Current through Vol. 42, No. 1, September 16, 2024
(a)
Notice of Violation. If upon
survey or investigation the Department finds that the continuum of care
facility or assisted living center is in violation of the Act or this Chapter,
the Department shall provide written notice of the violation to the continuum
of care facility or assisted living center.
(b)
Plan of Correction.
(1) A continuum of care facility or assisted
living center shall submit a plan of correction within ten (10) Department
business days after receipt of notice of violation. Failure to timely submit a
plan of correction shall be subject to the penalties provided in Title 63 O.S.
Section
1-890.6.
(2) An acceptable plan of correction shall:
(A) Address how corrective action will be
accomplished for those residents found to have been affected by the deficient
practice.
(B) Address how the
continuum of care facility or assisted living center will identify other
residents having the potential to be affected by the same deficient practice.
Plans of correction specific to residents identified on the deficiency
statement are acceptable only where the deficiency is determined to be unique
to that resident and not indicative of a possible systemic problem.
(C) Address what measures will be put into
place or systemic changes made to ensure that the deficient practice will not
recur.
(D) Indicate how the
continuum of care facility or assisted living center plans to monitor its
performance to make sure that corrections are sustained. The continuum of care
facility or assisted living center shall develop a plan for ensuring that
correction is achieved and sustained. The actions taken to correct the
deficient practice must be evaluated for its effectiveness. The plan of
correction shall be incorporated into the quality assurance system. At the
revisit, the monitoring records may be reviewed to determine the earliest date
of compliance. If there is no evidence of evaluation of the correction, the
earliest correction date will be the date of the revisit. The continuum of care
facility or assisted living center is not required to provide quality assurance
minutes for the purposes of this section.
(E) Include dates when corrective action will
be completed for each violation. The corrective action completion dates shall
not exceed sixty (60) calendar days from receipt of notice of
violation.
(F) Be signed by the
administrator.
(3) Upon
written request from the continuum of care facility or assisted living center,
the Department may extend the time period within which the violations are to be
corrected where correction involves substantial structural
improvement.Such request shall be provided to the Department
within the timeline specified at 310:663-25-4(b)(1) (relating to submission
within ten (10) Department business days) or prior to expiration of the
correction time originally approved. The burden of proof shall be on the
licensee to show good cause for not being able to comply with the timeline in
310:663-25-4(b)(2)(E) (relating to correction within sixty (60)
days).
(4) The Department shall
provide written notice of the acceptance or rejection of a plan of correction
within ten (10) Department business days. If the Department fails to provide
notice of acceptance or rejection within the required time frame, notice will
be provided as soon as time permits and any delay on the Department's part will
result in a day for day off-set in any per diem penalty. If the Department
finds that the plan of correction does not meet the requirements for an
acceptable plan of correction as specified in this section the Department shall
provide notice of the rejection and the reason for the rejection to the
continuum of care facility or assisted living center. The continuum of care
facility or assisted living center shall have ten (10) Department business days
after receipt of the notice of rejection in which to submit an amended plan. If
the amended plan is not timely submitted, or if the amended plan is rejected,
the Department shall give notice of intent to pursue penalties, as provided in
Title 63 O.S. Section
1-890.6.,
or notice of intent to conduct a revisit to determine if violations
continue.
(5) Acceptance of the
plan of correction by the Department does not absolve the continuum of care
facility or assisted living center of the responsibility for compliance should
the implementation not result in correction and compliance. Acceptance
indicates the Department's acknowledgment that the continuum of care facility
or assisted living center indicated a willingness to make timely
corrections.
(6) If the violation
has been corrected prior to submission and approval of a plan of correction,
the continuum of care facility or assisted living center may submit a report of
correction in place of a plan of correction. The report of correction shall
address those requirements specified in this section.
(7) If a continuum of care facility or
assisted living center desires to contest any Department action under this
section, it shall send a written request for a hearing to the Hearing Clerk,
Oklahoma State Department of Health, 1000 NE Tenth Street, Oklahoma City, OK
73117. The request for hearing shall be submitted within ten (10) Department
business days of receipt of notice of the contested action.
(c)
Right to Hearing.
The Department shall notify the assisted living center in writing of the
Department's intent to take remedial action, to impose an administrative
penalty, or to take action against the license issued under the act, and of the
rights of the assisted living center under this section, including without
limitation the right to a hearing.
Added at 15 Ok Reg 2605,
eff 6-25-98; Amended at 24 Ok Reg 2007, eff
6-25-071; Amended at 25 Ok Reg 2460, eff
7-11-08
1See Editor's Note at
beginning of this Chapter.