(a) Enforcement is a process by which a sanction is proposed, and if warranted, imposed on an applicant or licensee regulated by the Texas Health and Human Services Commission (HHSC) for failure to comply with applicable statutes, rules, and orders.
(b) HHSC has jurisdiction to enforce violations of the Act and this chapter.
(c) HHSC may deny, suspend, or revoke a license or impose an administrative penalty for:
  (1) failure to comply with any applicable provision of Texas Health and Safety Code (HSC), including Chapter 254 (relating to Freestanding Emergency Medical Care Facilities);
  (2) failure to comply with any provision of this chapter or any other applicable laws;
  (3) the facility, or any of its employees, commits an act which causes actual harm or risk of harm to the health or safety of a patient;
  (4) the facility, or any of its employees, materially alters any license issued by HHSC;
  (5) failure to comply with minimum standards for licensure;
  (6) failure to provide a complete license application;
  (7) failure to comply with an order of the executive commissioner or another enforcement procedure under the Act;
  (8) a history of failure to comply with the applicable rules relating to patient environment, health, safety, and rights;
  (9) the facility aiding, committing, abetting, or permitting the commission of an illegal act;
  (10) the facility, or any of its employees, committing fraud, misrepresentation, or concealment of a material fact on any documents required to be submitted to HHSC or required to be maintained by the facility pursuant to the Act and the provisions of this chapter;
  (11) failure to timely pay an assessed administrative penalty as required by HHSC;
  (12) failure to submit an acceptable plan of correction for cited deficiencies within the timeframe required by HHSC;
  (13) failure to timely implement plans of corrections to deficiencies cited by HHSC within the dates designated in the plan of correction; or
  (14) failure to comply with applicable requirements within a designated probation period.
(d) If HHSC proposes to deny, suspend, revoke a license, or impose an administrative penalty, HHSC shall send a notice of the proposed action by certified mail, return receipt requested, at the address shown in the current records of HHSC, or HHSC may personally deliver the notice. The notice to deny, suspend, or revoke a license, or impose an administrative penalty, shall state the alleged facts or conduct to warrant the proposed action, provide an opportunity to demonstrate or achieve compliance, and shall state that the applicant or license holder has an opportunity for a hearing before taking the action.
(e) Within 20 calendar days after receipt of the notice, the applicant or licensee may notify HHSC, in writing, of acceptance of HHSC's determination or request a hearing.
(f) A request for a hearing by the applicant or licensee shall be in writing and submitted to HHSC within 20 calendar days after receipt of the notice. Receipt of the notice is presumed to occur on the third day after the date HHSC mails the notice to the last known address of the applicant or licensee.
  (1) A hearing shall be conducted pursuant to Government Code Chapter 2001 (relating to Administrative Procedure) and 1 TAC Chapter 357, Subchapter I (relating to Hearings Under the Administrative Procedure Act).
  (2) If an applicant or licensee does not request a hearing in writing within 20 calendar days after receiving notice of the proposed action, the applicant or licensee is deemed to have waived the opportunity for a hearing and HHSC shall take the proposed action.

Source Note: The provisions of this §509.101 adopted to be effective December 4, 2023, 48 TexReg 7064