Revision 19-1; Effective July 1, 2019

Completion time frames differ depending on the specific facility or provider type and intake priority.

Setting:Intake Priority:Completion and approval in…
SSLCI or II10 calendar days
State HospitalI or II14 calendar days
State HospitalIII21 calendar days
All other provider typesI, II or III30 calendar days

See related 26 TAC Section 711.417.

3510 Extensions

Revision 19-1; Effective July 1, 2019

If additional time is required to complete the investigation, the PI program administrator or designee grants an extension for good cause. Good cause is described as a situation beyond the investigator’s control that prevents the case from being completed on time. The investigator notifies the service provider of the extension.

See related 26 TAC Section 711.419.

3520 Investigation Status Report and Report Provision

Revision 23-1; Effective July 26, 2023

Five-Day Status Report

PI provides a five-day status report to the provider’s administrator for investigations involving SSLCs and other settings that are considered ICF/IIDs. This updates the provider on the progress of the investigation.

Provider Abuse and Neglect Report

PI's final Provider Abuse/Neglect Report includes a summary of the investigation, including a list of the evidence, analysis of the evidence, and findings. See related 26 TAC Section 711.603.

Investigation Findings

The investigator makes the appropriate findings supported by the preponderance of the evidence.

FindingEvidence
confirmedthere is a preponderance of credible evidence to support that abuse, neglect, or exploitation occurred.
unconfirmedthere is a preponderance of credible evidence to support that abuse, neglect, or exploitation did not occur.
inconclusivethere is not a preponderance of credible evidence to indicate that abuse, neglect, or exploitation did or did not occur due to lack of witnesses or other available evidence.
unfoundedevidence gathered indicates that the allegation is spurious or patently without factual basis.

Designating a Systems Issue

When the preponderance of the evidence establishes that abuse, neglect, or exploitation occurred, the investigator designates a Systems Issue as the designated perpetrator in the IMPACT case management system, if:

  • the provider’s lack of established policy or procedure contributed to the abuse, neglect, or exploitation; or
  • the provider’s established policy is inadequate and fails to ensure the safety of the person receiving services.

See related 26 TAC Section 711.423.

Notification of the Findings

The investigator communicates the results of the investigation by sending the approved PI Provider Abuse/Neglect Report to the provider and, if applicable, the appropriate HHSC Regulatory Services Division program.

If the investigator notifies law enforcement or OIG at any time during the investigation, PI forwards a copy of the Provider Abuse/Neglect Report to that entity.

See related 26 TAC Section 711.605.

For all providers, the investigator notifies the reporter within five business days of completing the investigation, stating the outcome of the investigation, and providing them with information about the appeal process.

See related 26 TAC Section 711.609.