Revision 17-2; Effective October 11, 2017

 

§92.11 Criteria for Licensing

  1. A person must be licensed to establish or operate an assisted living facility in Texas.
    1. An assisted living facility is an establishment that:
      1. furnishes, in one or more facilities, food and shelter to four or more persons who are unrelated to the proprietor of the establishment;
      2. provides:
        1. personal care services;
        2. administration of medication by a person licensed or otherwise authorized in this state to administer the medication; or
        3. services described in clauses (i) and (ii) of this subparagraph; and
      3. may provide assistance with or supervision of the administration of medication.
    2. An assisted living facility may provide skilled nursing services for the following limited purposes:
      1. coordinate resident care with an outside home and community support services agency or health care professional;
      2. provide or delegate personal care services and medication administration, as described in this chapter;
      3. assess residents to determine the care required; and
      4. deliver, for a period not to exceed 30 days, temporary skilled nursing services for a minor illness, injury or emergency.
    3. DADS considers one or more facilities to be part of the same establishment and, therefore, subject to licensure as an assisted living facility, based on the following factors:
      1. common ownership;
      2. physical proximity;
      3. shared services, personnel, or equipment in any part of the facilities' operations; and
      4. any public appearance of joint operations or of a relationship between the facilities.
    4. The presence or absence of any one factor in paragraph (3) of this subsection is not conclusive.
  2. To obtain a license, a person must follow the application requirements in this subchapter and meet the criteria for a license.
  3. An applicant must affirmatively show that the applicant, license holder, controlling person, and any person required to submit background and qualification information meet the criteria and eligibility for licensing, in accordance with this section, and:
    1. the building in which the facility is housed:
      1. meets local fire ordinances;
      2. is approved by the local fire authority; and
      3. meets DADS licensing standards in accordance with Subchapter D of this chapter (relating to Facility Construction) based on an on-site inspection by DADS; and
      4. operation of the facility meets DADS licensing standards based on an on-site health inspection by DADS, which must include observation of the care of a resident; or
    2. the facility meets the standards for accreditation based on an on-site accreditation survey by the accreditation commission.
  4. An applicant who chooses the option authorized in subsection (c)(2) of this section must contact DADS to determine which accreditation commissions are available to meet the requirements of that subsection.
  5. DADS issues a license to a facility meeting all requirements of this chapter. The facility must not exceed the maximum allowable number of residents specified on the license.
  6. DADS denies an application for an initial license or a renewal of a license if:
    1. the applicant, license holder, controlling person, or any person required to submit background and qualification information has been debarred or excluded from the Medicare or Medicaid programs by the federal government or a state;
    2. a court has issued an injunction prohibiting the applicant, license holder, controlling person, or any person required to submit background and qualification information from operating a facility; or
    3. during the five years preceding the date of the application, a license to operate a health care facility, long-term care facility, assisted living facility, or similar facility in any state held by the applicant, license holder, controlling person, or any person required to submit background and qualification information has been revoked.
  7. A license holder or controlling person who operates a nursing facility or an assisted living facility for which a trustee was appointed and for which emergency assistance funds, other than funds to pay the expenses of the trustee, were used is subject to exclusion from eligibility for:
    1. the issuance of an initial license for a facility for which the person has not previously held a license; and
    2. the renewal of the license of the facility for which the trustee was appointed.
  8. DADS may deny an application for an initial license or refuse to renew a license if an applicant, license holder, controlling person, or any person required to submit background and qualification information:
    1. violates Texas Health and Safety Code, Chapter 247; a section, standard or order adopted under Chapter 247; or a license issued under Chapter 247 in either a repeated or substantial manner;
    2. commits an act described in §92.551(a)(2)-(7) of this chapter (relating to Administrative Penalties);
    3. aids, abets, or permits a substantial violation described in paragraphs (1)-(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. provides the following false or fraudulent information:
      1. knowingly submits false or intentionally misleading statements to DADS;
      2. uses subterfuge or other evasive means of filing an application for licensure;
      3. engages in subterfuge or other evasive means of filing on behalf of another who is unqualified for licensure;
      4. knowingly conceals a material fact related to licensure; or
      5. is responsible for fraud;
    6. fails to pay the following fees, taxes, and assessments when due:
      1. license fees as described in §92.4 of this chapter (relating to License Fees); or
      2. franchise taxes, if applicable;
    7. during the five years preceding the date of the application, has a history in any state or other jurisdiction of any of the following:
      1. operation of a facility that has been decertified or has had its contract canceled under the Medicare or Medicaid program;
      2. federal or state long-term care facility, assisted living facility, or similar facility sanctions or penalties, including monetary penalties, involuntary downgrading of the status of a facility license, proposals to decertify, directed plans of correction, or the denial of payment for new Medicaid admissions;
      3. unsatisfied final judgments, excluding judgments wholly unrelated to the provision of care rendered in long-term care facilities;
      4. eviction involving any property or space used as a facility; or
      5. suspension of a license to operate a health care facility, long-term care facility, assisted living facility, or a similar facility;
    8. violates Texas Health and Safety Code, §247.021 by operating a facility without a license; or
    9. is subject to denial or refusal as described in Chapter 99 of this title (relating to Denial or Refusal of License) during the time frames described in that chapter.
  9. DADS reviews all information provided by an applicant, a license holder, a person with a disclosable interest, or a manager when considering grounds for denial of an initial license application or a renewal application in accordance with subsection (h)(8) of this section. DADS may grant a license if DADS finds the applicant, license holder, person with a disclosable interest, affiliate, or manager is able to comply with the rules in this chapter.
  10. DADS reviews final actions when considering the grounds for denial of an initial license application or renewal application in accordance with subsections (f) and (h)(8) of this section. An action is final when routine administrative and judicial remedies are exhausted. An applicant must disclose all actions, whether pending or final.
  11. If an applicant owns multiple facilities, DADS examines the overall record of compliance in all of the applicant's facilities. An overall record poor enough to deny issuance of a new license does not preclude the renewal of a license of a facility with a satisfactory record.

 

§92.12 General Application Requirements

  1. An application must be made on the form prescribed by and available from DADS.
  2. An applicant must complete the application in accordance with the instructions provided with the application. An application must be signed, dated, and notarized, and must contain the applicable license fee as described in §92.4 of this chapter (relating to License Fees).
  3. An application must include the written approval of the local fire authority that the facility and its operations meet local fire ordinances.
  4. If an applicant decides not to continue the application process for a license after submitting an application and license fee, the applicant must submit to DADS a written request to withdraw the application. DADS does not refund the license fee for an application that is withdrawn, except as provided in §92.13(d) of this subchapter (relating to Time Periods for Processing All Types of License Applications).

 

§92.13 Time Periods for Processing All Types of License Applications

  1. DADS reviews an application for a license within 30 days after the date DADS' Licensing and Credentialing Section receives the application and notifies the applicant if additional information is needed to complete the application.
  2. DADS denies an application that remains incomplete 120 days after the date that DADS' Licensing and Credentialing Section receives the application.
  3. DADS issues a license within 30 days after DADS determines that the applicant and the facility have met all licensure requirements referenced in §92.14 of this subchapter (relating to Initial License Application Procedures and Requirements) or §92.15 of this subchapter (relating to Renewal Procedures and Qualification), as applicable.
  4. If DADS does not process an application in the time period stated, the applicant has a right to make a request to the program director for reimbursement of the license fees paid with the application.
    1. If the program director does not agree that the established time period has been violated or finds that good cause existed for exceeding the established time period, the program director denies the request.
    2. Good cause for exceeding the established time period exists if:
      1. the number of applications to be processed exceeds by 15 percent or more the number processed in the same calendar quarter of the preceding year;
      2. DADS must rely on another public or private entity to process all or a part of the application received by DADS, and the delay is caused by that entity; or
      3. other conditions existed giving good cause for exceeding the established time period.
    3. If the request for reimbursement is denied, the applicant may appeal to the DADS commissioner for resolution of the dispute. The applicant must send a written statement to the DADS commissioner describing the request for reimbursement and the reason for the request. The DADS commissioner will make a timely decision concerning the appeal and notify the applicant in writing of the decision.

 

§92.14 Initial License Application Procedures and Requirements

  1. An applicant must complete the DADS pre-licensure training course before submitting an application for an initial license. An applicant that is currently licensed under Texas Health and Safety Code, Chapter 247 is exempt from this requirement.
  2. An applicant for an initial license must submit an application in accordance with §92.12 of this subchapter (relating to General Application Requirements) and include the fees required in §92.4 of this chapter (relating to License Fees).
  3. DADS reviews an application for an initial license within 30 days after the date DADS' Licensing and Credentialing Section receives the application and notifies the applicant if additional information is needed to complete the application.
  4. The applicant must send written notice to DADS indicating that the facility is ready for a Life Safety Code (LSC) inspection. The written notice must be submitted with the application or within 120 days after DADS' Licensing and Credentialing Section receives the application. After DADS has received the written notice and the applicant has satisfied the application submission requirements in §92.11 of this subchapter (relating to Criteria for Licensing) and §92.12 of this subchapter, DADS staff conduct an on-site LSC inspection of the facility to determine if the facility meets the licensure requirements in Subchapter D of this chapter (relating to Facility Construction).
  5. If the facility fails to meet the licensure requirements within 120 days after the initial LSC inspection, DADS denies the application for a license.
  6. After a facility has met the licensure requirements in Subchapter D of this chapter (relating to Facility Construction) and has admitted at least one but no more than three residents, the applicant must send a written notice to DADS indicating the facility is ready for a health inspection.
    1. DADS staff conduct an on-site health inspection to determine if the facility meets the licensure requirements for standards of operation and resident care in Subchapter C of this chapter (relating to Standards for Licensure).
    2. If the facility fails to meet the licensure requirements for standards of operation and resident care within 120 days after the initial health inspection, DADS denies the application for a license.
  7. DADS issues a license within 30 days after DADS determines that the applicant and the facility have met the licensure requirements of this section. The issuance of a license constitutes DADS' official written notice to the facility of the approval of the application.
  8. DADS may deny an application for an initial license if the applicant, controlling person, or any person required to submit background and qualification information fails to meet the criteria for a license established in §92.11 of this subchapter.
  9. If DADS denies an application for an initial license, DADS sends the applicant a written notice of the denial and informs the applicant of the applicant's right to request an administrative hearing to appeal the denial. The administrative hearing is held in accordance with Texas Health and Human Services Commission rules at 1 TAC Chapter 357, Subchapter I (relating to Hearings Under the Administrative Procedure Act).

 

§92.15 Renewal Procedures and Qualifications

  1. A license issued under this chapter:
    1. expires two years after the date issued;
    2. must be renewed before the license expiration date; and
    3. is not automatically renewed.
  2. An application for renewal must comply with the requirements of §92.12 of this subchapter (relating to General Application Requirements) and §92.13 of this subchapter (relating to Time Periods for Processing All Types of License Applications). The submission of a license fee alone does not constitute an application for renewal.
  3. To renew a license, a license holder must submit an application for renewal with DADS before the expiration date. DADS considers the license holder has met the renewal application submission deadline if the license holder submits to DADS:
    1. a complete application for renewal no later than 45 days before the expiration of the current license;
    2. an incomplete application for renewal, with a letter explaining the circumstances that prevented the inclusion of the missing information, and DADS receives the incomplete application and the letter no later than 45 days before the expiration of the current license; or
    3. a complete application or an incomplete application with a letter explaining the circumstances that prevented the inclusion of the missing information to DADS, and DADS receives the application during the 45-day period ending on the date the current license expires, and the license holder pays the late fee established in §92.4(b) of this chapter (relating to License Fees) in addition to the basic renewal fee.
  4. If the application is postmarked on or before the submission deadline, the application is considered to be timely if it is received in DADS Licensing and Credentialing Section, Regulatory Services Division, within 15 days after the date of the postmark, or within 30 days after the date of the postmark and the license holder proves to the satisfaction of DADS that the delay was due to the shipper. It is the license holder's responsibility to ensure that the application is timely received by DADS.
  5. For purposes of Texas Government Code, §2001.054, DADS considers that an individual has submitted a timely and sufficient application for the renewal of a license if the license holder's application has met the submission deadlines in subsections (c) and (d) of this section. Failure to submit a timely and sufficient application will result in the expiration of the license.
  6. An application for renewal submitted after the expiration date of the license is considered to be an application for an initial license and must comply with the requirements for an initial license in §92.14 of this subchapter (relating to Initial License Application Procedures and Requirements).
  7. DADS reviews an application for a renewal license within 30 days after the date DADS Licensing and Credentialing Section receives the application and notifies the applicant if additional information is needed to complete the application.
  8. A license holder applying for a license renewal must affirmatively show that the facility meets DADS licensing standards based on an on-site inspection by DADS, which must include an observation of the care of a resident.
  9. If an applicant is relying on §92.11(c)(2) of this subchapter (relating to Criteria for Licensing) to comply with the requirements for licensure, the application for the renewal of a license must include a copy of the license holder's required accreditation report from the accreditation commission.
  10. DADS may pend action on an application for the renewal of a license for up to six months if the facility has not met licensure requirements during an on-site inspection.
  11. The issuance of a license constitutes DADS official written notice to the facility of the approval of the application.
  12. DADS may deny an application for the renewal of a license if the applicant, controlling person, or any person required to submit background and qualification information fails to meet the criteria for a license established in §92.11 of this subchapter.
  13. Before denying an application for renewal of a license, DADS gives the license holder:
    1. notice by personal service or by registered or certified mail of the facts or conduct alleged to warrant the proposed action; and
    2. an opportunity to show compliance with all requirements of law for the retention of the license.
  14. To request an opportunity to show compliance, the license holder must send its written request to the director of the Enforcement Section, Regulatory Services Division. The request must:
    1. be postmarked within 10 days after the date of DADS notice and be received in the office of the director of the Enforcement Section, Regulatory Services Division, within 10 days after the date of the postmark; and
    2. contain specific documentation refuting DADS allegations.
  15. The opportunity to show compliance is limited to a review of documentation submitted by the license holder and information DADS used as the basis for its proposed action and is not conducted as an adversary hearing. DADS gives the license holder a written affirmation or reversal of the proposed action.
  16. If DADS denies an application for the renewal of a license, the applicant may request:
    1. an informal reconsideration by the Health and Human Services Commission; and
    2. an administrative hearing or binding arbitration, as described in §92.601 of this chapter (relating to Arbitration), to appeal the denial.

 

§92.16 Change of Ownership

  1. A license holder may not transfer its license.
  2. At least 30 days before the anticipated date of the change of ownership, the prospective license holder must notify DADS of the change of ownership by submitting an application for an initial license based on a change of ownership under §92.14 of this subchapter (relating to Initial Application Procedures and Requirements) and the fee required in §92.4 of this chapter (relating to License Fees).
  3. To avoid a facility operating while unlicensed, an applicant must submit an application for an initial license based on a change of ownership at least 30 days before the anticipated date of the change of ownership. The effective date of the change of ownership cannot precede the date the application is received by DADS Licensing and Credentialing Section, Regulatory Services Division.
  4. DADS may assess an administrative penalty in accordance with Subchapter H, Division 9 of this chapter (relating to Administrative Penalties) against a person who fails to notify DADS before the effective date of the change of ownership.
  5. Pending DADS review of the application for an initial license based on a change of ownership, the current license holder must continue to meet all requirements for operation of the facility.
  6. DADS conducts an on-site health inspection to verify compliance with the licensure requirements before issuing a license based on a change of ownership. DADS may conduct a desk review instead of an on-site health inspection if DADS determines that the facility was required to obtain a new tax identification number and:
    1. less than 50 percent of the direct or indirect ownership interest in the former license holder changed when compared to the new license holder; or
    2. every owner with a disclosable interest in the new license holder had a disclosable interest in the former license holder.
  7. DADS, in its sole discretion, may conduct an on-site Life Safety Code inspection of the facility before issuing a license based on a change of ownership.
  8. DADS issues the license within 30 days after DADS determines that the applicant and the facility have met the licensure requirements of this section. The issuance of a license constitutes DADS official written notice to the facility of the approval of the application for a change of ownership.
  9. DADS may deny an application for a change of ownership if the applicant, controlling person, or any person required to submit background and qualification information fails to meet the criteria for a license established in §92.11 of this subchapter (relating to Criteria for Licensing).
  10. If DADS denies an application for an initial license based on a change of ownership, DADS sends the applicant a written notice of the denial and informs the applicant of the applicant's right to request an administrative hearing to appeal the denial. The administrative hearing is held in accordance with Texas Health and Human Services Commission rules at 1 TAC Chapter 357, Subchapter I (relating to Hearings Under the Administrative Procedure Act).
  11. If a license holder, that is not a publicly traded company, adds an owner with a disclosable interest, but the license holder does not undergo a change of ownership, the license holder must notify DADS no later than 30 days after the addition of the owner.

 

§92.17 Relocation

  1. Relocation is the closing of a facility and the movement of its residents to another location.
  2. A license holder must not relocate a facility without approval from DADS.
  3. Before a relocation, the license holder must submit an application for an initial license for the new location in accordance with §92.14 of this subchapter (relating to Initial Application Procedures and Requirements) and the fee required in §92.4 of this chapter (relating to License Fees).
  4. Residents must not be relocated until the new building has been inspected and approved as meeting the Life Safety Code licensure requirements in Subchapter D of this chapter (relating to Facility Construction).
  5. Following Life Safety Code approval by DADS, the license holder must notify DADS of the date the residents will be relocated.
  6. DADS issues a license for the new facility if the new facility meets the standards of operation and resident care based on an on-site health inspection. The effective date of the license is the date all residents are relocated.
  7. The license holder must continue to maintain the license at the current location and must continue to meet all requirements for operation of the facility until DADS has approved the relocation. The issuance of a license constitutes DADS' approval of the relocation. The license for the current location becomes invalid upon issuance of the new license for the new location.

 

§92.18 Increase in Capacity

  1. A license holder must not increase a facility's licensed capacity without approval from DADS.
  2. The license holder must submit an application for an increase in capacity in accordance with §92.12 (relating to General Application Requirements) and the fee required in §92.4 of this chapter (relating to License Fees).
  3. The license holder must arrange for an inspection of the facility by the local fire marshal and provide the signed fire marshal approval to DADS.
  4. After DADS' review of an application and after the applicant notifies DADS in writing that the facility is ready for a Life Safety Code (LSC) inspection, DADS staff conduct an on-site LSC inspection of the facility to determine if the facility meets the LSC licensure requirements in Subchapter D of this chapter (relating to Facility Construction).
  5. If the facility fails to meet the LSC licensure requirements within 120 days after the LSC inspection, DADS denies the application for an increase in capacity.
  6. After a facility has met LSC licensure requirements, DADS staff conduct an on-site health inspection to determine if the facility meets the licensure requirements for standards of operation and resident care in Subchapter C of this chapter (relating to Standards for Licensure).
  7. DADS issues a new license with an increased capacity within 30 days after DADS determines that all licensure requirements have been met. DADS may grant approval to occupy the increased capacity once DADS determines that all licensure requirements have been met.
  8. In order to meet the residents' health and safety needs in the event of a fire, natural disaster, or catastrophic event, DADS may grant approval to temporarily exceed a facility's licensed capacity provided the health and safety of residents are not compromised and the facility can meet the required health care service needs of all residents. A facility may exceed its licensed capacity under this circumstance, monitored by DADS, until residents can be transferred to a permanent location. DADS will issue authorization for the temporary increase in the facility's licensed capacity. The authorization to temporarily increase the capacity ends when the facility receives written notice from DADS ending the authorization.

 

§92.19 Decrease in Capacity

  1. A license holder that wishes to decrease the licensed capacity of the facility must provide written notification to DADS' Licensing and Credentialing Section. The written notification must include the desired capacity for the new license.
  2. Upon receipt of the written notification, DADS issues a new license with the desired capacity as indicated in the written notification.

 

§92.20 Provisional License

  1. DADS may issue a six-month provisional license in the case of a corporate change of ownership.
  2. DADS must issue a six-month provisional license for a newly constructed facility without conducting an NFPA 101 inspection if:
    1. an applicant makes a request in writing for a provisional license;
    2. the applicant submits working drawings and specifications to DADS for review in accordance with §92.64 of this chapter (relating to Plans, Approvals, and Construction Procedures) before facility construction begins;
    3. the applicant obtains all approvals, including a certificate of occupancy in a jurisdiction that requires one, from local authorities having jurisdiction in the area in which the facility is located, such as the fire marshal, health department and building inspector;
    4. the applicant submits a complete license application within 30 days after receipt of all local approvals described in paragraph (3) of this subsection;
    5. the applicant pays the license fee required by §92.4 of this chapter (relating to License Fees);
    6. the applicant, or a person who is a controlling person and an owner of the applicant, has constructed another facility in this state that complies with the NFPA 101; and
    7. the applicant is in compliance with resident-care standards for licensure required by Subchapter C of this chapter (relating to Standards for Licensure) based on an on-site inspection conducted in accordance with §92.81 of this chapter (relating to Inspections and Surveys).
  3. DADS considers the date facility construction begins to be the date the building construction permit for the facility was approved by local authorities.
  4. A provisional license expires on the earlier of:
    1. the 180th day after the effective date of the provisional license or the end of any extension period granted by DADS; or
    2. the date a two-year license is issued to the provisional license holder.
  5. DADS conducts an NFPA 101 inspection of a facility as soon as reasonably possible after DADS issues a provisional license to the facility.
  6. After conducting an NFPA 101 inspection, DADS issues a license in accordance with Texas Health and Safety Code §247.023 to the provisional license holder if the facility passes the inspection and the applicant meets all requirements for a license.

 

§92.21 Initial License for a Type A or Type B Facility for an Applicant in Good Standing

  1. An applicant may request that DADS issue, before conducting an on-site health inspection, an initial license for a Type A or Type B facility. The applicant must request the license by submitting a form prescribed by and made available from DADS.
  2. If an applicant makes a request in accordance with subsection (a) of this section, DADS determines the applicant is in good standing, and the applicant complies with subsection (d) of this section, the applicant is not required to admit a resident to the facility or have the on-site health inspection described in §92.14(f) of this subchapter (relating to Initial License Application Process and Requirements) before DADS issues an initial license.
  3. For purposes of this section, an applicant is in good standing if:
    1. one of the following conditions is met:
      1. the applicant has operated or been a controlling person of a licensed Type A or Type B facility in Texas for at least six consecutive years; or
      2. the applicant has not held a license for a Type A or Type B facility, but a controlling person of the applicant has operated or been a controlling person of a licensed Type A or Type B facility in Texas for at least six consecutive years; and
    2. each licensed facility operated by the applicant or the controlling person described in paragraph (1)(A) or (B) of this subsection:
      1. has not had a violation of a licensing rule:
        1. that:
          1. resulted in actual harm to a resident, which is defined as a negative outcome that compromises the resident’s physical, mental or emotional well-being; or
          2. posed an immediate threat of harm causing or likely to cause serious injury, impairment, or death to a resident; and
        2. that:
          1. the facility did not challenge;
          2. was affirmed; or
          3. is pending a final determination; and
      2. has not had a sanction imposed by DADS against the facility during the six years before the date an application is submitted that resulted in:
        1. a civil penalty;
        2. an administrative penalty;
        3. an injunction;
        4. the denial, suspension, or revocation of a license; or
        5. an emergency closure.
  4. An applicant that makes a request in accordance with subsection (a) of this section must:        
    1. submit to DADS:
      1. the applicant’s policies and procedures;
      2. evidence that the applicant has complied with §92.123 of this chapter (relating to Investigation of Facility Employees); and
      3. documentation that the applicant’s employees have the credentials described in §92.41(a) of this chapter (relating to Standards for Type A and Type B Assisted Living Facilities); and
    2. comply with §92.14(d) of this subchapter and §92.11(c)(1)(A) - (C) of this subchapter (relating to Criteria for Licensing).
  5. DADS issues an initial license to an applicant that makes a request in accordance with subsection (a) of this section if DADS determines that an applicant:
    1. is in good standing;
    2. has submitted information in accordance with subsection (d)(1) of this section that complies with this chapter; and
    3. is in compliance with the requirements of Subchapter D of this chapter (relating to Facility Construction), including meeting the requirements of a Life Safety Code (LSC) inspection within 120 days after the date DADS conducts the initial LSC inspection.
  6. DADS conducts an on-site health inspection within 90 days after the date DADS issues a license in accordance with subsection (e) of this section. The on-site health inspection includes DADS observation of the facility's provision of care to at least one resident.
  7. Until a facility that is issued an initial license under this section meets the requirements of the on-site health inspection described in subsection (f) of this section, the facility must attach a written addendum to the disclosure statement required by §92.41(d)(1) of this chapter as notice to a resident or a prospective resident that the facility has not met the requirements of the on-site health inspection. At a minimum, the addendum must state that:
    1. the facility has not met the requirements of an initial on-site health inspection for a license; and
    2. DADS will conduct an on-site health inspection for licensure within 90 days after the date the license is issued.

 

§92.22 Alzheimer's Certification of a Type B Facility for an Initial License Applicant in Good Standing

(a) An applicant may request that DADS, before conducting an on-site health inspection, issue an initial license for a Type B facility and an Alzheimer's certification for the facility or a distinct unit of the facility. The applicant must meet the requirements of §92.21 of this subchapter (relating to Initial License for a Type A or Type B Facility for an Applicant in Good Standing) for the initial license and the requirements of this section for certification of the facility or unit.

(b) An applicant must request certification by submitting forms prescribed by and made available from DADS and include the fee described in §92.4 of this chapter (relating to Licensing Fees).

(c) An applicant that makes a request in accordance with subsection (a) of this section is not required to admit a resident to the facility or unit or have the on-site health inspection described in §92.14(f) of this subchapter (relating to Initial License Application Process and Requirements) before DADS certifies the facility or unit if DADS determines that the applicant is in good standing:

(1) for the issuance of an initial license of the facility in accordance with §92.21(c) of this chapter; and

(2) for certification of the facility or unit in accordance with subsection (d) of this section.

(d) An applicant is in good standing to obtain certification of a facility or unit if:

(1) for at least six consecutive years before applying for certification:

(A) the applicant has been:

(i) the license holder for an Alzheimer's certified facility in Texas or a facility in Texas that has an Alzheimer's certified unit; or

(ii) a controlling person of the license holder for an Alzheimer's certified facility in Texas or a facility in Texas that has an Alzheimer's certified unit; or

(B) a controlling person of the applicant has been:

(i) the license holder for an Alzheimer's certified facility in Texas or a facility in Texas that has an Alzheimer's certified unit; or

(ii) a controlling person of the license holder for an Alzheimer's certified facility in Texas or a facility in Texas that has an Alzheimer's certified unit;

(2) each licensed facility operated by the applicant or the controlling person has not had a violation or sanction described in §92.21(c)(2) of this subchapter; and

(3) each licensed facility operated by the applicant or the controlling person has had no more than two violations listed in §92.125(a) of this chapter (relating to Resident's Bill of Rights and Provider Bill of Rights) during the six-year period immediately before the applicant applied for certification.

(e) For purposes of subsection (d)(3) of this section, a facility has a violation if:

(1) the applicant or controlling person operating the facility did not challenge the violation;

(2) a final determination on the violation is pending; or

(3) the violation was upheld.

(f) An applicant that makes a request in accordance with subsection (a) of this section must submit to DADS for approval:

(1) the applicant's policies and procedures required by §92.53 of this chapter (relating to Standards for Certified Alzheimer's Assisted Living Facilities); and

(2) documentation demonstrating that the applicant is complying with §92.53 and §92.123 of this chapter (relating to Investigation of Facility Employees).

(g) DADS certifies a facility or unit after an applicant makes a request in accordance with subsection (a) of this section if DADS determines that the applicant:

(1) meets the good standing requirements described in §92.21(c) of this subchapter and subsection (d) of this section;

(2) has submitted information in accordance with subsection (f) of this section; and

(3) is in compliance with:

(A) §92.51 of this chapter (relating to Certification of a Facility or Unit for Persons with Alzheimer's Disease and Related Disorders); and

(B) §92.53(i) of this chapter.

(h) DADS conducts an on-site health inspection to determine if the facility or unit meets the requirements of §92.53(a) - (h) of this chapter within 90 days after the date DADS certifies a facility or unit in accordance with subsection (g) of this section. During the on-site health inspection, DADS must observe the provision of care to at least one resident who has been admitted to the facility or unit.

(i) Until a facility or unit that is issued a certification under this section meets the requirements of the on-site health inspection described in subsection (h) of this section, the facility must attach a written addendum to the disclosure statement required by §92.53(d) of this chapter to notify a resident or a prospective resident that the facility or unit has not met the requirements of the on-site health inspection. At a minimum, the addendum must state that:

(1) the facility or unit has not met the requirements of an initial on-site health inspection for Alzheimer's certification; and

(2) DADS will conduct an on-site health inspection for Alzheimer's certification within 90 days after the date of certification.

(j) To obtain certification of a unit in a Type B facility that is already licensed, a license holder must comply with §92.51 of this chapter (relating to Certification of a Facility or Unit for Persons with Alzheimer's disease and Related Disorders).