(a) In lieu of demanding payment of an administrative penalty, the Commissioner may allow the person to use, under the supervision of the Texas Health and Human Services Commission (HHSC), a portion of the penalty to ameliorate the violation or to improve services, other than administrative services, in the facility.
(b) HHSC will offer amelioration to a person for a violation if HHSC determines that the violation does not constitute immediate jeopardy to the health and safety of a resident.
(c) HHSC will not offer amelioration to a person if HHSC determines that the violation constitutes immediate jeopardy to the health and safety of a resident.
(d) HHSC will offer amelioration to a person not later than the 10th day after the date the person receives from HHSC a final notification of assessment of administrative penalty that is sent to the person after an informal dispute resolution process but before an administrative hearing.
(e) A person to whom amelioration has been offered must file a plan for amelioration not later than the 45th day after the date the person receives the offer of amelioration from HHSC. In submitting the plan, the person must agree to waive the person's right to an administrative hearing if HHSC approves the plan.
(f) At a minimum, a plan for amelioration must:
  (1) propose changes to the management or operation of the facility that will improve services to or quality of care of residents;
  (2) identify, through measurable outcomes, the ways in which and the extent to which the proposed changes will improve services to or quality of care of residents;
  (3) establish clear goals to be achieved through the proposed changes;
  (4) establish a timeline for implementing the proposed changes; and
  (5) identify specific actions necessary to implement the proposed changes.
(g) HHSC may require that an amelioration plan propose changes that would result in conditions that exceed the minimum requirements for facility licensure.
(h) HHSC will approve or deny an amelioration plan not later than the 45th day after the date HHSC receives the plan. On approval of a person's plan, HHSC will deny a pending request for a hearing submitted by the person.
(i) HHSC will not offer amelioration to a person:
  (1) more than three times in a two-year period; or
  (2) more than one time in a two-year period for the same or similar violation.

Source Note: The provisions of this §551.241 adopted to be effective May 1, 2000, 25 TexReg 3557; amended to be effective June 1, 2002, 27 TexReg 4368; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1883; amended to be effective February 24, 2022, 47 TexReg 787