1. (a) DADS' Professional Credentialing Enforcement Unit receives and investigates:

   1. (1) referrals from Regulatory Services Division regional staff to determine an administrator's compliance with licensure requirements when survey findings cite deficiencies or substandard quality of care; and
   2. (2) complaints alleging an administrator violated one or more of the licensure rules.

2. (b) Persons wanting to file a complaint against a licensee may contact the Professional Credentialing Enforcement Unit:

   1. (1) by calling (512) 438-5495; or
   2. (2) by writing the Department of Aging and Disability Services, Professional Credentialing Enforcement Unit, Mail Code E-302, ATTN: NFA Complaint Investigations, P.O. Box 149030, Austin, TX 78714-9030.
3. (c) DADS sends a Nursing Facility Administrator Complaint form to persons wanting to file a complaint. The complainant must complete, sign, and return the form to DADS.

4. (d) If a referral or complaint is received, the Professional Credentialing Enforcement Unit notifies the licensee and, if applicable, the person filing the complaint of the:

   1. (1) alleged rule violation;
   2. (2) assigned case number; and
   3. (3) investigator contact information.

5. (e) DADS investigates referrals and complaints by first determining if a complaint is within Professional Credentialing Enforcement Unit authority to investigate, then by:

   1. (1) reviewing pertinent documentation maintained by the facility, including financial and resident medical records;
   2. (2) gathering additional evidence, including licensee and witness statements;
   3. (3) determining licensee culpability for survey or investigative findings; and
   4. (4) utilizing the services of a private investigator when special circumstances exist.
6. (f) DADS keeps records confidential in accordance with state and federal law.

7. (g) DADS prioritizes complaints as follows:

   1. (1) Priority one complaints allege physical abuse, sexual abuse, neglect, serious injury, death, or immediate jeopardy to resident health or safety. Investigations are initiated within 24 hours of receipt or by the next working day.
   2. (2) Priority two complaints allege all other types of misconduct by the licensee. Investigations are initiated within 30 days of receipt.
8. (h) After the investigation is complete, a final report with supporting documentation is given to the NFAAC for review and recommendation consideration on the appropriate action.

9. (i) After evaluating the NFAAC's recommendation, DADS makes a decision to:

   1. (1) impose a sanction;
   2. (2) collect additional information; or
   3. (3) dismiss the case.
10. (j) DADS notifies the licensee and, if applicable, the person filing a complaint of the status and final outcome of a complaint or referral.

Source Note:The provisions of this §555.51 adopted to be effective June 1, 2004, 29 TexReg 4233; amended to be effective June 1, 2009, 34 TexReg 2795; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1880.