Revision 22-1; Effective February 4, 2022

The Risk Assessment coordinator (RAC) team receives investigative reports related to allegations of abuse, neglect or exploitation of individuals who receive HCS, TxHmL or ICF/IID program services. The reports are reviewed by RACs to determine whether regulatory follow-up is required. Additional documentation may be requested from the program provider to verify that the program provider responded to the allegation of abuse, neglect and exploitation according to program standards. In addition, an on-site visit may be scheduled.

 

14610 Abuse, Neglect and Exploitation Policy and Procedures

Revision 22-1; Effective February 4, 2022

The final HHSC Provider Investigations (PI) report is reviewed by RACs to determine if/or what actions need to be taken by LTCR Survey Operations. Actions to be taken are determined by:

  • the severity of the allegation;
  • the disposition of the allegation;
  • the concerns/recommendations of the investigator; and
  • indicators of noncompliance noted by the RACs during the review of the final report narrative.

HHSC sends a final report to the program provider, unless the administrator and the secondary designee are the alleged perpetrator. The program provider has 14 calendar days from the receipt of the investigation findings to notify the RACs of its response to the findings by submitting Form 8494, Notification Regarding an Investigation of Abuse, Neglect or Exploitation,  in HCS and TxHmL programs, by fax to 512-206-3999 or through the WSC Portal. Form 8494 should include:

  • the program provider name;
  • contract number;
  • component code;
  • date submitted to LTCR;
  • who submitted the form, as well as area code and phone number and fax;
  • DFPS case number;
  • date the DFPS report was received;
  • HHSC data system ID number;
  • date of allegation;
  • type of allegation;
  • disposition of allegation;
  • concurrence with the disposition;
  • what actions were taken by the provider; and
  • if the provider will be requesting a methodological review or a review of the finding.

The program provider is responsible for attaching documentation when submitting Form 8494 to include a response for how the program provider handled any confirmed allegations or HHSC concerns or recommendations.

One of the following actions is taken by LTCR:

  • Desk review – A desk review is conducted if there is low risk to the individual(s). The determination of low risk is made if the allegation does not pose a risk to the health or safety of the individual(s) served.
  • On-site visit – On-site visits are conducted if it is determined that a significant risk exists for one or more individuals.