Current through Register Vol. 50, No. 9, September 20, 2024
A. Unless otherwise provided in the licensing
standards or other promulgated state rule or regulation, the following notice
and appeal procedures are applicable to all sanctions imposed by the department
pursuant to a Louisiana state statute or regulation.
B. Notice to Facility of Sanctions. The
department shall provide written notice to a health care facility of the
imposition of a sanction. The notice shall contain the following information:
1. the nature of the violation(s) and whether
the violation is a repeat violation;
2. the legal authority for the
violation(s);
3. the sanction
assessed for each violation and the effective date of the sanction;
4. notification that the facility has 10
calendar days from receipt of the notice within which to request an
administrative reconsideration of the proposed sanction;
5. notification of the administrative
reconsideration and/or administrative appeal procedures and the deadlines for
each; and
6. notification that the
department's decision becomes final and no administrative or judicial review
may be obtained if the facility fails to timely request an administrative
reconsideration and/or administrative appeal.
C. Waivers. When a civil fine for a class C
violation is imposed, the facility may choose to waive its right to an
administrative reconsideration and appeal hearing in exchange for paying 50
percent of the fine by submitting the waiver and payment to HSS within 30 days
of receipt of the notice imposing the civil fine.
D. Administrative Reconsideration. The
facility may request an administrative reconsideration of the department's
decision to impose a sanction.
1. The
facility's request for an administrative reconsideration must:
a. be in writing;
b. be received by HSS within 10 calendar days
of the provider's receipt of the notice of the imposition of the sanction;
and
c. include any documentation
that demonstrates that the sanction was in error.
2. A reconsideration shall be conducted by
designated employees of the department who did not participate in the initial
decision to recommend imposition of the sanction.
3. Correction of the deficiency or violation
cited for imposition of the sanction shall not be the basis for an
administrative reconsideration.
4.
A reconsideration shall be conducted as a desk review unless the facility
elects to make an oral presentation. The facility may request an oral
presentation by notifying HSS within the deadline provided in the notice
scheduling the administrative reconsideration.
5. A sanction may be confirmed, reduced or
rescinded as a result of the administrative reconsideration. A deficiency may
not be altered or rescinded as a result of the administrative reconsideration,
except a deficiency may be altered or rescinded in an administrative
reconsideration of a revocation, denial of renewal or suspension.
6. A reconsideration decision shall be based
upon all documents and the oral presentation furnished by the provider to the
department at the time of the administrative reconsideration.
7. A reconsideration decision is final unless
the facility timely requests an administrative appeal.
E. Administrative Appeal
1. The provider may request an administrative
appeal of the department's decision to impose a sanction.
2. The issue that may be adjudicated in the
appeal is the appropriateness of the sanction, including the classification of
the violation(s).
3. A deficiency
and its underlying facts may not be altered or rescinded as a result of the
administrative appeal, except a state deficiency and its underlying facts may
be altered or rescinded in an administrative appeal of a revocation, denial of
renewal or suspension. For example, in an appeal of a fine due to a Class A
violation, the DAL, after hearing the evidence, may decide to reduce the
violation to a Class B and reduce the fine accordingly. However, the DAL may
not reduce or alter the underlying deficiency on the survey report.
4. The facility's appeal request shall:
a. be in writing;
b. be received by the DAL within 30 days of
the provider's receipt of the notice of the imposition of the sanction when no
administrative reconsideration is requested, or when an administrative
reconsideration is requested, within 30 days of the receipt of the notice of
the results of the administrative reconsideration;
c. state what the facility contests and the
specific reasons for the disagreement; and
d. shall include any documentation that
demonstrates that the sanction was imposed in error.
5. In an appeal contesting a civil fine, the
facility shall either post an appeal bond with the DAL as provided in
R.S.
40:2009.11 for nursing facilities or
R.S.
40:2199(D) for all other
facilities, or the facility may choose to pay the fine and file a devolutive
appeal.
6. Correction of the
deficiency or violation cited for the imposition of the sanction will not be
considered as a basis for the appeal.
7. The administrative hearing shall be
limited to those issues specifically contested.
8. Except as hereinafter provided, when an
administrative appeal is requested in a timely and proper manner, the DAL shall
provide an administrative hearing in accordance with the provisions of the
APA.
E. Judicial Review.
The facility may request judicial review of the administrative appeal decision
in the Nineteenth Judicial District Court in accordance with the APA.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
40:2009.11, 40:2009.23, 40:2199 and
40:2199.1.
