances,
to return any records removed in a timely manner.
(k) Upon entry, the HHSC representative holds
an entrance conference with the ASC's designated representative to explain the
nature, scope, and estimated duration of the investigation.
(l) The HHSC representative holds an exit
conference with the ASC representative to inform the ASC representative of any
preliminary findings of the investigation. The ASC may provide any final
documentation regarding compliance during the exit conference.
(m) Once an investigation is complete, HHSC
reviews the evidence from the investigation to evaluate whether there is a
preponderance of evidence supporting the allegations contained in the
complaint.
(n) HHSC notifies
complainants regarding the investigations outcome within 10 business days after
completing the investigation.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.