(a) The Texas Health and Human Services Commission (HHSC) may deny an initial license or renewal of a license if any person described in §559.205(h) of this subchapter (relating to Criteria for Licensing):
  (1) is subject to denial or refusal as described in Chapter 560 of this title (relating to Denial or Refusal of License) during the time frames described in that chapter;
  (2) substantially fails to comply with the requirements described in §559.225 of this subchapter (relating to General Requirements) and §559.227 of this subchapter (relating to Program Requirements), including:
    (A) noncompliance that poses a serious threat to health and safety; or
    (B) a failure to maintain compliance on a continuous basis;
  (3) aids, abets, or permits a substantial violation described in paragraph (2) of this subsection about which the person had or should have had knowledge;
  (4) fails to provide the required information, facts, or references;
  (5) knowingly provides the following false or fraudulent information:
    (A) submits false or intentionally misleading statements to HHSC;
    (B) uses subterfuge or other evasive means of filing;
    (C) engages in subterfuge or other evasive means of filing on behalf of another who is unqualified for licensure;
    (D) knowingly conceals a material fact; or
    (E) is responsible for fraud;
  (6) fails to pay the following fees, taxes, and assessments when due:
    (A) licensing fees as described in §559.219 of this subchapter (relating to License Fees); and
    (B) franchise taxes, if applicable;
  (7) has a history of any of the following actions during the five-year period preceding the date of the application:
    (A) operation of a facility that has been decertified or had its contract canceled under the Medicare or Medicaid program in any state;
    (B) federal or state Medicare or Medicaid sanctions or penalties;
    (C) unsatisfied final judgments;
    (D) eviction involving any property or space used as a facility in any state; or
    (E) suspension of a license to operate a health facility, long-term care facility, or a similar facility in any state.
(b) Concerning subsection (a)(7) of this section, HHSC may consider exculpatory information provided by any person described in §559.205(h) of this subchapter and grant a license if HHSC finds that person able to comply with the rules in this chapter.
(c) HHSC does not issue a license to an applicant if the applicant has a history of any of the following actions during the five-year period preceding the date of the application:
  (1) revocation of a license to operate a health care facility, long-term care facility, or similar facility in any state;
  (2) debarment or exclusion from the Medicare or Medicaid programs by the federal government or a state; or
  (3) a court injunction prohibiting any person described in §559.205(h) of this subchapter from operating a facility.
(d) Only final actions are considered for purposes of subsections (a)(7) and (c) of this section. An action is final when routine administrative and judicial remedies are exhausted. All actions, whether pending or final, must be disclosed.
(e) If an applicant owns multiple facilities, the overall record of compliance in all facilities will be examined. An overall record poor enough to deny issuance of a new license will not preclude the renewal of licenses of individual facilities with satisfactory records.
(f) If HHSC denies a license or refuses to issue a renewal of a license, the applicant or license holder may request a hearing by following HHSC's rules in 1 TAC Chapter 357, Subchapter I (relating to Hearings Under the Administrative Procedure Act). An administrative hearing is conducted in accordance with Texas Government Code, Chapter 2001, and 1 TAC Chapter 357, Subchapter I.

Source Note: The provisions of this §559.215 adopted to be effective January 1, 2023, 47 TexReg 8709