HHSC Long-term Care Regulatory Annual Report for Fiscal

Long-term Care

Regulatory

Annual Report for

Fiscal Year 2018

As Required by

Texas Human Services Code

§242.005

Texas Human Resources Code

§21.011

Texas Government Code

§321.013(c)

Texas Health and Human Services Commission

January 2019

ii

Table of Contents

Executive Summary ............................................................................... 1

1. Introduction ...................................................................................... 2

2. Background ....................................................................................... 4

3. Trends in Long-term Care .................................................................. 6 Facility Capacity and Occupancy .............................................................. 6

Enforcement ......................................................................................... 6 Complaints and Incidents ....................................................................... 7

Visits and Contacts ................................................................................ 7

4. Projects, Initiatives, and Accomplishments ....................................... 9 Joint Trainings with Providers .................................................................. 9

Paperless Referral Process ...................................................................... 9 Resource Allocation................................................................................ 9

Immediate Jeopardy Reviews ................................................................ 10 Investigation Process Redesign ............................................................. 10 Texas Unified Licensure Information Portal (TULIP) .................................. 10

5. Statutory Policy Recommendations ................................................. 11 Fingerprint Checks for Certified Nurse Aides and Medication Aides ............. 11

6. Conclusion ....................................................................................... 12

List of Acronyms .................................................................................. 13

Appendix A. Assisted Living Facility (ALF) and Unlicensed Facility..... A-1

Assisted Living Facility and Unlicensed Facility Actions............................ A-1 Assisted Living and Unlicensed Facility Complaint and Incident Intakes ... A-15

Appendix B. Credentialing Programs ................................................... B-1 Credentialing Program Activity ............................................................ B-1

Appendix C. Day Activity and Health Services (DAHS) Facility ........... C-1

Day Activity and Health Services Facility Actions ................................... C-1 Day Activity and Health Services Facility Complaint and Incident Intakes.. C-8

Appendix D. Home and Community Support Services Agency (HCSSA)D-1 Home and Community Support Services Agency Actions ......................... D-1 Home and Community Support Services Agency Complaint and Incident

Intakes ...................................................................................... D-59

Appendix E. Intermediate Care Facility for Individuals with an Intellectual

Disability or Related Conditions (ICF/IID) ..................................... E-1

iii

Intermediate Care Facility for Individuals with an Intellectual Disability or Related Conditions Actions .............................................................. E-1

Intermediate Care Facility for Individuals with an Intellectual Disability or Related Conditions Complaint and Incident Intakes ............................. 10

Appendix F. Nursing Facility (NF) ....................................................... F-1 Nursing Facility Actions ....................................................................... F-1 Nursing Facility Complaint and Incident Intakes ................................... F-43

Appendix G. Trends ............................................................................. G-1 Trends in Long-Term Care Facilities, Home and Community Support Services

Agencies, and Waiver Programs ...................................................... G-1 Top 10 Rankings ............................................................................. G-32

Appendix H. Waiver Programs - Home and Community-based Services

(HCS) and Texas Home Living (TxHmL) .......................................... H-1 Home and Community-based Services and Texas Home Living Contracts.. H-1

Home and Community-based Services and Texas Home Living Complaints and Referrals ...................................................................................... H-3

1

Executive Summary

The Health and Human Services Commission’s (HHSC) Long-term Care Regulatory

(LTCR) program regulates facilities, agencies, programs, and individual providers of

long-term care services in Texas. LTCR is required by statute to prepare this annual

report on the operation and administration of the department’s responsibilities. The

Texas Health and Safety Code (§242.005) requires that the Legislative Budget

Board and the state auditor jointly prescribe the form and content of the report,

subject to the Texas Government Code (§321.013 (c)) for the state auditor. This

report also fulfills the LTCR portion of the annual report required in Texas Human

Resources Code (§21.011).

This report provides data on the number of providers licensed and/or certified,

LTCR visits and contacts with these providers, and any ensuing enforcement actions

taken against providers for failing to meet their regulatory obligations. As the

number of long-term care providers in Texas continues to increase, LTCR must

inspect, license, and investigate a higher number of complaints and incidents.

LTCR continually strives to increase its quality, consistency, efficiency, and

accountability as it carries out its regulatory responsibilities. LTCR includes a policy,

rules, and training section to assist the department in meeting these goals. Multiple

projects and initiatives have been accomplished or are in progress, including:

joint trainings with providers;

a paperless referral process;

a strategic reallocation of resources;

quality reviews of “immediate jeopardy” violations;

a redesigned investigation process; and

implementation of an online licensure portal.

During the 2019 legislative session, LTCR looks forward to working with lawmakers

on any statutory initiatives they identify to strengthen the state’s oversight of long-

term care settings to further protect public health and safety.

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1. Introduction

The Regulatory Services LTCR program’s mission is to protect the health and safety

of the more than 1 million older Texans and those with disabilities who need

services and supports to lead dignified, independent, and productive lives. To

continue fulfilling these critical functions in a state with a fast-growing older

population, HHSC is evaluating the best approach to address resource needs,

including requesting additional front-line staff positions.

The LTCR program regulates facilities, agencies, programs, and individual providers

of long-term care services through:

● inspections and surveys

● follow-up visits

● complaint and incident investigations

● enforcement actions

● other contacts required for carrying out state and federal licensure or

certification responsibilities, such as telephone monitoring

The following LTC facilities, agencies and programs must be licensed or, if exempt

from licensure, certified by the state and comply with licensure rules (or federal

certification requirements) to operate in Texas:

● Assisted living facilities (ALFs)

● Day activity and health services facilities (DAHS)

● Home and community support services agencies (HCSSAs)

● Intermediate care facilities for individuals with an intellectual disability or

related condition (ICFs/IID)

● Nursing facilities (NFs)

● Prescribed pediatric extended care centers (PPECCs)

● Home and Community-based Services (HCS) waiver providers (certified,

exempt from licensure)

● Texas Home Living (TxHmL) waiver providers (certified, exempt from

licensure)

The LTCR program also enrolls providers and manages the Medicaid provider

contract agreements for NFs and ICFs/IID to ensure they meet all federal

requirements to participate in the Medicaid program and are eligible to receive

Medicaid reimbursements. These enrollment activities include initial provider

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contract enrollment, contract renewals, contract amendments, changes of

ownership, and facility relocations.

The LTCR program is also responsible for the following activities and programs

related to the administration and operation of LTC facilities:

● Nursing facility administrator licensing and investigations

● Medication aides

● Nurse Aide Training and Competency Evaluation

● Nurse aide certification

● Employee Misconduct Registry

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2. Background

According to the U.S. Census Bureau, in 2010 there were 3.8 million people in

Texas age 60 and older; they made up approximately 15 percent of the total Texas

population of 25 million. This group is one of the fastest-growing populations in

Texas and is expected to more than triple between 2010 and 2050. By 2050, this

group is expected to grow to 12 million. (Data source: US Census 2010 and Texas

State Data Center, University of Texas at San Antonio)

By 2050, Texans age 60 and older will comprise 22 percent of the total Texas

population. According to a demographer with the U.S. Census Bureau, “The aging of

baby boomers means that within just a couple decades, older people are projected

to outnumber children for the first time in U.S. history”. As the older adult

population increases, Texas will need more health and human services and

community engagement activities (Texas State Plan on Aging 2015-2017).

Most older Texans live in one of the 25 metropolitan areas in Texas. The 77 metro

area counties contain 83 percent of the population age 60 and older. The remaining

17 percent of the older adult population lives in 177 rural counties. Sixty-eight rural

counties have a population density of less than seven people per square mile; less

than 1 percent of Texans age 60 and older live in these less densely populated

counties. (Source: Texas State Plan on Aging 2015-2017)

Thirty-five percent of Texans age 60 and older (1.3 million) have one or more

disabilities. Certain population groups are more likely to experience disability than

others:

● Disability is more common among women than among men age 75 and

older. This may reflect the fact that many more women than men live to be

this age.

● Among people age 65 and older with incomes below the poverty level, 54

percent have a disability, compared to 39 percent of those with incomes

above the poverty level.

In Texas, the growth of the aging population and increased longevity will mean a

marked increase in the number of people age 85 and older. In 2010, the population

age 85 and older was 305,000; by 2050, it is expected to increase to 1.6 million, an

increase of greater than 500 percent. This segment of the population will increase

from 1.2 percent to 2.8 percent of the total state population. Rates of disability and

serious chronic illness tend to increase with age. This rapid increase in the number

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of the oldest people is expected to increase the need for long-term services and

supports. (Source: Texas State Plan on Aging 2015-2017)

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3. Trends in Long-term Care

Facility Capacity and Occupancy

Along with the aging population, Texas has seen a steady or increasing need for NF

and ALF beds. The number of ALFs and NFs has increased by 11 percent and 2

percent since 2014, respectively. ICFs/IID and DAHS facilities decreased during this

same period. HHSC also licensed its first PPECC facility in 2018.

ALFs continue to be the fastest-growing segment of long-term care in Texas. From

2011 to 2018, the number of these facilities grew faster than any other provider

type. In 2011, Texas had 33,182 ALF residents; in 2018, it had 45,546. This trend

reflects the fact that more consumers are choosing ALFs as an alternative to NF

care, in part because residents might need assistance with activities of daily living

but do not necessarily need the medical care provided by a NF.

Occupancy rates for some facility types continue to be low, ranging from 51.1

percent for DAHS to 69.8 percent in ICFs/IID in 2018. When the occupancy data for

ICFs/IID are broken down between the state operated state supported living

centers versus private and community-based facilities, state operated facilities have

a much lower occupancy rate (49.7 percent compared to 92.5 percent). As

advocates encouraged these individuals to transition from institutional to

community-based settings, the Texas Legislature in the early 1990s imposed a

moratorium on new ICFs/IID. With an occupancy rate of 92.5 percent in private and

community operated facilities, some stakeholders have expressed interest in

increasing ICF/IID capacity.

Enforcement

A key part of the LTCR program’s responsibilities is to take the appropriate

enforcement actions when providers fail to comply with relevant rules and

regulations. The enforcement data in this report reflect a significant increase in the

imposition of Civil Monetary Penalties (CMPs) from previous years. This increase is

primarily due to guidance from the federal Centers for Medicare & Medicaid Services

(CMS) to the state survey agencies regarding a 2016 mandatory imposition of

federal remedies, which include CMPs. In 2018, 416 CMPs were imposed on Texas

facilities, compared to 292 in 2017. The total state amount received from CMPs was

$8,218,224.

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For NFs, the number of imposed and assessed administrative penalties also

increased from 2017 to 2018. HHSC imposed 64 administrative penalties

(compared to 56 in 2017) and assessed 17 administrative penalties (compared to

six in 2017).

Complaints and Incidents

To protect the health and safety of individuals receiving long-term care services,

Regulatory Services’ Complaint and Incident Intake staff fields and triages

complaints about providers as well as incidents self-reported by providers.

Complaints and incidents are then sent to the Survey Operations team to

investigate within prescribed timeframes based on the severity of the situation. The

workload of LTCR survey staff for comprehensive licensure surveys is predictable.

However, the number of complaints and incidents is highly variable and has a

tremendous impact on workloads.

For ALFs, the number of both complaints and incidents increased since fiscal year

2013 by 11 percent, with a five-year high in complaints (1,956 to 2,580, a 32

percent increase since fiscal year 2013) and a five-year increasing trend in

incidents (1,096 to 2,370, a 116 percent increase since fiscal year 2013).

LTCR also investigated a substantially higher number complaints and incidents

regarding NFs, with a five-year increasing trend in both. The number of complaints

increased 36.8 percent since 2013 (8,157 to 11,160) and the number of incidents

increased 52.3 percent in the same period (10,741 to 16,363).

Visits and Contacts

The number of visits and contacts that LTCR has with facilities, agencies, and other

LTC providers is affected by the number of providers, the number of complaints and

incidents, and the availability of staff to complete the task. Staffing challenges,

including the loss of positions in fiscal year 2018, hindered the program’s ability to

complete visits and contracts in prescribed timeframes.

The total number of facility contacts and visits decreased by 14 percent (3,075

visits) in fiscal year 2018 compared to fiscal year 2017. Most of this decrease was

for state licensed-only providers – ALFs saw a 24 percent decrease; DAHS saw a 21

percent decrease. However, the total number of HCSSA contacts and visits

increased in fiscal year 2018 compared to fiscal year 2017 by 16.8 percent to its

highest level in five years (4,500 visits/contacts).

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The number of reviews of waiver programs (reviews completed at the contract

level) decreased by 8.5 percent in fiscal year 2018 (1,287 reviews) compared to

fiscal year 2017 (1,407 reviews). The decrease can be seen in both Home and

Community-based Services reviews (951 reviews in fiscal year 2018 compared to

994 reviews in fiscal year 2017) and Texas Home Living reviews (336 reviews in

fiscal year 2018 compared to 413 reviews in fiscal year 2017). However, the

number of Home and Community-based Services residential reviews (reviews

completed in every home with a residential component) increased by 23.4 percent

(15,120 reviews in fiscal year 2018 compared to 12,248 reviews in fiscal year

2017). The majority of these reviews were completed on the residential component

in foster care (81.5 percent).

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4. Projects, Initiatives, and Accomplishments

The LTCR program strives to continuously improve on measures of quality,

consistency, efficiency, and accountability and has undertaken a variety of

initiatives to improve the services it provides to consumers, providers, and other

stakeholders. Many of these efforts focus on improving the consistency of the

survey process so that regulated entities are surveyed or investigated similarly

across the state.

Joint Trainings with Providers

HHSC will continue conducting joint trainings for both regulatory surveyors and

providers as part of its effort to improve its own consistency as well as the LTC

services provided to individuals. These well-attended joint trainings have generated

positive reviews from providers and survey staff alike. Courses are available for

NFs, ICFs/IID, ALFs and home health providers, and all are listed on the HHSC

website.

Paperless Referral Process

A streamlined, paperless process was implemented in 2018 for survey staff to refer

nursing facility administrators, medication aides, and certified nurse aides to

enforcement staff to assess appropriate penalties on these professionals for

violating certain regulations. This new process has significantly increased the

efficiency and consistency in how these referrals are conducted internally.

Resource Allocation

During the 2017 legislative session, 74 vacant full-time equivalent (FTE) positions

in LTCR were eliminated during the appropriations process for the 2018-19

biennium. In 2018, HHSC leadership received approval to transfer funding for 81

FTEs from other HHSC budget strategies to Regulatory Services, many of which

were for LTCR surveyor positions. This reinstatement of positions significantly

increased LTCR’s ability to meet federal and state requirements.

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Immediate Jeopardy Reviews

To improve consistency, the LTCR leadership team has continued to expand the

immediate jeopardy (IJ) call project statewide in 2018. During these calls, state

office survey and enforcement staff review potential IJ situations while the surveyor

is still at a facility. Appropriate regional staff also join these calls. This process has

improved consistency statewide in determining what constitutes an IJ and has

helped surveyors gain the skills to better assess IJ situations.

Investigation Process Redesign

LTCR is redesigning the complaint and incident investigation process to ensure

more consistent, thorough investigations. This effort emphasizes investigator off-

site preparation before going on-site to investigate, as well as a streamlining of the

reports they write detailing the results of their investigations. This effort has made

it easier for providers to identify the salient aspects of the investigation and better

understand the determinations made by LTCR surveyors. The process has already

been implemented in the NF program; other programs will adopt the process in the

coming year.

Texas Unified Licensure Information Portal (TULIP)

In early September, LTCR launched a web-based licensure system for licensed long-

term care providers. TULIP allows long-term care providers to conduct all state

licensure activities online, and HHSC will be phasing out paper licensure

applications. This system is expected to create numerous efficiencies and

conveniences for providers and LTCR staff alike. More specifically, providers are

now able to apply online for initial licenses, request license renewals online, and

pay any licensing fees online. They also now have immediate, anytime access to

the status of their license applications. LTCR will continue coordinating closely with

providers, HHSC Information Technology staff, and the TULIP vendor to improve

the system.

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5. Statutory Policy Recommendations

Fingerprint Checks for Certified Nurse Aides and

Medication Aides

The criminal background checks currently required for nurse aides and medication

aides are Texas Department of Public Safety (DPS) name-based checks, which

provide only an initial, snap-shot view of an individual’s criminal history. Requiring

the use of FBI fingerprint checks with a “rap back” service would allow HHSC to

receive ongoing notifications of any criminal history nationwide, including arrests,

prosecutions, and convictions, and would eliminate the need for a facility to conduct

name-based background checks on a nurse aide or another employee before hiring.

HHSC has requested an exceptional item on background checks as part of the

agency’s Legislative Appropriations Request for 2020-2021. HHSC LTCR staff would

receive and assess the results of the initial finger-print criminal background check

and, through ongoing “rap back” reports, be notified of any additional arrests or

convictions going forward. Providers would see greater protection from hiring or

continuing to employ unqualified aides, which reduces their risk of receiving

regulatory citations.

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6. Conclusion

HHSC leadership remains committed to ongoing focus on streamlining regulatory

practices, reducing duplicative regulation, limiting unnecessary expenditures, and

using technology and innovation wherever possible. This is particularly critical given

the challenges and demands facing state agencies and providers in the rapidly

changing health and human services environment.

A key part of this effort is to continue focusing on quality improvement. For

providers, this means implementing and enforcing quality assurance programs to

improve operations, compliance with regulations, and services. For HHSC, it means

continuing efforts both within LTCR and with other areas of the agency to assist

providers in their journey toward continual improvement. Texas has made

significant strides on certain key measures of quality, including a notable reduction

in the inappropriate use of antipsychotic medications in nursing facilities, and HHSC

believes it is vital to maintain this momentum.

To achieve the vision of transformation and quality improvement, the HHSC system

must further efforts to break down bureaucratic silos and ensure that providers,

managed care organizations, regulators, advocates, and other stakeholders all work

together to pursue innovations and improvements to protect the health and safety

of our most vulnerable Texans.

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List of Acronyms

Acronym Full Name

ADL Assistance with daily living

ALF Assisted living facility

AP Administrative penalty

CA/DA County Attorney/District Attorney

CFC Consumer First Choice

CFR Code of Federal Regulations

CMP Civil money penalty

CMS Centers for Medicare and Medicaid Services

CNA Certified Nurse Aide

DADS Department of Aging and Disability Services

DAHS Day activity and health services

DFPS Department of Family and Protective Services

DPS Department of Public Safety

FY Fiscal year

HAB Habilitation

HB House Bill

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Acronym Full Name

HCS Home and Community-based Services

HCSSA Home and community support services agencies

HHSC Health and Human Services Commission

HRC Human Resources Code

HSC Health and Safety Code

ICF/IID Intermediate care facility for individuals with an intellectual

disability or related condition

IJ Immediate jeopardy

IR Informal reconsideration

LAR Legally Authorized Representative

LSC Life Safety Code

NF Nursing facility

NFA Nursing facility administrator

NFPA National Fire Protection Association

OAG Office of the Attorney General

OASIS Outcome and Assessment Information Set

OSC Opportunity to show compliance

PAS Personal attendant services

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Acronym Full Name

PDP Personal development plan

PPECC Prescribed pediatric extended care center

RN Registered Nurse

S&C Survey and certification

Sec Section

SB Senate Bill

SSLC State supported living center

TAC Texas Administrative Code

TGC Texas Government Code

THRC Texas Human Resources Code

THSC Texas Human Services Code

TOC Texas Occupations Code

TULIP Texas Unified Licensure Information Portal

TxHmL Texas Home Living

UTI Urinary tract infection

WS&C Waiver survey and certification

A-1

Appendix A. Assisted Living Facility

(ALF) and Unlicensed Facility

Assisted Living Facility and Unlicensed Facility

Actions

The tables on pages A-5 and A-6 contain information relating to Texas Health and

Safety Code, Title 4, Subtitle B, Chapter 247, Assisted Living Facilities, facility

actions and unlicensed facility actions, by category, for fiscal year (FY) 2018.

Administrative Penalties

Basis for Imposing

The state long-term care regulatory program can assess an administrative penalty

against a person who:

● Violates this chapter or a rule, standard, or order adopted under this chapter

or a term of a license issued under this chapter.

● Makes a false statement, that the person knows or should know is false, of a

material fact:

On an application for issuance or renewal of a license or in an attachment

to the application.

With respect to a matter under investigation by the regulatory agency.

● Refuses to allow a representative of the department to inspect:

A book, record or file required to be maintained by a day activity and

health services facility.

Any portion of the premises of an assisted living facility.

● Willfully interferes with the work of a representative of the regulatory agency

or the enforcement of this chapter.

● Willfully interferes with a representative of the regulatory agency preserving

evidence of a violation of this chapter or a rule, standard, or order adopted

under this chapter or a term of a license issued under this chapter.

● Fails to pay a penalty assessed under this chapter before the 30th day after

the date the assessment of the penalty becomes final.

● Fails to notify the regulating agency of a change of ownership before the

effective date of the change of ownership.

A-2

Imposed

An action can be recommended by:

● The regional survey or investigation team and supported during enforcement

review.

● The regional or state office regulatory staff, considering the survey or

investigation findings or evaluating the facility’s history or performance.

State regulatory staff impose the action when the administrative penalty

recommendation has been reviewed and confirmed by state office. The facility is

formally notified of the administrative penalty citation and the penalty amount.

Additionally, the notice includes information about the appeal process available to

the facility.

Assessed

Penalties assessed are the final actions after the appeal process has been

completed (or an agreement to settle has been reached) and a final amount has

been decided, or if the person charged consents to the penalty or does not respond

in a timely manner to the notice of the penalty. The facility is notified of the amount

to be paid and the date payment is due. A lump sum payment or a monthly

payment plan may be agreed upon during the appeal or settlement process.

Injunctive/Other Relief and Civil Penalty Referrals

The regulating agency can refer a licensed or unlicensed facility to the Office of the

Attorney General (OAG) or district attorney or county attorney under Texas Health

and Safety Code Chapter 247. When a case is resolved through settlement, a

portion of the payment is designated a civil penalty and normally deposited to

general revenue. The OAG receives the portion designated as attorney fees and

costs.

Although there may be several survey or investigative visits to the same facility

resulting in civil penalty recommendations, the recommendations are generally

consolidated into one case when referred to the OAG.

A civil penalty can be awarded if a facility violates a licensing rule and the state

determines the violation threatens resident health and safety, or if the facility is

operating without a license.

A-3

Amelioration of Violations

In certain situations, the regulatory agency’s commissioner can allow, in lieu of

demanding payment of an administrative penalty, the use (under the agency’s

supervision) of any portion of the penalty to ameliorate the violation or to improve

services (other than administrative services) in the facility affected by the violation.

Trusteeships

The state regulatory program, through the OAG, can petition a court of competent

jurisdiction for the involuntary appointment or appointment by agreement of a

trustee to operate a facility if one or more of the following conditions exist:

● The facility is operating without a license.

● The facility’s license has been suspended or revoked.

● License suspension or revocation procedures against a facility are pending

and an imminent threat to the health and safety of the residents exists.

● An emergency presents an immediate threat to the health and safety of

residents.

● The facility is closing (whether voluntarily or through an emergency closing

order), and arrangements for relocation of the residents to other licensed

institutions have not been made before closure.

Emergency Suspension and Closing Orders

The state will suspend a facility’s license or order an immediate closing of all or part

of the facility if:

● the agency finds that the facility is operating in violation of the licensure

rules or

● the violation creates an immediate threat to the health and safety of a

resident.

The order suspending a license or closing a part of a facility is either immediately

effective on the date the license holder receives written notice, or on a later date

specified in the order. This suspension may occur simultaneously with any other

enforcement provision available to HHSC. The order is effective for 10 days.

Denial of License

The regulatory program can deny a facility’s license when the facility does not meet

licensure rules.

A-4

More specifically, it can deny a facility’s license if a facility:

● Violates Texas Health and Safety Code Chapter 247 or the rules adopted

under it in a repeated or substantial manner.

● Aids, abets, or permits a substantial violation of the rules.

● Fails to submit required information and documents needed to complete the

application process or provides false or fraudulent information.

● Fails to pay certain fees.

● Applicant has had a license revoked, has been debarred or excluded from the

Medicare or Medicaid program, has a court injunction prohibiting the

applicant or manager from operating a facility, has been subject to certain

enforcement actions, has a criminal conviction, has an unsatisfied judgment,

has been evicted or has had a license suspended.

● Committed any act described by Texas Health and Safety Code

§247.0451(a)(2)-(6).

● Has violated Texas Health and Safety Code §247.021.

● Any controlling person subject to refusal or denial as described in Texas

Administrative Code, Title 40, Part 1, Chapter 99, Denial or Refusal of

License.

Revocation of License

The regulating agency can revoke a facility’s license for a violation of Texas Health

and Safety Code Chapter 247 or a rule adopted under this chapter.

More specifically, it can revoke a license when the license holder:

● Violates Texas Health and Safety Code §247.0451(a)(2)-(6).

● Violates Texas Health and Safety Code Chapter 247 or the rules adopted

under it in a repeated or substantial manner.

● Submits false or misleading statements on an application.

● Uses subterfuge or other evasive means to obtain a license.

● Conceals a material fact or fails to disclose a material fact on a license

application.

● Violates Texas Health and Safety Code §247.021.

A-5

Assisted Living Facility Actions by Region for FY 2018

Type of Remedy Actions 01 02 03 04 05 06 07 08 09 10 11 Total

Administrative Penalties Imposed 0 1 14 4 0 12 3 1 1 2 4 42

Administrative Penalties (1) Assessed 0 0 0 0 0 2 0 0 0 0 1 3

OAG injunctive/ other relief

and civil penalties (2)

Referred 0 0 0 0 0 0 0 0 0 0 0 0

CA/DA injunctive/ other relief

and civil penalties (2)

Referred 0 0 0 0 0 0 0 0 0 0 0 0

Amelioration of violations Approved 0 0 0 0 0 0 0 0 0 0 0 0

Amelioration of violations Denied 0 0 0 0 0 1 0 0 0 0 0 1

Trusteeships Ordered 0 0 0 0 0 0 0 0 0 0 0 0

Emergency suspension and

closing orders

Ordered 0 0 0 0 0 0 0 0 0 0 0 0

Denials of license (3) Proposed 0 0 13 2 0 14 6 2 0 1 0 38

Denials of license (3) Denied 0 0 3 0 0 5 1 0 0 0 0 9

Revocations of license (4) Proposed 0 0 0 0 0 0 0 0 0 0 0 0

Revocations of license (4) Revoked 0 0 0 0 0 0 0 0 0 0 0 0

Notes:

1. Assessed administrative penalties can include final actions on penalties imposed in a previous fiscal year.

2. The agency refers injunctive/other relief and civil penalties to the county or district attorney if the agency has an existing agreement to do

so; otherwise, they are referred to the Office of the Attorney General.

3. The agency can propose to deny renewal of a license for many reasons. However, if a facility has been cited for one or more violations of

the licensing rules and those violations have not been determined to have been corrected by the date the facility’s license is due for

renewal, the agency can propose to deny the application. If the facility subsequently corrects the violation(s), the agency can withdraw its

proposal to deny the application for license renewal. Denied actions may also include final actions on cases proposed in a previous fiscal

year.

4. Revoked actions can include final actions on cases proposed in a previous fiscal year.

A-6

Unlicensed Facility Actions by Region for FY 2018


OAG injunctive/ other relief

and civil penalties

Referred 0 0 1 0 0 1 2 0 0 2 0 6

Assisted Living Facility Administrative Penalties for FY 2018

Region City Facility

ID Facility

Visit Exit

Date Imposed Assessed Collected Balance H

02 - Abilene Jacksboro 000811 Greystone Park Retirement &

Assisted Living

06/01/2017 $1,250 $1,250 $0 N

03 - Arlington Carrollton 101033 Autumn Leaves of North Carrollton

at Castle Hills

01/19/2018 $900 $900 $0 N

03 - Arlington Carrollton 106316 Oxford Glen at Carrollton 10/20/2017 $1,000 $1,000 $0 N

03 - Arlington Dallas 000871 Agape Place Personal Care Home 06/29/2017 $350 $350 $0 N

03 - Arlington Dallas 104038 Windsor Senior Living 06/12/2017 $2,050 $2,050 $0 N

03 - Arlington Flower

Mound

103044 Autumn Leaves of Flower Mound 11/09/2017 $300 $300 $0 N

03 - Arlington Flower

Mound

105287 Rosewood Assisted Living and

Memory Care

03/24/2018 $900 $0 $900 Y

03 - Arlington Fort Worth 102977 St. John's Residential Care Home III

Inc

11/29/2017 $350 $0 $350 Y

03 - Arlington Fort Worth 104442 St John's Residential Care Home,

Inc

09/06/2017 $600 $600 $0 N

03 - Arlington Garland 104041 Springfield Senior Living 02/12/2018 $700 $700 $0 N

03 - Arlington Keller 105555 Legacy at Bear Creek 09/22/2017 $900 $900 $0 N

03 - Arlington Lewisville 106491 Beehive Assisted Living - Lewisville,

Flower Mound

01/28/2018 $500 $0 $500 N

A-7


ID Facility

Visit Exit


03 - Arlington Southlake 105649 The Landing at Watermere 10/31/2017 $650 $650 $0 N

03 - Arlington Stephenville 030090 Good Tree Retirement 12/24/2017 $1,800 $1,800 $0 N

03 - Arlington Westworth

Village

106056 The Westmore 02/28/2018 $400 $0 $400 Y

04 - Tyler De Berry 030363 Happy Acres Personal Care 02/07/2018 $1,050 $0 $1,050 N

04 - Tyler Longview 104611 Emmanuel Homes #3 09/08/2017 $350 $350 $0 N

04 - Tyler Mount

Pleasant

106133 The Lodge Assisted Living and

Memory Care

01/31/2018 $300 $300 $0 N

04 - Tyler Tyler 000308 East Texas ALF Reunion Inn LLC 05/03/2018 $600 $0 $600 N

06 - Houston Houston 000419 Nissi Home of Texas 05/18/2017 $650 $650 $0 N

06 - Houston Houston 000710 Braeswood Personal Care Homes

Inc

02/07/2018 $500 $0 $500 N

06 - Houston Houston 000797 Brookdale Galleria 03/15/2018 $1,000 $0 $1,000 N

06 - Houston Houston 030099 Elmcroft of Cy-Fair 05/31/2018 $900 $900 $0 N

06 - Houston Houston 030099 Elmcroft of Cy-Fair 04/12/2018 $600 $600 $0 N

06 - Houston Houston 030388 Brookdale Spring Shadows 11/29/2017 $1,000 $0 $1,000 N

06 - Houston Houston 030389 Brookdale Spring Shadows 12/27/2017 $350 $0 $350 N

06 - Houston Houston 105872 Silverado - Vintage Preserve 07/18/2017 $1,800 $1,800 $0 N

06 - Houston Katy 106069 Legacy at Falcon Point 04/25/2017 $600 $600 $0 N

06 - Houston Pearland 100756 Trinity Oaks of Pearland 06/01/2018 $900 $0 $900 N

06 - Houston Richmond 103987 Agape Heritage Home 12/19/2017 $400 $0 $400 Y

06 - Houston Stafford 000474 The Hampton at Meadows Place 11/28/2017 $1,650 $0 $1,650 N

07 - Austin Austin 104789 Angels of Sunland 11/01/2017 $350 $0 $350 N

07 - Austin Georgetown 030408 Assisted Living at Tallwood 01/05/2018 $700 $0 $700 N

A-8


ID Facility

Visit Exit


07 - Austin Pflugerville 105497 Serenity Senior Living 02/16/2018 $200 $200 $0 N

08 - San Antonio San Antonio 100822 Boarding with Tender Care Inc 02/20/2018 $1,350 $1,350 $0 N

09 - Abilene San Angelo 000387 Brookdale South San Angelo 02/16/2018 $350 $350 $0 N

10 - El Paso El Paso 030084 Royal Estates of El Paso 03/23/2018 $500 $0 $500 N

10 - El Paso El Paso 106042 Rosedale Adult Foster Home 09/19/2017 $450 $450 $0 N

11 - Corpus

Christi

Harlingen 100341 Angelcare Acres 08/15/2017 $1,900 $1,900 $0 N

11 - Corpus

Christi

Harlingen 101249 Angelcare Haven 04/11/2017 $550 $0 $550 N

11 - Corpus

Christi

McAllen 030409 Biltmore Assisted Living 08/17/2017 $350 $350 $350 $0 Y

11 - Corpus

Christi

Mission 100787 The Bridges at Mission 10/18/2017 $700 $700 $0 N

Totals $32,700 $350 $21,000

42 Total assisted living facility administrative penalties imposed.

Notes:

1. The imposed column is the total amount of penalty after the state has reviewed and confirmed the administrative penalty citation and

amount. This is the amount due and payable if there is no alternative amount resulting from an appeal held or settlement agreement

reached.

2. The assessed column is the amount of penalty due after the appeal process has been completed (or an agreement to settle has been

reached) and a final amount has been decided, or if the person charged consents to the penalty or does not respond timely to the notice

of the penalty.

3. The collected column is the amount of money the facility has paid to HHSC.

A-9

4. The balance column is the amount of penalty the facility owes. These amounts do not necessarily reflect the final amount the facility may

owe. The amounts can change based on a hearing or negotiated settlement. Since these amounts may change, there is no total for this

column. An administrative penalty with a negative balance may indicate an overpayment or that the penalty was rescinded after payment.

5. The “H” column stands for hearing, and a “Y” in this column indicates the facility requested a hearing on the violation. Once a facility

requests and meets the criteria for a hearing on the violation, the case results will be pending until the appeal process is complete. An “N”

indicates the facility did not request a hearing.

A-10

Assisted Living Facility Injunctive/Other Relief and Civil Penalty

Referrals to the Office of the Attorney General for FY 2018

HHSC did not refer any assisted living facilities to the office of the attorney general

for injunctive/other relief and civil penalties in FY 2018.

Assisted Living Facility Injunctive/Other Relief and Civil Penalty

Referrals to the County or District Attorney for FY 2018

HHSC did not refer any assisted living facilities to the county or district attorney for

injunctive/other relief and civil penalties in FY 2018.

Unlicensed Facility Injunctive/Other Relief and Civil Penalty



ID Facility

Date

Referred

03 - Arlington Burleson 106776 Mustang Creek Estates Burleson House C &

D

11/15/2017

06 - Houston Houston 010383 Brookhavens Residential Care Center 02/16/2018

07 - Austin Austin 107175 1915 Santa Clara 03/15/2018

07 - Austin Austin 106065 6805 Hardy Dr 03/15/2018

10 - El Paso El Paso 106998 6717 Mariposa 12/21/2017

10 - El Paso El Paso 102395 6616 Paseo Redondo 12/21/2017

6 Total unlicensed facility injunctive/other relief and civil penalty referrals to the

Office of the Attorney General.

Unlicensed Facility Injunctive/Other Relief and Civil Penalty Referrals

to the County or District Attorney for FY 2018

HHSC did not refer any unlicensed facilities to the county or district attorney for

injunctive/other relief and civil penalties in FY 2018.

Assisted Living Facility Amelioration of Violations for FY 2018


ID Facility Decision

Decision

Date

Amount

Ameliorated

06 - Houston Houston 000332 Limbe House Denied 09/15/2017 $0

1 Total assisted living facility amelioration processed.

A-11

Assisted Living Facility Trusteeships Ordered for FY 2018

HHSC did not order any trustees placed in assisted living facilities in FY 2018.

Assisted Living Facility Emergency Suspension and Closing Orders

for FY 2018

HHSC did not issue any emergency suspension and closing orders related to

assisted living facilities in FY 2018.

A-12

Assisted Living Facility License Denials and Revocations Proposed for FY 2018


ID Facility

Proposed

Action

Revoked

Date

Denied

Date Status

03 - Arlington Dallas 103088 Evergreen Assisted Living LLC Deny Rescinded

03 - Arlington Dallas 105832 Total Joy Living Deny IR Letter

03 - Arlington Dallas 106968 Faith Cares for You Deny 04/17/2018 License

Denied

03 - Arlington Desoto 103317 Autumn Sun Assisted Living Homes, LLC Deny Hearing

03 - Arlington Fort Worth 102977 St. John's Residential Care Home III Inc Deny Hearing

03 - Arlington Fort Worth 106954 St. John's Residential Care Homes Inc Deny Rescinded

03 - Arlington Fort Worth 107102 CNS South 400 Deny Rescinded

03 - Arlington Fort Worth 107103 CNS South 400 Deny Rescinded

03 - Arlington Frisco 105901 Kingsgate Homecare Services LLC Deny Rescinded

03 - Arlington Grand Prairie 105663 Accessible Living Deny Rescinded

03 - Arlington Lancaster 050536 Professional Care Facility I I Deny Hearing

03 - Arlington Lancaster 103420 Brixton Village Assisted Living Deny Rescinded

03 - Arlington Sherman 106749 Grayson Senior Living Deny Formal

Hearing

Letter

04 - Tyler Athens 106949 Athens Assisted Living and Memory Care Deny Hearing

04 - Tyler Longview 106800 Parkview on Hollybrook Deny Rescinded

06 - Houston Brookshire 000867 Willow River Farms Deny OSC Letter

06 - Houston Brookshire 104811 32303 Pintail Street Deny Hearing

06 - Houston Houston 000609 The Roc Personal Care Deny Hearing

06 - Houston Houston 000710 Braeswood Personal Care Homes Inc Deny Rescinded

A-13


ID Facility

Proposed

Action

Revoked

Date

Denied

Date Status

06 - Houston Houston 000809 Liberty Island Personal Care Homes Inc Deny Action

Propose

06 - Houston Houston 000987 Liberty Island Personal Care Homes Inc Deny Action

Propose

06 - Houston Houston 030093 Goodness and Mercy Health Care Deny 11/10/2017 License

Denied

06 - Houston Houston 030371 Best Personal Care Facility Deny 05/08/2018 License

Denied

06 - Houston Houston 050507 Lakewood 24 Hour P C 2 Deny Rescinded

06 - Houston Houston 105658 Komfort Keepers Residential Home Deny Formal

Hearing

Letter

06 - Houston Houston 106497 Lavender Place Assisted Living Deny 04/06/2018 License

Denied

06 - Houston La Marque 030166 Laurel House Deny Rescinded

06 - Houston Sharpstown 106258 Tender Care Assisted Living Deny 01/26/2018 License

Denied

06 - Houston Tomball 100721 TCG Tomball Campus LLC Deny Rescinded

07 - Austin Dessau 107005 Tech Ridge Oaks Assisted Living and Memory

Care

Deny Rescinded

07 - Austin Pflugerville 107157 Clarecreek Senior Living Deny Formal

Hearing

Letter

07 - Austin Round Rock 030119 The Cottages at Chandler Creek II Deny Rescinded

07 - Austin Round Rock 107007 Double Creek Assisted Living and Memory Care Deny Rescinded

07 - Austin Type 106790 Gabriel House at Down Home Ranch Deny Formal

Hearing

Letter

A-14


ID Facility

Proposed

Action

Revoked

Date

Denied

Date Status

07 - Austin Waco 107021 Waco Life Care Center Deny 03/02/2018 License

Denied

08 - San Antonio San Antonio 030098 McDaniels Personal Care Home Deny IR Letter

08 - San Antonio San Antonio 106920 Resilience Assisted Living Facility, LLC Deny Rescinded

10 - El Paso El Paso 106475 Maximus Matthew Loving Care Home Deny Formal

Hearing

Letter

38 Total assisted living facility license denials and revocations proposed.

Notes:

Status column values:

1. Action Propose - HHSC has proposed to deny this license.

2. Formal Hearing Letter - a letter has been sent to the facility offering the opportunity to appeal the action.

3. Hearing - the facility has requested a hearing.

4. IR Letter - a letter has been sent to the facility offering informal review.

5. License Denied - the application for a license was denied.

6. OSC Letter - a letter has been sent to the facility offering the opportunity to show compliance.

7. Rescinded - HHSC rescinded the proposed action.

A-15

Assisted Living and Unlicensed Facility Complaint

and Incident Intakes

Complaints

A complaint allegation is an assertion that a requirement of state licensure has

been violated and can come directly from individuals or residents, family members,

health care providers, advocates, law enforcement, or other state agencies. Report

sources can be oral or written.

Incidents

An incident is an official notification to the state survey agency from an assisted

living facility provider that the physical or mental health or welfare of a resident has

been or may be adversely affected by mistreatment, neglect, or abuse. These

reports also include injuries of unknown source and exploitation or misappropriation

of consumer or resident property.

Priority Assignment

The regulatory program’s complaint intake unit evaluates each complaint based on

its unique circumstances and assigns priorities accordingly. When timeliness is

crucial to the health and safety of a resident(s), such as in a situation of heating or

air conditioner equipment failure, alleged staff walkout, etc., an investigation can be

initiated immediately by telephone, regardless of the priority code assignment. After

the initial contact, each complaint is assigned a priority. The priorities available are:

● On or before 24 hours

● On or before 14 calendar days



● Professional review

● Withdrawn

● Not required

On or Before 24 Hours

Immediate response by regulatory investigators is warranted because a provider

allegedly created or allowed a present and ongoing situation in which the provider’s

noncompliance with one or more requirements of licensure or certification has failed

A-16

to protect residents from abuse, neglect, or mistreatment or has caused, or is likely

to cause, serious injury, harm, impairment or death to a resident.

On or Before 14 Calendar Days

The present or ongoing threat of continued abuse, neglect, or mistreatment has

been removed. The resident is no longer in imminent danger; however, the

provider’s alleged noncompliance with one or more requirements of licensure or

certification may have or has a high potential to cause harm that impacts a

resident’s mental, physical or psychosocial status and is of such consequence that a

rapid response by the regulatory program is indicated. There is evidence or

suspicion that system(s) failure contributed to or brought on the threat. Usually,

specific rather than general information (e.g. descriptive identifiers, individual

names, date, time, location of occurrence, description of harm) will factor into the

assignment of this level of priority.


A provider’s alleged noncompliance with one or more requirements of licensure or

certification has caused or may cause harm that is of limited consequence and does

not significantly impair the resident’s mental, physical or psychosocial status.



certification has a low potential for more than minimal harm or resulted in physical,

mental, or psychosocial harm that did not directly affect resident health and safety

and functional status. This priority may also be assigned for alleged violations of

regulations that do not directly affect resident health and safety.

Professional Review

A provider who has cause to believe the physical or mental health or welfare of a

resident has been or may be adversely affected by mistreatment, neglect, or abuse

must self-report to the state survey agency immediately upon learning of the

alleged conduct or conditions. This notice could include injuries of unknown source

and exploitation or misappropriation of resident property.

Complaint intake staff assign a professional review priority when a provider self-

reports an incident and the provider’s oral report indicates that the provider’s

immediate corrective action is reasonably likely to ensure that abuse, neglect,

A-17

mistreatment, or injury to the resident will not occur again, or at least not while the

provider conducts its investigation and professional quality assurance staff reviews

the provider’s written investigation report.

Based on review of the facility investigation report, if further investigation is

warranted to assess whether the provider’s abuse prohibition policies ensure

compliance with regulatory requirements, the professional review unit will send

notification to regulatory regional staff to schedule an on-site investigation.

Withdrawn

A complaint report filed with the regulatory agency is withdrawn at the request of

the complainant, except when abuse, neglect, or exploitation is alleged. Please refer

to Survey and Certification Clarification 15-01

(https://www.HHSC.state.tx.us/providers/communications/2015/scc/SCC2015-

01.pdf).

Not Required

The state determines it has no jurisdiction to investigate a complaint or a referral,

or a report to another agency, board, or entity is required.

Assisted Living Facility All Intakes by Priority and Region for FY

2018

Intake Priority 01 02 03 04 05 06 07 08 09 10 11 Total

On or before 24

hours

6 4 46 6 4 38 26 22 0 5 4 161

On or before 14

days

54 10 424 82 25 315 166 195 15 23 34 1,343

On or before 30

days

43 26 582 111 18 340 174 254 25 35 39 1,647

On or before 45

days

39 20 486 108 13 265 159 156 17 11 35 1,309

Professional

review

14 9 150 42 4 76 70 44 9 4 14 436

Withdrawn 1 0 10 2 0 0 3 3 2 0 2 23

Not required 1 0 9 5 1 8 5 2 0 0 0 31

Total 158 69 1,707 356 65 1,042 603 676 68 78 128 4,950

https://www.dads.state.tx.us/providers/communications/2015/scc/SCC2015-01.pdf


A-18

Assisted Living Facility Complaints by Priority and Region for FY

2018

Complaint

Priority 01 02 03 04 05 06 07 08 09 10 11 Total

On or before 24

hours

5 3 44 6 4 38 25 22 0 5 2 154

On or before 14

days

25 6 244 58 13 173 94 138 6 17 16 790

On or before 30

days

32 20 382 67 13 208 105 187 11 30 26 1,081

On or before 45

days

13 9 189 43 3 114 51 76 4 5 14 521

Withdrawn 0 0 1 1 0 0 1 0 0 0 0 3

Not required 1 0 9 5 1 8 5 2 0 0 0 31

Total 76 38 869 180 34 541 281 425 21 57 58 2,580

Assisted Living Facility Incidents by Priority and Region for FY 2018

Incident

Priority 01 02 03 04 05 06 07 08 09 10 11 Total

On or before 24

hours

1 1 2 0 0 0 1 0 0 0 2 7

On or before 14

days

29 4 180 24 12 142 72 57 9 6 18 553

On or before 30

days

11 6 200 44 5 132 69 67 14 5 13 566

On or before 45

days

26 11 297 65 10 151 108 80 13 6 21 788

Professional

review

14 9 150 42 4 76 70 44 9 4 14 436

Not required 1 0 9 1 0 0 2 3 2 0 2 20

Total 82 31 838 176 31 501 322 251 47 21 70 2,370

A-19

Unlicensed Facility Complaint Intakes by Priority and Region for FY

2018

Intake priority 01 02 03 04 05 06 07 08 09 10 11 Total

On or before 24

hours

0 0 1 0 0 3 1 0 0 0 0 5

On or before 14

days

0 0 6 0 0 13 4 2 0 1 0 26

On or before 30

days

0 0 14 1 2 19 2 3 0 1 2 44

On or before 45

days

2 0 25 1 5 53 17 9 0 2 3 117

Withdrawn 0 0 1 0 0 1 0 0 0 0 0 2

Not required 0 0 3 0 0 0 0 0 0 0 0 3

Total 2 0 50 2 7 89 24 14 0 4 5 197

B-1

Appendix B. Credentialing Programs

Credentialing Program Activity

The long-term care regulatory agency operates the following programs related to

the administration and operation of long-term care facilities:

● Nursing facility administrator licensing and investigation

● Medication aide permits

● Nurse Aide Training and Competency Evaluation

● Nurse aide certification

● Employee Misconduct Registry

Credentialing Program Counts by Fiscal Year

Credentialing Program FY 2016 FY 2017 FY 2018

Licensed nursing facility administrators 2,210 2,112 2,174

Active medication aides 9,941 10,593 9,746

Approved Nurse Aide Training and Competency

Evaluation Programs (facility-based)

310 310 302

Approved Nurse Aide Training and Competency

Evaluation Programs (non facility-based)

602 615 595

Active certified nurse aides listed on the Nurse

Aide Registry

114,397 115,427 114,920

Nursing Facility Administrator Program

Activity Action FY 2016 FY 2017 FY 2018

New licenses Issued 167 166 159

License renewals (1) Renewed 1,030 916 1,015

Provisional licenses Issued 41 61 33

Referrals (2) Received 217 255 161

Complaints against nursing

facility administrators (3)

Received 0 2 1

New sanctions against

administrator license

Imposed 61 41 69

Nursing facility administrators

required sanctions

Fulfilled 45 35 89

Administrative penalties Assessed 2 3 1

B-2


National Association of Boards

of Examiners of Long-term Care

Administrators exams

Administered 211 155 139

State exams Administered 211 171 156

Notes:

1. Nursing facility administrators are licensed for two years.

2. Nursing facility administrators are automatically referred to the regulatory professional

credentialing enforcement unit for investigation when substandard quality of care or an

immediate jeopardy is identified at a Medicaid- or Medicare-certified facility during their

tenure.

3. Complaints received from the public.

Medication Aide Program


New medication aide permits Issued 1,272 1,124 1,197

Testing dates at schools Scheduled 170 156 163

Initial exams Administered 1,387 1,263 1,441

Retest dates Scheduled 345 212 292

Permits Renewed 9,425 9,469 9,222

Complaints Received 10 14 2

Sanctions Imposed 15 8 7

Nurse Aide Training and Competency Evaluation Program (NATCEP)


New NATCEPs Approved 175 152 134

NATCEPs Renewed 221 311 177

NATCEPs withdrawn from

participation

Withdrew 104 142 132

Competency Evaluation

Programs

Approved 227 236 238

B-3

Nurse Aide Registry


New nurse aides to program Added 15,944 20,679 16,412

Nurse aides removed from

active status

Removed 32,849 26,798 26,694

Nurse aides from expired status

to active status

Returned 76,689 67,542 62,993

New misconduct referrals

received/ processed

Processed 75 99 51

Employee misconduct cases Dismissed 18 11 11

Employee misconduct cases Revoked 81 74 47

Client contacts made by mail Contacted 47,066 43,632 48,387

Public inquiries Received 0 0 0

Client contacts made by

telephone

Contacted 130,156 103,980 102,291

Employee Misconduct Registry


New employee misconduct

referrals

Processed 60 65 39

New unlicensed facility

employees to the registry

Added 59 110 47

New unlicensed HCSSA, HCS or

ICF/ IID employees to the

registry

Added 229 261 180

C-1

Appendix C. Day Activity and Health

Services (DAHS) Facility

Day Activity and Health Services Facility Actions

The table on page C-4 contains information relating to Texas Human Resources

Code, Title 6, Chapter 103, Day Activity and Health Services, facility actions, by

category, for fiscal year (FY) 2018.


Basis for Imposing

The long-term care regulatory program can assess an administrative penalty

against a person who:

● Violates this chapter; a rule, standard or order adopted under this chapter;

or a term of a license issued under this chapter.


material fact:


to the application.

With respect to a matter under investigation by the regulatory agency.

● Refuses to allow a representative of the agency to inspect:

A book, record or file required to be maintained by a day activity and

health services facility.

Any portion of the premises of an assisted living facility.

● Willfully interferes with the work of a representative of the agency or the

enforcement of this chapter.

● Willfully interferes with a representative of the agency preserving evidence of

a violation of this chapter or a rule, standard, or order adopted under this

chapter or a term of a license issued under this chapter.

● Fails to pay a penalty assessed under this chapter before the 30th day after

the date the assessment of the penalty becomes final.

● Fails to notify the agency of a change of ownership before the effective date

of the change of ownership.

Imposed


C-2


review.

● Regional or state office staff, considering the survey or investigation findings

or evaluating the facility’s history and performance.

The state imposes the action when the administrative penalty recommendation has

been reviewed and confirmed by state office. The facility is formally notified of the

administrative penalty citation and the penalty amount. Additionally, the notice

includes information about the appeal process available to the day activity and

health services provider.

Assessed



been decided, or if the person charged consents to the penalty or does not respond

in a timely manner to the notice of the penalty. The provider is notified of the

amount to be paid and the date payment is due. A lump-sum payment or a monthly

payment plan may be agreed upon during the appeal or settlement process.

Injunctive or Other Relief Referrals to the Office of the Attorney

General

Injunctive or other relief cases are referred to the Office of the Attorney General for

action if the regulating agency finds a violation that creates an immediate threat to

resident health and safety or the facility is operating without a license.



of the facility if:

● The agency finds that the facility is operating in violation of the licensure

rules.

● The violation creates an immediate threat to the health and safety of a

resident.

The order suspending a license or closing a part of a facility is immediately effective

on the date the license holder receives written notice or on a later date specified in

the order. This suspension of a license may occur simultaneously with any other

enforcement provision available to the agency. The order is valid for 10 days.

C-3

Denial of License

The regulating agency can deny a facility’s license when the facility substantially

fails to comply with certain rule requirements or the license holder aids, abets or

permits substantial violation of the rules; fails to provide required information or

provides false or fraudulent information; fails to pay certain fees; the license holder

has operated a facility that has been decertified or had its contract terminated, has

been subject to sanctions, has a criminal conviction, has an unsatisfied final

judgment, or has been evicted or had its license suspended; or any controlling

person is subject to denial or refusal of a license as described in Texas

Administrative Code, Title 40, Part 1, Chapter 99, Denial or Refusal of License.


The state can revoke the license of a license holder who violates the rules or

standards for licensing required by Texas Human Resources Code Chapter 103.

The agency also can revoke a license if the licensee submitted false or misleading

statements in the application for license, used subterfuge or other evasive means to

obtain a license, or concealed a material fact or failed to disclose information that

would have been the basis to deny a license.

The revocation of a license can occur simultaneously with any other enforcement

provision.

C-4

Day Activity and Health Services Facility Action by Region for FY 2018


Administrative Penalties Imposed 0 0 0 0 0 0 0 1 0 0 5 6

Administrative Penalties (1) Assessed 0 0 0 0 0 1 0 0 0 0 0 1

Injunctive or other relief (2) Referred 0 0 0 0 0 0 0 0 0 0 0 0


closing orders

Ordered 0 0 0 0 0 0 0 0 0 0 0 0





Notes:


2. Injunctive or other relief cases are referred to the Office of the Attorney General.

3. The agency can propose to deny renewal of a license for many reasons. However, if a facility has been cited for one or more violations of

the licensing rules and those violations have not been determined to have been corrected by the date the facility’s license is due for

renewal, the agency can propose to deny the application. If the facility subsequently corrects the violation(s), the agency can withdraw its

proposal to deny the application for license renewal. Denied actions may also include final actions on cases proposed in a previous fiscal

year.

4. Revoked actions can include final actions on cases proposed in a previous fiscal year.

Day Activity and Health Services Facility Administrative Penalties for FY 2018


ID Facility

Visit Exit


08 - San Antonio Pearsall 101422 Frio Adult Day Care 03/16/2018 $41,200 $0 $41,200 N

11 - Corpus Christi Brownsville 104672 Grace Center 05/10/2017 $900 $0 $900 N

C-5


ID Facility

Visit Exit


11 - Corpus Christi Donna 104592 Fuente De Juventud Adult Day

Care #2

05/02/2018 $500 $500 $0 N

11 - Corpus Christi Donna 105043 Nuestra Familia Adult Day Care

Inc

05/01/2018 $500 $500 $0 N

11 - Corpus Christi Mission 103144 Emmanuel Adult Day Care 03/10/2017 $138,000 $0 $138,000 Y

11 - Corpus Christi Palmview 050703 Del Pueblo Adult Day Care 04/06/2018 $1,500 $1,500 $0 N

Totals $182,600 $2,500

6 Total day activity and health services facility administrative penalties imposed.

Notes:


amount. This is the amount due and payable if there is no alternative amount resulting from an appeal held or settlement agreement

reached.



of the penalty.

3. The collected column is the amount of money the facility has paid to HHSC.







C-6

Day Activity and Health Services Facility Injunctive or Other Relief


HHSC did not refer any day activity and health services facilities to the Office of the

Attorney General for injunctive/other relief in FY 2018.

Day Activity and Health Services Facility Emergency Closing

Orders for FY 2018

HHSC did not issue any emergency closing orders for day activity and health

services facilities in FY 2018.

C-7

Day Activity and Health Services Facility License Denial and Revocation Proposals for FY 2018


ID Facility

Proposed

Action

Revoked

Date

Denied

Date Status

03 - Arlington Dallas 106628 A.A Adult Daycare and Day Activity and

Health Services

Deny Rescinded

04 - Tyler Mount Vernon 106899 Franklin County Family Health Center Deny Formal Hearing

Letter

05 - Beaumont Coldspring 106270 A & S Adult Day Care Deny 11/14/2017 License Denied

06 - Houston Houston 003098 Liberty Island Adult Day Care Inc Deny Action Propose

06 - Houston Houston 106643 Best Adult Day Health Service Center Deny Withdrawn

06 - Houston Houston 106772 Care II Assist You Deny Formal Hearing

Letter

06 - Houston Houston 107027 Martha St. Adult Day Care Deny 08/08/2018 License Denied

08 - San Antonio San Antonio 107118 Bright & Early Adult Day Activity Deny 08/03/2018 License Denied

11 - Corpus Christi Edinburg 106620 El Centro Deny Hearing

11 - Corpus Christi Harlingen 106849 La Estrellita Adult Day Care Deny 12/22/2017 License Denied

10 Total day activity and health services facility licensure denials and revocations proposed.

Notes:


1. Action Propose - HHSC has proposed to deny this license.

2. Formal Hearing Letter - a letter has been sent to the facility offering the opportunity to appeal the action.


4. License Denied - the application for a license was denied.


6. Withdrawn - HHSC withdrew the proposed action.

C-8

Day Activity and Health Services Facility Complaint

and Incident Intakes

Complaints

A complaint allegation is an assertion that a requirement of state licensure has

been violated and can come directly from individuals or residents, family members,

health care providers, advocates, law enforcement, or other state agencies. Report

sources can be oral or written.

Incidents

An incident is an official notification to the state survey agency from a day activity

and health services provider that the physical or mental health or welfare of a

consumer has been or may be adversely affected by mistreatment, neglect or

abuse. These reports also include injuries of unknown source and exploitation or

misappropriation of consumer or resident property.

Priority Assignment

Complaint and incident intake staff evaluates each complaint based on its unique

circumstances and assigns priorities accordingly. When timeliness is crucial to

consumer health and safety, such as in a situation of heating or air conditioner

equipment failure, alleged staff walkout, etc., an investigation is initiated

immediately by telephone, regardless of the priority code assignment. After the

initial contact, each complaint is assigned a priority. The priorities are:





● Withdrawn

● Not required


Immediate response by regulatory investigators is warranted because a provider

allegedly created or allowed a present and ongoing situation in which the provider’s


C-9

to protect consumers from abuse, neglect, or mistreatment or has caused, or is

likely to cause, serious injury, harm, impairment, or death to a consumer.



been removed. The consumer(s) is no longer in imminent danger; however, the



consumer’s mental, physical, or psychosocial status and is of such consequence

that a rapid response by regulatory investigators is indicated. There is evidence or


specific rather than general information (e.g. descriptive identifiers, individual






not significantly impair the consumer’s mental, physical, or psychosocial status.

Professional Review

A provider who has cause to believe the physical or mental health or welfare of a

consumer(s) has been or may be adversely affected by mistreatment, neglect, or

abuse must self-report to the state survey agency immediately upon learning of the


and exploitation or misappropriation of consumer property.

Complaint intake staff assign a professional review priority when a provider self-

reports an incident to the state and the provider’s oral report indicates that the

provider’s immediate corrective action is reasonably likely to ensure that abuse,

neglect, mistreatment or injury to the consumer(s) will not occur again, or at least

not while the provider conducts its investigation and professional quality assurance

staff reviews the provider’s written investigation report.



compliance with regulatory requirements, the professional review unit will send

notification to regulatory regional staff to schedule an on-site investigation.

C-10

Withdrawn

A complaint report filed with the state is withdrawn at the request of the

complainant, except when abuse, neglect, or exploitation is alleged. Please refer to

Survey and Certification Clarification 15-01


01.pdf).

Not Required



Day Activity and Health Services Facility All Intakes by Priority and

Region for FY 2018


On or before 24 hours 1 0 0 0 0 3 0 8 0 0 5 17

On or before 14 days 5 0 3 0 1 16 0 28 0 4 55 112

On or before 30 days 7 0 20 5 1 36 4 62 0 19 229 383

Professional review 2 0 3 0 0 4 1 6 0 12 20 48

Withdrawn 0 0 0 0 0 0 0 0 0 0 0 0

Not required 1 0 0 0 0 2 0 1 0 2 5 11

Total 16 0 26 5 2 61 5 105 0 37 314 571

Day Activity and Health Services Facility Complaints by Priority and

Region for FY 2018

Complaint Priority 01 02 03 04 05 06 07 08 09 10 11 Total


On or before 14 days 5 0 3 0 0 14 0 24 0 4 46 96

On or before 30 days 5 0 15 5 1 31 3 51 0 15 185 311

Withdrawn 0 0 0 0 0 0 0 0 0 0 0 0

Not required 0 0 0 0 0 0 0 0 0 1 1 2

Total 11 0 18 5 1 48 3 82 0 20 237 425



C-11

Day Activity and Health Services Facility Incidents by Priority and

Region for FY 2018

Incident Priority 01 02 03 04 05 06 07 08 09 10 11 Total


On or before 14 days 0 0 0 0 1 2 0 4 0 0 9 16

On or before 30 days 2 0 5 0 0 5 1 11 0 4 44 72


Not required 1 0 0 0 0 2 0 1 0 1 4 9

Total 5 0 8 0 1 13 2 23 0 17 77 146

D-1

Appendix D. Home and Community Support

Services Agency (HCSSA)

Home and Community Support Services Agency

Actions

The table on pages D-4 and D-5 contain information relating to Texas Health and

Safety Code, Title 2, Subtitle G, Chapter 142, Home and Community Support

Services, agency actions, by category for fiscal year (FY) 2018.


Basis for Imposing

An administrative penalty can be assessed against a person who violates

requirements of Texas Health and Safety Code Chapter 142 or Texas Administrative

Code, Title 40, Part 1, Chapter 97, Licensing Standards for Home and Community

Support Service Agencies, or Texas Occupations Code, Title 3, Subtitle A, Chapter

102, Solicitation of Patients.

Imposed

The long-term care regulatory program imposes the action when the administrative

penalty recommendation has been reviewed and confirmed by state office. The

home and community support services agency is formally notified of the

administrative penalty citation and the penalty amount. Additionally, the notice

includes information about the appeal process available to the agency.

Assessed


completed (or an agreement to settle has been reached) and a final amount and

due date have been decided, or the person accepts the determination by the

regulatory agency or fails to respond to the notice letter in a timely manner. The

home and community support services agency is notified of the amount to be paid

and the date payment is due. A lump-sum payment or a monthly payment plan can

be agreed upon during the appeal or settlement process.

D-2

Civil Penalties

A person is liable for a civil penalty, of not less than $1,000 or more than $2,500

for each day of the violation, if he or she:

● Engages in the business of providing home health, hospice, or personal

assistance services for pay without a license issued under Texas Health and

Safety Code Chapter 142 and Texas Administrative Code Title 40, Chapter 97.

● Represents to the public that he or she is a provider of home health, hospice,

or personal assistance services for pay without a license issued under Texas

Health and Safety Code Chapter 142 and Texas Administrative Code Title 40,

Chapter 97.

An action to recover a civil penalty is in addition to an action brought for injunctive

relief under Texas Health and Safety Code §142.013 or any other remedy provided

by law. The Office of the Attorney General pursues this action on behalf of the state

to collect the civil penalty.

Denials of License Application

The state regulatory agency can deny a license for any of the reasons specified in

Texas Administrative Code Title 40 §97.21 (relating to denial of an application for a

license), such as:

● Failure to comply with the statute.

● Failure to comply with the licensure requirements.

● Knowingly aiding, abetting, or permitting another person to violate the

statute or licensure requirements.

● Failure to meet the criteria for a license established in Texas Administrative

Code Title 40 §97.11 (relating to criteria and eligibility for licensing).

Denials of License Renewal

The state also can deny the application to renew a license of an existing home and

community support services agency.

Expirations of License (in Lieu of Enforcement Actions)

Instead of pursuing additional enforcement actions, the state can choose to allow a

home and community support services agency to let its license expire.

D-3

Immediate Suspensions

The suspension of a home and community support services agency license can be on

an emergency basis. The suspension is effective immediately and is in effect until

lifted. The agency is provided an opportunity for a hearing no later than seven days

after the effective date of the suspension.

Surrenders of License (in Lieu of Enforcement Actions)

The state can offer an agency the option to surrender its license, instead of

receiving additional enforcement actions.

License Revocations

The regulating agency can revoke a license issued to an applicant or agency if the

applicant or agency:

● Fails to comply with any provision of Texas Health and Safety Code Chapter

142.

● Fails to comply with any provision of Texas Administrative Code Title 40,

Chapter 97.

● Engages in conduct that violates Texas Occupations Code Chapter 102.

D-4

Home Health Agency Actions by Region for FY 2018

Type of Remedy Actions 01 02 03 04 05 06 07 08 09 10 11 Totals

Administrative penalties Imposed 20 22 110 9 6 269 95 73 11 14 70 699

Administrative penalties (1) Assessed 2 2 5 0 0 10 2 1 0 0 2 24

Injunctive/other relief and civil

penalties (2)

Referred 0 0 0 0 0 0 0 0 0 0 0 0

Denials of initial license

application (3)

Proposed 0 1 7 0 0 15 3 1 1 2 4 34


application (3)

Denied 0 0 2 0 0 4 2 0 1 0 1 10

Denials of license renewal (4) Proposed 0 1 5 0 1 8 2 3 0 0 2 22

Denials of license renewal (4) Denied 0 0 1 0 0 3 0 3 0 0 1 8

Expirations of license (5) Completed 0 0 1 0 0 10 0 2 0 0 3 16

Immediate suspensions Suspended 0 0 0 0 0 0 0 0 0 0 0 0

Surrenders of license (6) Completed 0 0 9 2 1 7 4 0 0 0 4 27



Notes:


2. The regulatory agency refers injunctive/other relief and civil penalties to the Office of the Attorney General.

3. Proposed actions cannot result in denials if the home health agency comes into compliance with the licensing requirements before a

proposal becomes final.

4. Denial of license renewal proposals cannot result in a denial action if the agency comes into compliance with the licensure requirements

before a proposal becomes final. Denied actions can include actions proposed in previous fiscal years.

5. When the home health agency license is allowed to expire in lieu of further enforcement action.

6. When the home health agency license is surrendered in lieu of further enforcement action.

D-5

7. Revocation of license proposals can end up as other licensure actions, such as expiration of license in lieu of further enforcement action or

surrender of license in lieu of further enforcement action, without having to revoke the license.

Hospice Agency Actions by Region for FY 2018


Administrative penalties (1) Imposed 5 4 25 3 0 27 17 18 2 2 10 113



penalties (2)

Referred 0 0 0 0 0 0 0 0 0 0 0 0


application (3)

Proposed 0 0 3 0 0 3 0 1 0 0 1 8


application (3)

Denied 0 0 1 0 0 1 0 0 0 0 1 3

Denials of license renewal (4) Proposed 0 0 3 0 0 0 0 0 0 0 0 3

Denials of license renewal (4) Denied 0 0 0 0 0 0 0 0 0 0 0 0

Expirations of license (5) Completed 0 0 2 0 0 0 0 0 0 0 0 2

Immediate suspensions Suspended 0 0 0 0 0 0 0 0 0 0 0 0

Surrenders of license (6) Completed 0 0 1 0 0 2 0 0 0 0 2 5



Notes:


2. The regulatory agency refers injunctive/other relief and civil penalties to the Office of the Attorney General.

3. Proposed actions cannot result in denials if the hospice agency comes into compliance with the licensing requirements before a proposal

becomes final.

4. Denial of license renewal proposals cannot result in a denial action if the hospice agency comes into compliance with the licensure

requirements before a proposal becomes final. Denied actions may include actions proposed in previous fiscal years.

D-6

5. When the hospice agency license is allowed to expire in lieu of further enforcement action.

6. When the hospice agency license is surrendered in lieu of further enforcement action.

7. Revocation of license proposals can end up as other licensure actions, such as expiration of license in lieu of further enforcement action or

surrender of license in lieu of further enforcement action, without having to revoke the license.

Home Health Agency Administrative Penalties for FY 2018

Region City License

Number Agency

Visit Exit

Date Imposed Assessed Collected Balance

01 - Lubbock Amarillo 008662 Accolade Home Care 01/05/2018 $1,500 $1,200 $1,200 $0

01 - Lubbock Amarillo 012959 Amarillos Best Homehealth Care

Inc

01/11/2018 $750 $750 $0

01 - Lubbock Amarillo 002118 Caprock Home Health Services Inc 11/07/2017 $750 $750 $0

01 - Lubbock Amarillo 002118 Caprock Home Health Services Inc 04/26/2018 $750 $750 $0

01 - Lubbock Amarillo 009669 Children's Home Healthcare 12/14/2017 $1,000 $1,000 $0

01 - Lubbock Amarillo 009484 Encompass Health Home Health 03/12/2018 $750 $750 $0

01 - Lubbock Amarillo 014910 Epic Pediatric Therapy 03/15/2018 $750 $750 $0

01 - Lubbock Amarillo 015882 High Plains Senior Care 05/10/2018 $750 $750 $750 $0

01 - Lubbock Amarillo 015882 High Plains Senior Care 05/10/2018 $750 $750 $0 $750

01 - Lubbock Amarillo 017959 Pro Case of Texas LLC 11/07/2017 $1,500 $1,500 $0

01 - Lubbock Borger 011621 Golden Plains Home Care 05/01/2018 $1,500 $0 $1,500

01 - Lubbock Brownfield 002205 BRMC Home Care 10/13/2017 $750 $750 $0

01 - Lubbock Levelland 001599 Community Action Home Health 11/20/2017 $750 $0 $0 $0

01 - Lubbock Lubbock 001401 Caprock Home Health Services Inc 01/12/2018 $1,500 $1,500 $0

01 - Lubbock Lubbock 001401 Caprock Home Health Services Inc 11/08/2017 $750 $750 $0

01 - Lubbock Lubbock 001401 Caprock Home Health Services Inc 09/13/2017 $750 $750 $0


D-7

Region City License

Number Agency

Visit Exit



01 - Lubbock Lubbock 007781 Interim Healthcare of West Texas

LLC

03/23/2018 $1,500 $1,500 $0

01 - Lubbock Lubbock 017836 Thrive Skilled Pediatric Care 08/17/2017 $850 $850 $0

02 - Abilene Abilene 002242 Caprock Home Health Services Inc 12/07/2017 $750 $750 $0


02 - Abilene Abilene 002242 Caprock Home Health Services Inc 05/08/2018 $1,500 $1,500 $0


02 - Abilene Abilene 002242 Caprock Home Health Services Inc 03/06/2018 $1,500 $1,500 $0

02 - Abilene Abilene 001638 Hendrick Housecalls 03/01/2018 $750 $750 $0

02 - Abilene Abilene 012710 Kindred at Home 09/07/2017 $3,250 $3,250 $0

02 - Abilene Abilene 011817 Visiting Angels 01/24/2018 $750 $750 $0

02 - Abilene Brownwood 011726 Girling Community Care Texas by

Harden Healthcare

11/03/2017 $750 $750 $0


Harden Healthcare

01/23/2018 $750 $750 $0


Harden Healthcare

03/21/2018 $750 $750 $0

02 - Abilene Cisco 015686 Tri Star Home Care Inc 11/03/2017 $750 $750 $0

02 - Abilene Knox City 003586 Knox County Hospital Home Care 10/19/2017 $3,000 $2,000 $0 $2,000

02 - Abilene Seymour 012305 Kindred at Home 04/04/2018 $750 $750 $0

02 - Abilene Seymour 007336 Outreach Home Care 12/06/2017 $750 $750 $0

02 - Abilene Wichita Falls 005429 Angels Care Home Health 11/17/2017 $3,750 $3,750 $0

02 - Abilene Wichita Falls 015831 Encompass Health Home Health 03/21/2018 $750 $750 $0

02 - Abilene Wichita Falls 015831 Encompass Health Home Health 12/05/2017 $1,500 $1,500 $0

D-8

Region City License

Number Agency

Visit Exit


02 - Abilene Wichita Falls 006260 Healthpro Primary Home Care 05/10/2018 $1,500 $1,500 $0

02 - Abilene Wichita Falls 012938 Kindred at Home 10/06/2017 $2,250 $2,250 $0

02 - Abilene Wichita Falls 012545 New Life Home Healthcare

Services

04/30/2018 $0 $0 $0

02 - Abilene Winters 003174 North Runnels Home Health

Agency

11/08/2017 $750 $750 $0

03 - Arlington Addison 014770 Theracare Home Health 04/11/2018 $1,000 $1,000 $0

03 - Arlington Allen 017694 Crystal Comfort Home Care LLC 12/07/2017 $6,750 $0 $6,750

03 - Arlington Arlington 006576 A&T Moore Health Care

Corporation

04/26/2018 $500 $500 $0

03 - Arlington Arlington 011849 Available Home Care Inc 09/01/2017 $1,250 $1,250 $0

03 - Arlington Arlington 013583 Caretrends Health Service 07/24/2017 $750 $750 $0

03 - Arlington Arlington 012699 Excellent Home Health Services 08/02/2017 $1,250 $1,250 $0

03 - Arlington Arlington 016570 Familias Primary Care Services 04/17/2018 $1,000 $1,000 $0

03 - Arlington Arlington 007235 HCI Services 12/14/2017 $1,750 $0 $1,750

03 - Arlington Arlington 016957 Midas Healthcare Services Inc 09/21/2017 $1,250 $0 $1,250

03 - Arlington Arlington 015947 St Jude's Home Health Agency 11/01/2017 $500 $500 $0

03 - Arlington Arlington 018163 Ut Home Healthcare Inc 01/24/2018 $1,000 $0 $1,000

03 - Arlington Arlington 018163 Ut Home Healthcare Inc 03/22/2018 $2,000 $0 $2,000

03 - Arlington Balch

Springs

016917 Americana Care-Casa Luz LLC 09/27/2017 $1,250 $1,250 $0

03 - Arlington Balch

Springs

016917 Americana Care-Casa Luz LLC 11/09/2017 $2,500 $2,500 $0

03 - Arlington Benbrook 015436 Lifespring Home Care 06/16/2017 $2,000 $2,000 $0

03 - Arlington Burleson 007484 Colony Health Care 08/17/2017 $2,250 $2,250 $0

D-9

Region City License

Number Agency

Visit Exit


03 - Arlington Carrollton 016629 Solid Care Home Health Agency

Inc

03/20/2018 $1,000 $1,000 $0

03 - Arlington Cedar Hill 017600 True Providence Healthcare

Services

04/12/2018 $1,250 $0 $1,250

03 - Arlington Coppell 012624 E Comfort Home Health Care LLC 08/18/2017 $750 $750 $0

03 - Arlington Coppell 012795 Omega Home Healthcare Agency 07/25/2017 $1,000 $0 $1,000

03 - Arlington Coppell 012795 Omega Home Healthcare Agency 08/14/2017 $1,250 $0 $1,250

03 - Arlington Dallas 015943 Abasi Home Healthcare Inc 04/13/2018 $1,000 $1,000 $0

03 - Arlington Dallas 008770 Allied Home Health Agency 04/17/2018 $2,000 $0 $2,000

03 - Arlington Dallas 016583 Amada Senior Care 08/11/2017 $4,250 $4,250 $0

03 - Arlington Dallas 015807 Amaris Health Care Inc. 04/10/2018 $500 $0 $500

03 - Arlington Dallas 017759 Careone Caregiving Home Health

Agency

12/21/2017 $6,000 $0 $6,000

03 - Arlington Dallas 004402 Coram CVS Specialty Infusion

Services

03/26/2018 $1,250 $0 $1,250

03 - Arlington Dallas 014337 County Home Health 11/27/2017 $2,750 $0 $2,750

03 - Arlington Dallas 010825 Credence Home Health Services

Inc

04/23/2018 $5,000 $0 $5,000

03 - Arlington Dallas 013623 Daniella Home Health Services Inc 10/12/2017 $3,000 $3,000 $0

03 - Arlington Dallas 017765 Elvis Home Health Care LLC 04/11/2018 $500 $500 $0

03 - Arlington Dallas 015029 Epic Pediatric Therapy 04/20/2018 $1,500 $1,500 $0

03 - Arlington Dallas 015993 Ever Dynamic Home Health

Services LLC

03/02/2018 $3,750 $0 $3,750

03 - Arlington Dallas 011756 Girling Community Care Texas by

Harden Healthcare

08/11/2017 $750 $0 $750

03 - Arlington Dallas 017558 Golden Heart Senior Care of Dallas 02/08/2018 $3,250 $3,251 -$1

D-10

Region City License

Number Agency

Visit Exit


03 - Arlington Dallas 013832 Grace Compassion Home Health

Agency

01/18/2018 $500 $500 $0

03 - Arlington Dallas 007404 Human Touch Home Health Inc 04/03/2018 $3,750 $0 $3,750

03 - Arlington Dallas 007404 Human Touch Home Health Inc 09/13/2017 $3,750 $2,438 $2,031 $406

03 - Arlington Dallas 012649 J-Jireh Healthcare Services LLC 09/21/2017 $1,750 $1,500 $1,500 $0

03 - Arlington Dallas 011755 Kindred at Home 09/21/2017 $1,250 $1,250 $0

03 - Arlington Dallas 017985 Monarch Home Health Services

LLC

10/13/2017 $750 $750 $0

03 - Arlington Dallas 016730 National Nursing & Rehab Dallas

LLC

08/31/2017 $2,000 $2,000 $0

03 - Arlington Dallas 012184 Paloma Home Health Agency Inc 08/30/2017 $2,000 $2,000 $0

03 - Arlington Dallas 010082 Passionate Care Home Health

Services Inc

09/28/2017 $2,750 $2,292 $458

03 - Arlington Dallas 011074 Promise Homehealth Inc 11/20/2017 $3,000 $3,000 $0

03 - Arlington Dallas 013826 Sana Healthcare Inc 03/21/2018 $1,750 $0 $1,750

03 - Arlington Dallas 017169 Texas Care One Home Health

Agency

10/26/2017 $500 $500 $0

03 - Arlington Dallas 011748 United Royalcare Healthservices

Inc

11/21/2017 $500 $500 $0

03 - Arlington Dallas 011748 United Royalcare Healthservices

Inc

12/11/2017 $2,500 $500 $2,000

03 - Arlington Denton 017164 Socorro Home Health Care Inc 03/08/2018 $6,500 $0 $6,500

03 - Arlington Duncanville 006886 A One Plus Home Health Care

Agency LLC

02/23/2018 $1,500 $1,500 $0

03 - Arlington Euless 007581 Professional Home Health Care Inc 01/31/2018 $2,250 $2,250 $0

03 - Arlington Euless 012623 Right at Home 03/22/2018 $2,500 $0 $2,500

D-11

Region City License

Number Agency

Visit Exit


03 - Arlington Forney 017209 Love Abundantly Home Care

Agency LLC

01/30/2018 $1,000 $1,000 $0

03 - Arlington Fort Worth 016794 1st Choice Home Health Agency 09/06/2017 $4,000 $3,000 $3,000 $0

03 - Arlington Fort Worth 017083 Best Sunshine Home Care LLC 10/31/2017 $2,750 $0 $2,750

03 - Arlington Garland 015989 1advocate Home Health 09/28/2017 $500 $500 $0

03 - Arlington Garland 016895 Acredable Healthcare Services LLC 10/12/2017 $3,000 $2,500 $500

03 - Arlington Garland 013791 Alive Home Health Care Inc 01/19/2018 $1,750 $1,750 $0

03 - Arlington Garland 009861 Bethel Home Care 07/14/2017 $500 $0 $500

03 - Arlington Garland 009861 Bethel Home Care 08/07/2017 $750 $0 $750

03 - Arlington Garland 012254 Better Options Homecare Services

Inc

04/11/2018 $1,500 $1,500 $0

03 - Arlington Garland 010902 Everest Home Health Agency 11/09/2017 $2,000 $0 $2,000

03 - Arlington Garland 011588 Homeland Home Health Agency

Inc

07/11/2017 $3,750 $1,250 $2,500

03 - Arlington Garland 009658 JCP & P Home Healthcare Agency 08/11/2017 $1,100 $1,100 $0

03 - Arlington Garland 009658 JCP & P Home Healthcare Agency 07/14/2017 $1,250 $1,250 $0

03 - Arlington Garland 011143 Leone Homehealth Care Agency

Inc

02/28/2018 $2,750 $2,750 $0

03 - Arlington Garland 012049 Praise Home Health Agency 04/11/2018 $1,000 $1,000 $0

03 - Arlington Garland 017419 Premier Home Care Agency 04/10/2018 $4,750 $0 $4,750

03 - Arlington Garland 014341 Rock of Ages Home Health Care

Inc

09/14/2017 $2,250 $2,250 $0

03 - Arlington Grand

Prairie

016376 Angels at Work Tina Sample LLC 09/01/2017 $4,500 $4,000 $500


Prairie

011521 Classic Home Health Care Services

Inc

11/06/2017 $1,500 $1,500 $0

D-12

Region City License

Number Agency

Visit Exit



Prairie

015612 De Lovely Home Care Inc. 04/03/2018 $2,250 $375 $1,875


Prairie

013584 Prime World Home Care Service

Inc

10/27/2017 $3,500 $0 $3,500


Prairie

017109 Reliantcare Hospice 07/17/2017 $1,000 $0 $1,000


Prairie

012771 Safeway Healthcare Services Inc 10/03/2017 $2,050 $2,050 $0

03 - Arlington Grapevine 017337 Firstlight Homecare of Southlake 11/14/2017 $1,750 $0 $1,750

03 - Arlington Grapevine 017337 Firstlight Homecare of Southlake 12/28/2017 $2,500 $0 $2,500

03 - Arlington Irving 017871 Frontview Home Health 03/08/2018 $500 $500 $0

03 - Arlington Irving 006779 Jessnic Home Health Agency Inc 02/26/2018 $2,250 $0 $2,250

03 - Arlington Irving 013673 Rosyray Home Care Services Inc 03/29/2018 $2,250 $750 $1,500

03 - Arlington Lancaster 013071 Inspired To Care Home Health

Agency

03/19/2018 $4,500 $0 $4,500

03 - Arlington Lewisville 017670 Imparting Knowledge Home

Health Inc

05/16/2018 $500 $0 $500

03 - Arlington Little Elm 017490 Elements of Love Pediatrics Home

Healthcare LLC

01/29/2018 $6,750 $1,125 $5,625

03 - Arlington McKinney 016769 Amira Cares Home Aide Services

LLC

10/17/2017 $5,250 $0 $5,250

03 - Arlington Mesquite 004681 Agape Home Healthcare 06/29/2017 $500 $500 $0

03 - Arlington Mesquite 012652 SAS Home Health Services Inc 03/13/2018 $3,500 $0 $3,500

03 - Arlington Pantego 012666 Bliss Home Health Care Inc 10/18/2017 $1,750 $1,750 $0

03 - Arlington Pantego 012357 Comfort Hands Health Care

Services LLC

02/12/2018 $2,000 $2,000 $0

D-13

Region City License

Number Agency

Visit Exit


03 - Arlington Plano 016565 Ameristars Best Care Inc 11/21/2017 $2,000 $1,200 $800

03 - Arlington Plano 008284 Grace Home Health Inc 01/11/2018 $500 $500 $0

03 - Arlington Plano 018410 Home Care Assistance 04/04/2018 $1,750 $1,750 $0

03 - Arlington Plano 009311 Lifeline Healthcare Services Inc 11/28/2017 $750 $750 $0

03 - Arlington Richardson 017231 A Friendly Home Health Care 10/16/2017 $750 $750 $0

03 - Arlington Richardson 004704 Abicare Home Health LLC 08/04/2017 $1,250 $0 $1,250

03 - Arlington Richardson 012014 Morning Rose Home Health Care

LLC

11/10/2017 $5,000 $0 $5,000

03 - Arlington Richardson 007339 Outreach Home Care 01/04/2018 $1,500 $1,500 $0

03 - Arlington Richardson 011719 Quality Based Home Health LLC 09/05/2017 $750 $750 $0

03 - Arlington Richardson 013158 Smartcare Health Services Inc 02/14/2018 $1,250 $1,250 $0

03 - Arlington Richardson 012429 Viva Pediatrics 04/04/2018 $6,900 $0 $6,900

03 - Arlington Rockwall 011332 Chilex Home Care Services 01/03/2018 $2,000 $1,000 $1,000

03 - Arlington Rowlett 016056 Auxiegoldie Home Health Services

Inc

05/01/2018 $4,250 $4,250 $0 $4,250

03 - Arlington Rowlett 016056 Auxiegoldie Home Health Services

Inc

05/01/2018 $4,250 $4,250 $0 $4,250

03 - Arlington Rowlett 017756 Remedy Home Health Agency Inc 10/27/2017 $4,000 $0 $4,000

03 - Arlington Sherman 007272 Advantx Home Care Inc 10/17/2017 $3,000 $3,000 $0

03 - Arlington Sherman 007940 Sher Den Home Health Inc 04/05/2018 $750 $750 $0

03 - Arlington Weatherford 000993 Home Health Professionals Inc 01/09/2018 $0 $1,500 -$1,500

03 - Arlington Wylie 016700 ABC Caring Health Services Inc 10/17/2017 $1,000 $700 $100 $600

03 - Arlington Wylie 017547 Dove Height Home Care 03/14/2018 $1,500 $1,500 $0

03 - Arlington Wylie 016331 Stelina Companion and Personal

Care Services LLC

09/26/2017 $500 $500 $0

D-14

Region City License

Number Agency

Visit Exit


04 - Tyler Henderson 007040 Acea Home Health 08/11/2017 $650 $650 $0

04 - Tyler Hughes

Springs

015636 Advantagecare Home Health Inc 09/21/2017 $750 $750 $0

04 - Tyler Longview 007586 Texas Home Health of America 07/13/2017 $1,500 $1,500 $0

04 - Tyler Longview 016855 Then Theres Cheerful Givers HHA

Inc

09/06/2017 $1,500 $1,500 $0

04 - Tyler New Boston 017469 Helping Hands Home Health 07/26/2017 $2,750 $900 $1,850

04 - Tyler Sulphur

Springs

017040 Hopewell Home Healthcare LLC 10/12/2017 $5,250 $5,250 $0

04 - Tyler Tyler 017818 Bridgeway Health Services 09/27/2017 $750 $750 $0

04 - Tyler Tyler 012611 Right at Home of Northeast Texas 10/19/2017 $750 $650 $0 $650

04 - Tyler Tyler 012611 Right at Home of Northeast Texas 03/19/2018 $1,500 $0 $1,500

05 - Beaumont Anahuac 016431 Innovative Health Services Inc 07/27/2017 $2,250 $2,250 $0

05 - Beaumont Beaumont 011901 Amazing Angels Home Health 09/20/2017 $750 $750 $0

05 - Beaumont Beaumont 013338 Caring Hearts Home Care 08/23/2017 $1,500 $1,500 $0

05 - Beaumont Beaumont 008921 Texas Home Health of America 08/02/2017 $750 $750 $0

05 - Beaumont Cleveland 017191 Solace Home Health Care Services 07/21/2017 $2,250 $2,150 $100

05 - Beaumont Woodville 012677 Care Plus Home Health 07/28/2017 $750 $750 $0

06 - Houston Bay City 016603 Shining Nightingale Health Care 04/12/2018 $3,100 $0 $3,100

06 - Houston Bellaire 008310 A-Care Home Health Services 02/15/2018 $500 $0 $500

06 - Houston Bellaire 011753 Girling Community Care Texas by

Harden Healthcare

12/29/2017 $1,500 $1,500 $0

06 - Houston Bellaire 011753 Girling Community Care Texas by

Harden Healthcare

09/11/2017 $750 $750 $0

06 - Houston Bellaire 012038 Guardian Healthcare 04/13/2018 $1,500 $0 $1,500

D-15

Region City License

Number Agency

Visit Exit


06 - Houston Brookshire 016364 Anointed Hands Home Healthcare 12/28/2017 $2,250 $1,868 $382

06 - Houston Conroe 012264 St Agnes Caregivers Inc 01/26/2018 $2,750 $2,750 $0

06 - Houston Conroe 011013 Synergy Homecare 03/01/2018 $1,500 $1,500 $0

06 - Houston Cypress 017717 Cyfair Healthcare LLC 01/25/2018 $1,500 $1,500 $0

06 - Houston Cypress 017018 Helping Hands Personal Care

Services LLC

08/16/2017 $1,300 $0 $1,300

06 - Houston Friendswood 017597 Silver Linings Home Care LLC 03/23/2018 $1,500 $1,500 $0

06 - Houston Friendswood 017597 Silver Linings Home Care LLC 02/22/2018 $500 $500 $0

06 - Houston Galveston 006270 Sigma Health Care Inc 10/20/2017 $1,550 $1,550 $0

06 - Houston Houston 016793 1 Stop Health Care Services LLC 11/30/2017 $1,500 $1,500 $0

06 - Houston Houston 017077 1st Traditions Homecare LLC 07/20/2017 $3,550 $0 $3,550

06 - Houston Houston 003568 A & A Home Health Services Inc 04/17/2018 $750 $0 $750

06 - Houston Houston 012085 A & T Multi-healthcare Services

LLC

10/30/2017 $1,500 $0 $1,500

06 - Houston Houston 011356 A Better Homecare 03/14/2018 $750 $750 $0

06 - Houston Houston 009242 A C Health Services Inc 01/12/2018 $1,500 $1,500 $0

06 - Houston Houston 012948 Abba Gentle Healthcare LLC 05/04/2018 $1,250 $0 $1,250

06 - Houston Houston 008842 Ace Healthcare Services Inc 03/20/2017 $2,150 $2,150 $0

06 - Houston Houston 017055 Age in Place 07/24/2017 $2,500 $0 $2,500

06 - Houston Houston 016248 All Day Healthcare Inc. 04/26/2018 $1,500 $0 $1,500

06 - Houston Houston 010069 All Nations Home Health Services

Inc

07/03/2017 $1,500 $1,500 $0

06 - Houston Houston 010069 All Nations Home Health Services

Inc

12/07/2017 $700 $700 $0

06 - Houston Houston 011358 Allbright Health Care Services Inc 07/20/2017 $2,250 $2,250 $0

D-16

Region City License

Number Agency

Visit Exit


06 - Houston Houston 008001 Alpha Healthcare Network Inc 03/08/2018 $1,750 $0 $1,750

06 - Houston Houston 008001 Alpha Healthcare Network Inc 06/30/2017 $2,250 $0 $2,250

06 - Houston Houston 011783 Alpha Home Health Services 06/27/2017 $2,250 $0 $2,250

06 - Houston Houston 017770 Always Best Care Senior Services 03/28/2018 $2,000 $0 $2,000

06 - Houston Houston 017770 Always Best Care Senior Services 03/30/2018 $4,250 $4,250 $0 $4,250

06 - Houston Houston 013617 Apex Homehealth Services Inc 10/04/2016 $3,450 $2,800 $2,800 $0

06 - Houston Houston 007603 Assist- Med Inc 10/20/2017 $600 $0 $600

06 - Houston Houston 013884 AssuranceJ Homecare Services Inc 11/08/2017 $1,400 $1,400 $0

06 - Houston Houston 015159 Astro Medical Services LLC 03/14/2018 $750 $0 $750

06 - Houston Houston 017693 Atma Home Care 01/23/2018 $1,000 $0 $1,000

06 - Houston Houston 017693 Atma Home Care 01/25/2018 $2,000 $0 $2,000

06 - Houston Houston 009115 Avida Care Services LLC 08/25/2017 $3,000 $0 $3,000

06 - Houston Houston 009115 Avida Care Services LLC 11/01/2017 $1,500 $0 $1,500

06 - Houston Houston 017514 Bathfol Health Services Inc 10/27/2017 $4,600 $4,600 $0

06 - Houston Houston 012342 Bellaire Home Health Care LLC 04/11/2018 $750 $750 $0

06 - Houston Houston 013719 Blakes Blessing Health Care Inc 08/21/2017 $2,250 $2,250 $0

06 - Houston Houston 016845 Bless It Hands Home Health Care 08/24/2017 $1,450 $1,450 $0

06 - Houston Houston 012069 Care and Comfort Home Health 04/11/2018 $750 $750 $0

06 - Houston Houston 010311 Care Options Health Services Inc 08/04/2017 $750 $750 $0

06 - Houston Houston 017655 Caregivers Health Care 01/10/2018 $4,000 $4,000 $0

06 - Houston Houston 010117 Careworks 12/20/2017 $750 $750 $0

06 - Houston Houston 017525 Caring Health Services 04/20/2018 $3,000 $3,000 $0

D-17

Region City License

Number Agency

Visit Exit


06 - Houston Houston 007827 Caring Professional Health

Services Inc

05/09/2018 $750 $750 $0

06 - Houston Houston 017629 Christian Companions 01/12/2018 $4,250 $0 $4,250

06 - Houston Houston 017386 Christmas Charity Inc 11/02/2017 $2,250 $2,250 $0

06 - Houston Houston 016210 Clinical View Home Health 10/12/2017 $2,250 $0 $2,250

06 - Houston Houston 016210 Clinical View Home Health 09/26/2017 $3,250 $3,250 $0

06 - Houston Houston 005445 Coastal Medical Services Inc 09/15/2017 $1,500 $500 $1,000

06 - Houston Houston 015961 Cobarm Healthcare Services Inc 11/28/2017 $3,950 $0 $3,950

06 - Houston Houston 017680 Comfortcare Homehealth Services

LLC

01/11/2018 $2,000 $333 $1,667

06 - Houston Houston 015935 Cristos Health Care Services Inc 02/22/2018 $750 $750 $0

06 - Houston Houston 017283 Cy-creek Healthcare Services Inc. 10/19/2017 $700 $0 $700

06 - Houston Houston 010018 Decency Home Health Care

Services Inc

12/14/2017 $4,500 $4,500 $0

06 - Houston Houston 017707 Designed with Loving Care Home

Health

01/23/2018 $3,500 $0 $3,500

06 - Houston Houston 017505 Devoted Loving Care Inc 11/22/2017 $3,000 $3,000 $0

06 - Houston Houston 016460 Dolrac Healthcare Services Inc. 07/25/2017 $3,250 $0 $3,250

06 - Houston Houston 013860 Dynamic Home Health Services 03/06/2018 $750 $0 $750

06 - Houston Houston 013860 Dynamic Home Health Services 02/06/2018 $750 $750 $0

06 - Houston Houston 016770 Eden Healthcare LLC 08/04/2017 $1,500 $1,500 $0

06 - Houston Houston 017373 Elite Vintage Health Care LLC 07/12/2017 $1,450 $0 $0 $0

06 - Houston Houston 008175 Emmaco Home Health Services

Inc

04/13/2018 $1,500 $0 $1,500

06 - Houston Houston 012553 Encore Caregivers 02/28/2018 $750 $750 $0

D-18

Region City License

Number Agency

Visit Exit


06 - Houston Houston 014986 Epic Pediatric Therapy 08/11/2017 $2,400 $2,500 -$100

06 - Houston Houston 014986 Epic Pediatric Therapy 01/18/2018 $1,500 $1,500 $0

06 - Houston Houston 014985 Epic Pediatric Therapy 03/28/2018 $750 $750 $0

06 - Houston Houston 014985 Epic Pediatric Therapy 01/05/2018 $750 $750 $0

06 - Houston Houston 005283 Eternal Healthcare Center Inc 03/28/2018 $1,250 $1,250 $0

06 - Houston Houston 008533 Evangel Home Care Services 01/12/2018 $3,000 $0 $3,000

06 - Houston Houston 012997 Evangel Pediatric Services 05/10/2018 $750 $0 $750

06 - Houston Houston 016349 Evergreen Healthcare Services Inc 10/25/2017 $1,400 $0 $1,400

06 - Houston Houston 012502 Excellence Home Healthcare 11/09/2017 $700 $700 $0

06 - Houston Houston 009965 Extended Hand Home Health Care

Inc

01/11/2018 $3,000 $500 $2,500

06 - Houston Houston 012705 Famcare Home Health Services

Inc

10/27/2017 $2,250 $0 $2,250

06 - Houston Houston 010335 Flagstar Healthcare Services 01/05/2018 $6,500 $0 $6,500

06 - Houston Houston 008744 Fountain Home Health 04/11/2018 $1,250 $1,250 $0

06 - Houston Houston 017005 Golden Years Home Health Care 09/26/2017 $1,250 $1,250 $0

06 - Houston Houston 013191 Guiding Home Care Inc 10/11/2017 $600 $600 $0

06 - Houston Houston 006529 Gulf Coast Community Health

Services Inc

09/15/2017 $750 $750 $0

06 - Houston Houston 017638 Happy Keepers Homecare and

Assistance

12/07/2017 $3,000 $0 $3,000

06 - Houston Houston 017081 Harmony Senior Livinghome Inc 10/02/2017 $3,000 $520 $2,480

06 - Houston Houston 017749 Healing Through Caring Homecare 01/24/2018 $750 $750 $0

06 - Houston Houston 013619 Healthcare Providers of America

Inc

01/12/2018 $1,000 $1,000 $0

D-19

Region City License

Number Agency

Visit Exit


06 - Houston Houston 009005 Healthcare Solutions 05/10/2018 $1,500 $0 $1,500

06 - Houston Houston 007443 Healthsource Home Care Inc 12/27/2017 $4,000 $833 $3,167

06 - Houston Houston 014258 Heavenly Providers Health Care

Inc

01/05/2018 $5,000 $0 $5,000

06 - Houston Houston 017502 Heuristic Home Health Care LLC 11/30/2017 $1,950 $1,950 $0

06 - Houston Houston 009817 His Caring Arms Health Services 08/11/2017 $3,700 $2,500 $2,500 $0

06 - Houston Houston 007403 Home Care Plus 12/05/2017 $1,400 $1,400 $0

06 - Houston Houston 015631 Home for Texas 08/25/2017 $1,500 $1,500 $0

06 - Houston Houston 017340 Home Helpers 03/01/2018 $3,000 $3,000 $0

06 - Houston Houston 017087 Home Sweet Home Provider

Services

08/16/2017 $1,500 $1,500 $0

06 - Houston Houston 016625 Homecare Horizons Inc 03/23/2018 $750 $0 $750

06 - Houston Houston 007865 Horizon Home Health Care 01/23/2018 $2,250 $0 $2,250

06 - Houston Houston 016674 Houston Therapy Consult PLLC 07/27/2017 $1,500 $1,500 $0

06 - Houston Houston 017344 Hummingbird Care Group 10/11/2017 $700 $0 $700

06 - Houston Houston 017454 Infinity Healthcare Services Inc 11/10/2017 $2,100 $0 $2,100

06 - Houston Houston 016543 Innovision Home Health Care Inc 10/27/2017 $1,200 $1,200 $0

06 - Houston Houston 016543 Innovision Home Health Care Inc 07/28/2017 $4,150 $7,608 -$3,458

06 - Houston Houston 003376 Inter Active Health Care Inc 07/28/2017 $700 $700 $0

06 - Houston Houston 017115 Intra Home Health Care Agency

LLC

09/20/2017 $3,000 $3,000 $0

06 - Houston Houston 017115 Intra Home Health Care Agency

LLC

10/05/2017 $3,600 $3,600 $0

06 - Houston Houston 016113 Ivory Healthcare Agency 06/22/2017 $1,250 $833 $417

06 - Houston Houston 012039 Jaimel Health Care Services LLC 10/19/2017 $650 $650 $0

D-20

Region City License

Number Agency

Visit Exit


06 - Houston Houston 017292 Jewel Home Healthcare 10/11/2017 $2,000 $0 $2,000

06 - Houston Houston 009823 Jovic Healthcare Services Inc 01/10/2018 $1,500 $975 $0 $975

06 - Houston Houston 017074 Kindred at Home-Personal Home

Care Assistance-Houston

03/09/2018 $750 $750 $0

06 - Houston Houston 017074 Kindred at Home-Personal Home

Care Assistance-Houston

08/02/2017 $3,000 $3,000 $0

06 - Houston Houston 017776 Loved Ones 02/28/2018 $3,000 $3,500 -$500

06 - Houston Houston 010275 Maxwell Providers Inc 01/04/2018 $4,500 $0 $4,500

06 - Houston Houston 010275 Maxwell Providers Inc 03/21/2018 $750 $750 $0

06 - Houston Houston 015202 Med Force Medical Services Inc 01/05/2018 $1,500 $0 $1,500

06 - Houston Houston 008138 Med-health Inc 01/12/2018 $4,500 $0 $4,500

06 - Houston Houston 015307 Medistar Provider Services Inc 02/14/2018 $2,750 $0 $2,750

06 - Houston Houston 010103 Medsol Home Healthcare & Case

Management Services LLC

12/21/2017 $1,500 $1,500 $0

06 - Houston Houston 008935 Mercy Healthcare Services Inc 03/22/2018 $750 $750 $0

06 - Houston Houston 017543 Millennial Personal Care Service

LLC

03/28/2018 $3,000 $0 $3,000

06 - Houston Houston 016882 Modern Homecare Solutions 08/24/2017 $1,800 $1,800 $0

06 - Houston Houston 015316 Mother Love Health Care Services 10/27/2017 $5,200 $1,733 $3,467

06 - Houston Houston 017019 Motsoo Home Health 07/25/2017 $2,250 $0 $2,250

06 - Houston Houston 016978 Multi-service Healthcare Inc 08/01/2017 $1,617 $975 $1,138 -$163

06 - Houston Houston 017002 Mzee Home Care Services LLC 07/19/2017 $1,500 $975 $525

06 - Houston Houston 017345 ND Healthcare Services Inc 09/20/2017 $5,800 $4,200 $4,200 $0

06 - Houston Houston 009755 New Life Home Services 02/01/2018 $1,500 $1,500 $0

06 - Houston Houston 017050 Newstart Home Care Services Inc 07/21/2017 $1,450 $718 $732

D-21

Region City License

Number Agency

Visit Exit


06 - Houston Houston 001793 Nurses Night and Day Inc 04/20/2018 $500 $0 $500

06 - Houston Houston 013287 Nutrend Healthcare Inc 02/07/2018 $500 $500 $0

06 - Houston Houston 009228 Optimal Community Support

Services

08/18/2017 $1,450 $1,000 $1,000 $0

06 - Houston Houston 018135 Optimum Care Home Health

Agency

01/12/2018 $2,250 $2,250 $0

06 - Houston Houston 004685 Option Care 03/09/2018 $1,500 $1,500 $0

06 - Houston Houston 010153 Pacific Care Home Health Services

LLC

11/10/2017 $750 $750 $0

06 - Houston Houston 007083 Pacific Home Health Care Inc 02/08/2018 $1,000 $1,000 $0

06 - Houston Houston 013372 Paradigm Home Health Solutions

PLLC

08/23/2017 $800 $0 $800

06 - Houston Houston 017495 Passion for Caring Home Health

Inc

11/16/2017 $2,400 $0 $2,400

06 - Houston Houston 016173 Pediatric Home Healthcare LLC 09/20/2017 $1,500 $1,500 $0

06 - Houston Houston 015456 Perpetual Health Home Care Inc 01/11/2018 $2,750 $0 $2,750

06 - Houston Houston 015083 Pin Oak Caregivers LLC 09/18/2017 $750 $750 $0

06 - Houston Houston 016983 Pinnacle Quality Care Services LLC 07/26/2017 $2,850 $2,850 $0

06 - Houston Houston 013227 Prihomehealth Inc 10/26/2017 $600 $600 $0

06 - Houston Houston 018121 Priority Methodist Home

Healthcare LLC

03/08/2018 $5,250 $0 $5,250

06 - Houston Houston 015319 Providian Health Care 08/24/2017 $600 $600 $0

06 - Houston Houston 002306 PSA Healthcare Inc 09/15/2017 $750 $750 $0

06 - Houston Houston 017420 Rapha Home Health Care Inc 11/17/2017 $3,000 $1,950 $1,950 $0

06 - Houston Houston 009621 Resource Care Corporation 07/21/2017 $4,500 $3,000 $1,500

D-22

Region City License

Number Agency

Visit Exit


06 - Houston Houston 009621 Resource Care Corporation 12/29/2017 $2,850 $2,850 $0

06 - Houston Houston 007241 Resource Home Health Services 02/06/2018 $500 $0 $500

06 - Houston Houston 009741 Restore Health Care Services Inc 04/11/2018 $500 $0 $500

06 - Houston Houston 004088 Rose Home Health Services Inc 04/13/2018 $500 $500 $0

06 - Houston Houston 017240 Satellite Wellbound of Houston 10/23/2017 $1,200 $0 $1,200

06 - Houston Houston 012801 Senior Allegiance 02/28/2018 $750 $750 $0

06 - Houston Houston 015815 SeniorBridge 03/01/2018 $750 $750 $0

06 - Houston Houston 014235 Seniority Homecare Inc 10/20/2017 $1,400 $1,400 $0

06 - Houston Houston 008005 Special Kids Care 10/10/2017 $750 $750 $0

06 - Houston Houston 008577 St Francis Health Care Services

Inc

02/02/2018 $2,250 $2,250 $0

06 - Houston Houston 016630 St Marys Healthcare Inc 08/24/2017 $1,750 $0 $1,750

06 - Houston Houston 009600 Star Home Health Inc 09/18/2017 $750 $0 $750

06 - Houston Houston 017704 Starching Home Health Services

Inc

11/13/2017 $750 $0 $750

06 - Houston Houston 008686 States Health Inc 03/29/2018 $1,500 $1,500 $0

06 - Houston Houston 017529 Stay at Home with Our Help 11/30/2017 $15,600 $0 $15,600

06 - Houston Houston 010333 STI Health Care Services Inc 01/31/2018 $500 $500 $0

06 - Houston Houston 017457 Strength Within LLC 11/15/2017 $1,500 $975 $975 $0

06 - Houston Houston 015950 Superior Integrated Home Health

Care Inc

07/31/2017 $3,250 $0 $3,250

06 - Houston Houston 016884 Supreme Health Care Inc 08/24/2017 $3,350 $3,350 $0

06 - Houston Houston 008353 Teamcare Home Health Services

Inc

02/08/2018 $2,500 $1,625 $700 $925

06 - Houston Houston 008776 Texas Home Health of America 12/06/2017 $2,000 $2,000 $0

D-23

Region City License

Number Agency

Visit Exit





06 - Houston Houston 008776 Texas Home Health of America 09/15/2017 $750 $750 $0


06 - Houston Houston 007607 Texas Home Health of America 02/21/2018 $750 $750 $0

06 - Houston Houston 011752 Texas Premier Care Services Inc 04/23/2018 $500 $500 $0

06 - Houston Houston 017698 Three B's Home Health Care Inc 01/24/2018 $3,000 $3,000 $0

06 - Houston Houston 013317 Topical Healthcare Services Inc 08/17/2017 $750 $750 $0

06 - Houston Houston 009281 Touch of Class 09/18/2017 $1,500 $1,500 $0

06 - Houston Houston 009281 Touch of Class 04/17/2018 $750 $750 $0

06 - Houston Houston 012364 Trustus Home Health Services Inc 10/19/2017 $5,200 $0 $5,200

06 - Houston Houston 017812 Uni Star Personal Care LLC 04/25/2018 $1,750 $0 $1,750

06 - Houston Houston 014109 Unified Medical Group Inc 12/19/2017 $7,500 $0 $7,500

06 - Houston Houston 003259 Unlimited Home Care Inc 03/07/2018 $750 $0 $750

06 - Houston Houston 016913 Visiting Angels 07/06/2017 $1,950 $1,950 $0

06 - Houston Houston 017415 World Health Services Inc 10/20/2017 $3,000 $300 $2,700

06 - Houston Houston 017685 YA's Healthcare Provider Agency 01/24/2018 $2,000 $0 $2,000

06 - Houston Katy 017071 Fusion One Healthcare 08/03/2017 $6,500 $4,550 $3,032 $1,518

06 - Houston Katy 017431 Healthcare Resources of Texas 11/15/2017 $1,500 $1,500 $0

06 - Houston Katy 011091 Memorial Home Healthcare

Incorporated

11/27/2017 $1,700 $0 $1,700


Incorporated

03/08/2018 $1,500 $0 $1,500

D-24

Region City License

Number Agency

Visit Exit



Incorporated

10/24/2017 $1,700 $0 $1,700

06 - Houston Katy 013343 Miracle Nurses Healthcare

Services Inc

11/02/2017 $1,500 $1,500 $0

06 - Houston Katy 016147 Pathfinder Home Health 03/22/2018 $500 $500 $0

06 - Houston Katy 017328 Seds Kids Care 11/09/2017 $1,500 $975 $525

06 - Houston Kingwood 016944 Encompass Health Home Health 04/20/2018 $1,500 $1,500 $0

06 - Houston Kingwood 011929 Health Solutions Home Health 12/27/2017 $1,500 $0 $1,500

06 - Houston Lake

Jackson

016203 Caring Senior Service of Brazoria

County

07/27/2017 $750 $750 $0

06 - Houston Lake

Jackson

017968 CHI St. Luke's Health - Brazosport

Home Health

10/20/2017 $700 $0 $700

06 - Houston League City 015295 Carebuilders at Home Houston 1 09/19/2017 $1,500 $1,100 $1,100 $0

06 - Houston League City 015295 Carebuilders at Home Houston 1 08/02/2017 $1,500 $1,100 $1,100 $0

06 - Houston League City 009291 Jeby Health Care Services Inc 09/20/2017 $1,500 $1,500 $0

06 - Houston Magnolia 017699 Majestic Consulting 01/29/2018 $1,750 $0 $1,750

06 - Houston Missouri

City

017764 Assist Private Care LLC 02/08/2018 $2,000 $0 $2,000


City

017682 Family Affair Health Care 01/10/2018 $2,000 $2,000 $0


City

013173 Jestco Health Care Inc 03/29/2018 $3,000 $0 $3,000

06 - Houston Pasadena 017241 Elite Health Providers of Houston

LLC

02/01/2018 $5,250 $5,250 $0

06 - Houston Pasadena 011267 Jordan Health Services 03/14/2018 $750 $750 $0

06 - Houston Pearland 017623 Benevolence Home Care 12/07/2017 $750 $750 $0

D-25

Region City License

Number Agency

Visit Exit


06 - Houston Pearland 014899 Friendly Faces Senior Care 04/20/2018 $750 $0 $750

06 - Houston Pearland 016206 YesToHomeCare 04/09/2018 $750 $750 $0

06 - Houston Richmond 009181 Blessed Healthcare Inc 07/18/2017 $750 $750 $0

06 - Houston Richmond 010642 Chezin Health Care Services 02/01/2018 $2,250 $750 $1,500

06 - Houston Richmond 017711 Dakus Ventures Inc 01/23/2018 $1,750 $700 $1,050

06 - Houston Richmond 017711 Dakus Ventures Inc 02/27/2018 $1,500 $0 $1,500

06 - Houston Richmond 017630 Firstlight Home Care of Sugar

Land and Richmond Texas

01/10/2018 $6,750 $0 $6,750

06 - Houston Richmond 017736 Forward Health Care LLC 01/24/2018 $1,000 $1,000 $0

06 - Houston Richmond 017684 Genesis Healthcare Services 01/25/2018 $1,000 $650 $0 $650

06 - Houston Richmond 017313 JD Homecare Inc 10/10/2017 $2,600 $0 $2,600

06 - Houston Richmond 009839 Maritona Health Services Inc. 12/14/2017 $800 $800 $0

06 - Houston Richmond 016718 Stamd Health Care Incorporated 09/29/2017 $600 $600 $0

06 - Houston Rosenberg 009816 Logic Homehealth Services Inc 03/16/2018 $3,750 $3,750 $0

06 - Houston Rosenberg 009816 Logic Homehealth Services Inc 01/18/2018 $750 $750 $0

06 - Houston Rosenberg 010105 Siercam Healthcare Services LLC 02/21/2018 $750 $750 $0

06 - Houston Sealy 017100 JSE Healthcare Inc 08/08/2017 $3,250 $3,250 $0

06 - Houston Sealy 017010 Oak River Healthcare Services Inc 11/09/2017 $2,950 $2,950 $0

06 - Houston Spring 017278 Always Best Care Spring Tomball 10/06/2017 $1,500 $1,500 $0

06 - Houston Spring 017696 Gracesprings Healthcare Services 01/09/2018 $1,500 $0 $1,500

06 - Houston Spring 015274 Magnet Health Care Services Inc 03/19/2018 $2,000 $0 $2,000

06 - Houston Spring 014182 Maxim Healthcare Services Inc 12/01/2017 $875 $875 $0

06 - Houston Spring 012397 Pathfinder Pediatric Home Care

Inc

03/29/2018 $1,500 $1,500 $0

D-26

Region City License

Number Agency

Visit Exit


06 - Houston Stafford 010027 A&l Health Care Services LLC 08/24/2017 $1,500 $0 $1,500

06 - Houston Stafford 012300 Ace-ellent Healthcare Services Inc 10/26/2017 $1,400 $1,400 $0

06 - Houston Stafford 009929 Caring Angel Healthcare Services

Inc

03/14/2018 $1,500 $0 $1,500

06 - Houston Stafford 008719 Caring Professional Home Health

Services Inc

04/19/2018 $750 $750 $0

06 - Houston Stafford 011239 Chase Healthcare Service Inc 04/05/2018 $3,750 $0 $3,750

06 - Houston Stafford 016545 Ebra Home Health Services Inc 04/13/2018 $2,250 $0 $2,250

06 - Houston Stafford 012747 Embassy Home Healthcare 03/06/2018 $750 $750 $0

06 - Houston Stafford 011090 Estan Healthcare Services Inc 10/20/2017 $1,400 $1,400 $0

06 - Houston Stafford 013934 Maria Regina Home Health Agency

Inc

03/15/2018 $3,000 $0 $3,000

06 - Houston Stafford 012912 Maxim Healthcare Services Inc 02/08/2018 $1,500 $1,500 $0

06 - Houston Stafford 012216 North Home Healthcare LLC 03/22/2018 $2,250 $2,250 $0

06 - Houston Stafford 009635 Rapid Home Health Care 08/17/2017 $700 $700 $0

06 - Houston Stafford 008433 Sto Nino Home Health Inc 02/23/2018 $750 $750 $0

06 - Houston Stafford 008626 Vitalcare Health Services 03/14/2018 $750 $0 $750

06 - Houston Sugar Land 015630 Acute Healthcare Services Inc 08/04/2017 $700 $700 $0

06 - Houston Sugar Land 016130 Alpha Links Healthcare Services 10/19/2017 $1,400 $0 $1,400

06 - Houston Sugar Land 016906 Altus Home Healthcare of Houston

LP

08/17/2017 $600 $600 $0

06 - Houston Sugar Land 017410 Amada Senior Care-Sugar Land 10/20/2017 $6,700 $4,355 $1,452 $2,903

06 - Houston Sugar Land 010997 Anis Healthcare Services Inc 10/31/2017 $750 $750 $0

06 - Houston Sugar Land 008482 Axis Care Group Home Health

Services Inc

04/05/2018 $1,500 $1,500 $0

D-27

Region City License

Number Agency

Visit Exit


06 - Houston Sugar Land 008482 Axis Care Group Home Health

Services Inc

12/22/2017 $2,100 $2,100 $0

06 - Houston Sugar Land 011142 CCC Health Care Inc 11/29/2017 $700 $700 $0

06 - Houston Sugar Land 017832 Comcare Health Services LLC 11/03/2017 $5,200 $5,200 $0

06 - Houston Sugar Land 009497 Healthpoint Home Health and

Infusion Services

06/15/2017 $1,500 $1,500 $0

06 - Houston Sugar Land 015938 Kappa Home Health Services Inc 01/09/2018 $1,500 $1,500 $0

06 - Houston Sugar Land 015938 Kappa Home Health Services Inc 10/27/2017 $2,300 $2,300 $0

06 - Houston Sugar Land 015938 Kappa Home Health Services Inc 07/24/2017 $750 $750 $0

06 - Houston Sugar Land 017028 Mabel Livinghome Inc 08/15/2017 $2,500 $0 $2,500

06 - Houston Sugar Land 017790 Sugar Land Supportive Healthcare

Services LLC

04/06/2018 $1,000 $0 $1,000

06 - Houston The

Woodlands

018165 At Your Side Home Care The

Woodlands

04/05/2018 $500 $500 $0

06 - Houston The

Woodlands

017118 LT Home Healthcare 02/01/2018 $2,000 $2,000 $0

06 - Houston The

Woodlands

013350 Windsong Home Health Agency 08/24/2017 $750 $750 $0

06 - Houston Tomball 017626 Home Helpers and Direct Link 01/03/2018 $3,250 $0 $3,250

06 - Houston Tomball 013291 Silver-Spring Healthcare Services 02/21/2018 $500 $500 $0

06 - Houston Waller 013948 EPS Healthcare Services Inc 01/30/2018 $0 $0 $0

06 - Houston Waller 013948 EPS Healthcare Services Inc 01/30/2018 $750 $0 $750

06 - Houston Webster 007134 Denson Home Health Inc 02/26/2018 $2,250 $2,250 $0

07 - Austin Austin 018092 A J Prestige Home Health Care LLC 03/26/2018 $2,500 $0 $2,500

07 - Austin Austin 017891 Accession Home Health Services 08/17/2017 $1,250 $1,250 $0

D-28

Region City License

Number Agency

Visit Exit


07 - Austin Austin 012567 Brookdale at Home Austin 07/14/2017 $750 $750 $0

07 - Austin Austin 015575 Coastal Home Health Care Inc 07/07/2017 $2,750 $0 $2,750

07 - Austin Austin 007556 Disability Services of The

Southwest Inc

10/05/2017 $1,500 $1,500 $0

07 - Austin Austin 015057 Edward's Home Health & Hospice 11/30/2017 $500 $0 $500

07 - Austin Austin 015057 Edward's Home Health & Hospice 11/07/2017 $500 $0 $500

07 - Austin Austin 017032 Expectations Unshackled 02/02/2018 $4,500 $0 $4,500

07 - Austin Austin 017032 Expectations Unshackled 01/17/2018 $500 $500 $0

07 - Austin Austin 017168 Fresenius Medical Care Staff Assist

Austin North

08/11/2017 $7,250 $7,250 $0

07 - Austin Austin 017689 Friends and Family Healthcare

PLLC

07/06/2017 $2,250 $2,250 $0

07 - Austin Austin 011732 Girling Community Care Texas by

Harden Healthcare

07/10/2017 $1,000 $1,000 $0

07 - Austin Austin 018067 Golden Years Homecare 03/13/2018 $500 $0 $500

07 - Austin Austin 014207 Gucci Healthcare Services Inc 01/26/2018 $500 $500 $0

07 - Austin Austin 009777 Hill Country Care Providers 10/10/2017 $750 $750 $0

07 - Austin Austin 016857 Homewatch Caregivers of South

West Austin

07/27/2017 $2,000 $2,000 $0

07 - Austin Austin 017966 Jordan Health Services 11/21/2017 $500 $0 $500

07 - Austin Austin 017045 Jordan Health Services 10/27/2017 $3,250 $3,250 $0

07 - Austin Austin 017966 Jordan Health Services 09/27/2017 $2,000 $2,000 $0

07 - Austin Austin 015311 Living at Home 09/06/2017 $500 $500 $0

07 - Austin Austin 012913 Maxim Healthcare Services Inc 10/04/2017 $1,500 $1,500 $0

D-29

Region City License

Number Agency

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07 - Austin Austin 003605 Meals On Wheels Central Texas

In-home Care

01/26/2018 $750 $750 $0

07 - Austin Austin 016600 MGA Pediatric Homecare 07/25/2017 $750 $750 $0

07 - Austin Austin 003114 New Hope Health Care Inc 10/05/2017 $1,250 $800 $800 $0

07 - Austin Austin 016942 Nurses Unlimited Inc 10/04/2017 $3,500 $3,500 $0

07 - Austin Austin 017099 Our Family Home Care 01/04/2018 $1,250 $1,250 $0

07 - Austin Austin 007810 Outreach Home Care 12/05/2017 $1,250 $1,250 $0

07 - Austin Austin 017255 Patient's Premier Choice LLC 02/23/2018 $2,500 $0 $2,500

07 - Austin Austin 015185 Redbud Homecare Services LLC 11/01/2017 $500 $0 $500

07 - Austin Austin 015185 Redbud Homecare Services LLC 08/22/2017 $1,500 $1,500 $0

07 - Austin Austin 012568 Right at Home 1202 12/20/2017 $500 $500 $0

07 - Austin Austin 008065 Rosy In Home Services Inc 08/16/2017 $1,750 $0 $1,750

07 - Austin Austin 017925 Season of Peace LLC 09/06/2017 $500 $500 $0

07 - Austin Austin 017923 Silverheart Home Care LLC 09/06/2017 $2,500 $1,650 $850

07 - Austin Austin 017261 Soal Home Health Services LLC 03/13/2018 $500 $500 $0

07 - Austin Austin 012904 Texas Home Care Partners LLC 10/11/2017 $2,000 $2,000 $0

07 - Austin Austin 007742 Texas Home Health Skilled

Services

03/09/2018 $1,000 $1,000 $0

07 - Austin Austin 017864 Thrive Skilled Pediatric Care 06/14/2017 $500 $500 $0

07 - Austin Austin 016424 Total Care Provider LLC 11/21/2017 $1,750 $1,750 $0

07 - Austin Austin 016424 Total Care Provider LLC 01/04/2018 $500 $500 $0

07 - Austin Austin 015235 Viva Pediatrics 09/20/2017 $1,500 $1,500 $0

07 - Austin Bastrop 005899 Bluebonnet Home Health Care of

Texas Inc

01/17/2018 $500 $500 $0

D-30

Region City License

Number Agency

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07 - Austin Brenham 012119 Golden Years Homecare

Specialists II

04/11/2018 $1,500 $1,500 $0

07 - Austin Bryan 011573 Guardian Healthcare 03/28/2018 $500 $0 $500

07 - Austin Bryan 017806 Homespark LLC 10/20/2017 $1,750 $1,750 $0

07 - Austin Bryan 017824 Right at Home 10/18/2017 $1,000 $700 $700 $0

07 - Austin Bryan 016278 Signature Select Services 10/26/2017 $500 $500 $0

07 - Austin Buda 016868 Nellie's Heart Caregiving

Incorporated

09/06/2017 $750 $750 $0

07 - Austin Burnet 016739 Seton Home Care 03/28/2018 $3,250 $0 $3,250

07 - Austin College

Station

018330 Texas Home Health Group of

College Station LLC

01/12/2018 $750 $750 $0

07 - Austin College

Station

016581 Texas Home Health of America 12/18/2017 $750 $0 $750

07 - Austin College

Station

015187 Visiting Angels 03/28/2018 $3,000 $0 $3,000

07 - Austin Elgin 017058 Nurse Next Door 01/19/2018 $2,000 $2,000 $0

07 - Austin Georgetown 016937 Encompass Health Home Health 07/13/2017 $750 $750 $0

07 - Austin Georgetown 016574 Health at Home 07/26/2017 $750 $750 $0

07 - Austin Harker

Heights

018096 Bellah Therapies LLC 12/07/2017 $4,750 $792 $3,958

07 - Austin Harker

Heights

014748 Family Care Home Health 09/29/2017 $1,500 $1,100 $0 $1,100

07 - Austin Harker

Heights

009082 Heights Home Health 10/31/2017 $1,000 $1,000 $0

07 - Austin Harker

Heights

009082 Heights Home Health 06/23/2017 $250 $250 $0

D-31

Region City License

Number Agency

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07 - Austin Killeen 017590 Compassionate Companions LLC 09/12/2017 $4,250 $709 $3,541

07 - Austin Killeen 017590 Compassionate Companions LLC 08/07/2017 $500 $500 $0

07 - Austin Killeen 017795 Quality Personal Care Inc 08/08/2017 $1,500 $1,500 $0

07 - Austin Lakeway 016423 Comforcare 04/30/2018 $500 $500 $0

07 - Austin Lakeway 017945 Muve Home Health LLC 12/12/2017 $6,150 $0 $6,150

07 - Austin Leander 008795 Central Texas Caregivers Inc 09/06/2017 $1,000 $0 $0 $0

07 - Austin Manor 016658 A-prime Medical Home Health Inc 11/10/2017 $1,000 $1,000 $0

07 - Austin Marble Falls 014453 Visiting Angels 07/26/2017 $3,000 $0 $3,000

07 - Austin Pflugerville 008716 Interim Healthcare of Austin 03/01/2018 $2,500 $2,500 $0

07 - Austin Pflugerville 017825 Paradise Personal Assistance

Services LLC

08/22/2017 $500 $500 $0

07 - Austin Pflugerville 018340 Propedia Health Services Inc 04/04/2018 $3,000 $0 $3,000

07 - Austin Round Rock 017349 Amada Senior Care Austin 03/15/2018 $10,000 $0 $10,000

07 - Austin Round Rock 007626 Apicon Home Health Agency Inc 01/04/2018 $1,000 $0 $1,000

07 - Austin Round Rock 017282 CHM Adult Care Center Co 09/19/2017 $14,000 $0 $14,000

07 - Austin Round Rock 017185 Christy Grace Health Center Inc 03/22/2018 $4,000 $4,000 $0

07 - Austin Round Rock 017185 Christy Grace Health Center Inc 08/24/2017 $1,500 $1,500 $0

07 - Austin Round Rock 015047 Homeslice Caregivers 08/16/2017 $750 $0 $750

07 - Austin Round Rock 018188 Jordan Health Services 08/31/2017 $750 $750 $0

07 - Austin Round Rock 010220 New Era Homecare Solutions Inc 12/13/2017 $2,250 $0 $2,250

07 - Austin Round Rock 017801 Nica Home Care 07/06/2017 $750 $750 $0

07 - Austin Round Rock 018339 Rehabcare 04/24/2018 $1,250 $1,250 $0

07 - Austin Round Rock 015885 Theracare Home Health 01/25/2018 $1,500 $1,500 $0

D-32

Region City License

Number Agency

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07 - Austin Round Rock 015475 Total Care Home Health Inc 01/24/2018 $2,750 $0 $2,750

07 - Austin Round Rock 014569 Unic Home Healthcare Inc 08/15/2016 $2,250 $2,250 $0

07 - Austin San Marcos 002191 Central Texas Medical Center

Home Health

12/07/2017 $1,500 $1,500 $0

07 - Austin San Marcos 014462 Kindred at Home 03/15/2018 $2,000 $2,000 $0

07 - Austin Taylor 018337 Texas Home Health Group of

Taylor LLC

02/07/2018 $750 $750 $0

07 - Austin Temple 016946 Brookdale Meridian Temple 05/04/2018 $750 $750 $0

07 - Austin Temple 017075 Disability Services of the

Southwest Inc

02/15/2018 $750 $750 $0

07 - Austin Temple 013943 Epic Health Services 09/13/2017 $1,750 $1,750 $0

07 - Austin Temple 018252 Texas Home Health Group of

Temple LLC

11/16/2017 $750 $750 $0

07 - Austin Waco 017576 A Mile of Comfort LLC 09/28/2017 $4,250 $0 $4,250

07 - Austin Waco 015980 Bluebonnet Health Services of

Waco

02/08/2018 $500 $500 $0

07 - Austin Waco 011951 Guardian Healthcare 03/01/2018 $500 $500 $0

07 - Austin Waco 008089 Visiting Angels 05/02/2018 $2,000 $2,000 $0

07 - Austin Whitney 014837 Divine Living Assistance Services 09/27/2017 $3,500 $3,500 $0

08 - San

Antonio

Boerne 014370 Texas Kids Home Therapy and

Nursing PLLC

12/08/2017 $1,700 $1,700 $0

08 - San

Antonio

Converse 018107 Everlasting Home Health Care Inc 12/11/2017 $7,100 $1,183 $5,917

08 - San

Antonio

Crystal City 003516 Lopez Health Systems Inc 08/02/2017 $1,450 $1,450 $0

D-33

Region City License

Number Agency

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08 - San

Antonio

Del Rio 017639 Del Rio Grande Home Healthcare 10/11/2017 $2,050 $2,050 $0

08 - San

Antonio

Eagle Pass 010971 National Medical Homecare Inc 08/15/2017 $1,400 $1,400 $0

08 - San

Antonio

Eagle Pass 013889 Superior Home Health of Eagle

Pass LLC

03/23/2018 $2,750 $2,100 $650

08 - San

Antonio

Leon Valley 017875 Lone Star Provider Care LLC 01/11/2018 $1,100 $1,100 $0

08 - San

Antonio

New

Braunfels

016590 Equality Homecare Inc 10/12/2017 $3,300 $0 $3,300

08 - San

Antonio

San Antonio 009636 A Plus Family Care LLC 02/15/2018 $500 $500 $0

08 - San

Antonio

San Antonio 016197 A1 Ultra Homecare 03/06/2018 $500 $0 $500

08 - San

Antonio

San Antonio 013050 Ability Pediatric Therapy and

Nursing

09/25/2017 $1,850 $1,850 $0

08 - San

Antonio

San Antonio 016687 ACP Primary Home Care Inc 08/04/2017 $2,150 $2,150 $0

08 - San

Antonio

San Antonio 018034 Ageless Living Home Health LLC 02/02/2018 $2,300 $2,300 $0

08 - San

Antonio

San Antonio 011343 All Your Home Health Incorporated 01/12/2018 $4,550 $0 $4,550

08 - San

Antonio

San Antonio 017064 Amazing Grace Primary Home

Care

09/11/2017 $550 $550 $0

08 - San

Antonio

San Antonio 014728 AQTS Home Health 08/30/2017 $1,100 $1,100 $0

08 - San

Antonio

San Antonio 016527 Aramis Health Services 11/30/2017 $4,000 $4,000 $0

D-34

Region City License

Number Agency

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08 - San

Antonio

San Antonio 011379 Axis Home Health 03/08/2018 $700 $700 $0

08 - San

Antonio

San Antonio 015675 Brightstar Care 04/04/2018 $1,450 $0 $1,450

08 - San

Antonio

San Antonio 015675 Brightstar Care 12/22/2017 $2,450 $2,450 $0

08 - San

Antonio

San Antonio 017165 Brit-Tex Nursing Services Inc 08/11/2017 $1,450 $1,450 $0

08 - San

Antonio

San Antonio 017894 By Design Homecare Inc 11/09/2017 $1,400 $1,400 $0

08 - San

Antonio

San Antonio 002798 Caprock Home Health Services Inc 04/13/2018 $500 $500 $0

08 - San

Antonio

San Antonio 002798 Caprock Home Health Services Inc 09/01/2017 $500 $500 $0

08 - San

Antonio

San Antonio 018438 Christus VNA Homecare San

Antonio

05/07/2018 $2,200 $2,200 $0 $2,200

08 - San

Antonio

San Antonio 018437 Christus VNA Homecare San

Antonio

05/07/2018 $2,200 $2,200 $0 $2,200

08 - San

Antonio

San Antonio 017683 Comforcare Home Care - San

Antonio

11/15/2017 $650 $650 $0

08 - San

Antonio

San Antonio 017522 Dalasi's House 11/02/2017 $4,150 $0 $4,150

08 - San

Antonio

San Antonio 009747 Eagle Healthcare Services 10/26/2017 $2,500 $2,500 $0

08 - San

Antonio

San Antonio 009908 En Su Casa Caregivers 09/01/2017 $500 $500 $0

08 - San

Antonio

San Antonio 009490 Encompass Health Home Health 01/25/2018 $700 $700 $0

D-35

Region City License

Number Agency

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08 - San

Antonio


08 - San

Antonio


08 - San

Antonio

San Antonio 013878 Epic Health Services 04/18/2018 $650 $650 $0

08 - San

Antonio


08 - San

Antonio

San Antonio 013878 Epic Health Services 01/10/2018 $1,100 $1,100 $0

08 - San

Antonio


08 - San

Antonio

San Antonio 010344 Esteem Home Health Care 08/24/2017 $2,800 $1,850 $617 $1,233

08 - San

Antonio

San Antonio 017546 Executive Care 10/18/2017 $3,000 $0 $3,000

08 - San

Antonio

San Antonio 017519 F.L.A.R.E Your In Home Care

Provider

06/28/2017 $3,100 $2,300 $2,299 $1

08 - San

Antonio

San Antonio 018104 First Steps Therapy Services PLLC 05/10/2018 $650 $0 $650

08 - San

Antonio

San Antonio 013250 Helping Hands of San Antonio

Home Care

11/08/2017 $500 $2,650 -$2,150

08 - San

Antonio

San Antonio 007822 Home Instead Senior Care 04/18/2018 $500 $500 $0

08 - San

Antonio

San Antonio 010115 Home Nursing & Therapy Services 01/12/2018 $1,800 $1,800 $0

08 - San

Antonio

San Antonio 011260 Jordan Health Services 05/11/2018 $550 $0 $550

D-36

Region City License

Number Agency

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08 - San

Antonio

San Antonio 011737 Kindred at Home 02/20/2018 $3,550 $3,550 $0

08 - San

Antonio

San Antonio 007638 La Estrella Home Care 12/05/2017 $500 $500 $0

08 - San

Antonio

San Antonio 007638 La Estrella Home Care 11/16/2017 $550 $550 $0

08 - San

Antonio

San Antonio 009943 Lifespan Home Health 10/18/2017 $550 $550 $0

08 - San

Antonio

San Antonio 011059 Little Engine Homecare Inc 12/18/2017 $1,350 $1,350 $0

08 - San

Antonio

San Antonio 009962 Living Tree of Life 04/06/2018 $1,250 $1,250 $0

08 - San

Antonio

San Antonio 004137 Med Team Inc 01/25/2018 $1,300 $1,300 $0

08 - San

Antonio

San Antonio 004137 Med Team Inc 09/01/2017 $600 $1,600 -$1,000

08 - San

Antonio

San Antonio 017293 Mission Road Developmental

Center

04/05/2018 $750 $750 $0

08 - San

Antonio

San Antonio 017995 MMCare 02/14/2018 $700 $700 $0

08 - San

Antonio

San Antonio 016564 Ohana Pediatric Home Health LLC 10/13/2017 $3,200 $0 $3,200

08 - San

Antonio

San Antonio 017269 Pediatric Home Healthcare LLC 03/15/2018 $500 $500 $0

08 - San

Antonio

San Antonio 007102 Pride PHC Services Inc 09/01/2017 $500 $500 $0

08 - San

Antonio

San Antonio 008669 Quality Home Health Care

Services

02/01/2018 $2,300 $975 $1,150 -$175

D-37

Region City License

Number Agency

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08 - San

Antonio

San Antonio 016403 Resilient Home Health Care Inc 11/17/2017 $1,650 $1,650 $0

08 - San

Antonio

San Antonio 016403 Resilient Home Health Care Inc 04/17/2018 $500 $500 $0

08 - San

Antonio

San Antonio 016403 Resilient Home Health Care Inc 03/08/2018 $550 $550 $0

08 - San

Antonio

San Antonio 017648 Senior Helpers of Greater San

Antonio

03/16/2018 $4,100 $0 $4,100

08 - San

Antonio

San Antonio 017425 St. Michael Provider LLC 08/22/2017 $1,400 $1,399 $1

08 - San

Antonio

San Antonio 013689 Superior Home Health of San

Antonio LLC

03/22/2018 $1,400 $1,400 $0

08 - San

Antonio

San Antonio 013689 Superior Home Health of San

Antonio LLC

03/14/2018 $2,000 $0 $2,000

08 - San

Antonio

San Antonio 015902 Sweet Pea's Pedi Care Inc 07/28/2017 $1,500 $1,500 $0

08 - San

Antonio

San Antonio 017757 Texas United Rehab Unlimited Inc 01/09/2018 $1,850 $1,850 $0

08 - San

Antonio

San Antonio 016749 Touching Hearts at Home 03/01/2018 $7,750 $0 $7,750

08 - San

Antonio

Victoria 017714 Arisco Home Healthcare Services

Inc

04/06/2018 $1,950 $0 $1,950

08 - San

Antonio

Victoria 015535 Home Instead 01/29/2018 $1,100 $1,100 $0

08 - San

Antonio

Victoria 016780 Texas Home Health of America 02/14/2018 $750 $0 $750

08 - San

Antonio

Victoria 010635 Victorian Healthcare Services Inc 07/31/2017 $1,300 $0 $1,300

D-38

Region City License

Number Agency

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09 - Abilene Big Spring 010706 Encompass Health Home Health 03/14/2018 $750 $750 $0

09 - Abilene Big Spring 015634 Kindred at Home 11/09/2017 $2,250 $2,250 $0

09 - Abilene Midland 007641 Inhome Care 08/03/2017 $3,000 $3,000 $0

09 - Abilene Midland 009842 St Josephs Home Health Inc 12/07/2017 $750 $0 $750

09 - Abilene Odessa 003467 Nurses Unlimited Inc 10/23/2017 $750 $750 $0



09 - Abilene Odessa 004878 Star Care Home Health Inc 03/23/2018 $3,850 $3,850 $0

09 - Abilene San Angelo 009732 Angels Care Home Health of San

Angelo

03/15/2018 $1,500 $1,500 $0

09 - Abilene San Angelo 008619 Concho Valley Home Health Care 11/03/2017 $2,250 $2,250 $0

09 - Abilene San Angelo 008619 Concho Valley Home Health Care 03/08/2018 $750 $750 $0

10 - El Paso Clint 016508 Lone Star Home Health Care Inc 10/24/2017 $500 $0 $500

10 - El Paso El Paso 017568 Amistad Personal Assistance

Services

09/29/2017 $750 $750 $0

10 - El Paso El Paso 018094 Bella Providers LLC 01/24/2018 $500 $500 $0

10 - El Paso El Paso 016456 Celestial Personal Assistance

Services LLC

11/10/2017 $750 $0 $750

10 - El Paso El Paso 007904 Inhome Care 08/03/2017 $2,000 $200 $1,800

10 - El Paso El Paso 016959 Merida Healthcare Group 02/16/2018 $1,500 $0 $1,500

10 - El Paso El Paso 016443 Noble Personal Home Care LLC 04/10/2018 $2,000 $2,000 $0

10 - El Paso El Paso 017918 Nuevo Hogar Home Care Providers 10/20/2017 $500 $500 $0

10 - El Paso El Paso 018491 Quantum Home Care LLC 04/18/2018 $2,000 $0 $2,000

10 - El Paso El Paso 009990 Revive Home Care Inc 08/03/2017 $1,000 $1,000 $0

D-39

Region City License

Number Agency

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10 - El Paso El Paso 016432 Shield of Grace Home Healthcare

LLC

03/01/2018 $1,500 $0 $1,500

10 - El Paso El Paso 010357 Tender Care Home Health 02/23/2018 $1,250 $1,250 $0

10 - El Paso El Paso 016897 Visiting Angels 10/12/2017 $500 $500 $0

10 - El Paso Fabens 016908 Our Family Home Health Care

Agency

04/12/2018 $1,250 $1,250 $0

11 - Corpus

Christi

Alice 007114 Saldivar Primary Home Care 04/20/2018 $1,900 $1,900 $0

11 - Corpus

Christi

Alton 015762 Sincere Health Care LLC 08/08/2017 $2,500 $0 $2,500

11 - Corpus

Christi

Beeville 017654 La Amistad Provider Services 02/23/2018 $11,250 $0 $11,250

11 - Corpus

Christi

Brownsville 017716 A Better Choice Home Health

Services Inc

03/19/2018 $1,250 $1,250 $0

11 - Corpus

Christi

Brownsville 016165 Dream Care LLC 02/06/2018 $1,350 $1,350 $0

11 - Corpus

Christi

Brownsville 009456 Infinity Care Providers Inc 02/02/2018 $7,000 $0 $7,000

11 - Corpus

Christi

Brownsville 002897 Interim Healthcare 05/11/2018 $500 $0 $500

11 - Corpus

Christi

Brownsville 016862 My Safe Heaven Corporation 11/03/2017 $1,500 $1,500 $0

11 - Corpus

Christi

Brownsville 004014 San Martin Home Health Inc 06/29/2017 $1,850 $1,850 $0

11 - Corpus

Christi

Brownsville 010693 Valley Care Home Health Services

LLC

03/07/2018 $2,200 $0 $2,200

11 - Corpus

Christi

Brownsville 010693 Valley Care Home Health Services

LLC

10/06/2017 $1,000 $1,000 $0

D-40

Region City License

Number Agency

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11 - Corpus

Christi

Brownsville 014661 Von'd Kids 11/07/2017 $2,050 $2,050 $0

11 - Corpus

Christi

Corpus

Christi

003825 Carestat Provider Services 01/12/2018 $4,050 $4,050 $0

11 - Corpus

Christi

Corpus

Christi

007918 Caring Senior Service of Corpus

Christi

02/08/2018 $4,250 $0 $4,250

11 - Corpus

Christi

Corpus

Christi

015681 Educare Community Living Corp

Texas

03/21/2018 $2,200 $2,200 $0

11 - Corpus

Christi

Corpus

Christi

011265 Jordan Health Services 11/17/2017 $4,300 $4,300 $0

11 - Corpus

Christi

Corpus

Christi

007510 National Nursing & Rehab Inc 07/21/2017 $2,200 $2,200 $0

11 - Corpus

Christi

Corpus

Christi

011952 Prime Care Home Health Inc 11/03/2017 $500 $500 $0

11 - Corpus

Christi

Edinburg 011833 Allstate Primary Home Care 02/16/2018 $3,250 $3,250 $0

11 - Corpus

Christi

Edinburg 010228 Champion Health Care 03/19/2018 $700 $700 $0

11 - Corpus

Christi

Edinburg 003459 Family Home Health Services 10/05/2017 $1,000 $1,000 $0

11 - Corpus

Christi

Edinburg 013499 Reyna Health Care Inc 10/19/2017 $500 $500 $0

11 - Corpus

Christi

Harlingen 017264 A Dream Come True Home Care 12/15/2017 $3,900 $0 $3,900

11 - Corpus

Christi

Harlingen 017264 A Dream Come True Home Care 02/15/2018 $4,100 $0 $4,100

11 - Corpus

Christi

Harlingen 003014 Harlingen Acute Care Inc 11/10/2017 $3,500 $3,500 $0

D-41

Region City License

Number Agency

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11 - Corpus

Christi

Harlingen 002649 South Texas Nursing Care Inc 09/15/2017 $3,400 $3,400 $0

11 - Corpus

Christi

Harlingen 006515 Valley View Primary Home Care 11/13/2017 $7,750 $7,750 $0

11 - Corpus

Christi

Kingsville 011188 South Texas Home Health 11/09/2017 $3,950 $3,950 $0

11 - Corpus

Christi

Laredo 010096 Best Healthcare LLC 02/16/2018 $2,500 $2,500 $0

11 - Corpus

Christi

Laredo 017246 CMV Home Health LLC 04/06/2018 $3,100 $3,100 $0

11 - Corpus

Christi

Laredo 014576 Estrella Provider Services LLC 02/09/2018 $1,100 $1,100 $0

11 - Corpus

Christi

Laredo 010070 Excellent Nursing Care PC 09/29/2017 $13,150 $13,150 $0

11 - Corpus

Christi

Laredo 011592 Farias Home Health Care LLC 03/01/2018 $650 $650 $0

11 - Corpus

Christi

Laredo 011264 Jordan Health Services 04/13/2018 $2,850 $0 $2,850

11 - Corpus

Christi

Laredo 017076 Manna Provider Services LLC 11/08/2017 $750 $750 $0

11 - Corpus

Christi

Laredo 012679 Mi Esperanza Provider Care 12/22/2017 $2,000 $0 $2,000

11 - Corpus

Christi

Laredo 017660 Saint Bernadette's Primary Home

Care

02/13/2018 $1,950 $650 $1,300

11 - Corpus

Christi

Laredo 017498 St. Luke's Primary Home Care LLC 05/15/2018 $14,200 $0 $14,200

11 - Corpus

Christi

Laredo 017498 St. Luke's Primary Home Care LLC 05/15/2018 $0 $0 $0

D-42

Region City License

Number Agency

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11 - Corpus

Christi

Laredo 011405 United Home Health 09/22/2017 $2,500 $2,500 $0

11 - Corpus

Christi

Los Fresnos 015231 Amazing Grace Primary Home

Care LLC

02/07/2018 $1,650 $1,650 $0

11 - Corpus

Christi

McAllen 010285 A New Hope Health Care Inc 12/07/2017 $2,500 $2,500 $0

11 - Corpus

Christi

McAllen 010285 A New Hope Health Care Inc 04/18/2018 $3,950 $0 $3,950

11 - Corpus

Christi

McAllen 017138 BK Home Health Therapy Services 08/14/2017 $4,950 $4,950 $0

11 - Corpus

Christi

McAllen 017480 De Todo Corazon Primary Home

Care

03/01/2018 $0 $0 $0

11 - Corpus

Christi

McAllen 017480 De Todo Corazon Primary Home

Care

03/01/2018 $1,000 $1,000 $1,000 $0

11 - Corpus

Christi

McAllen 008177 First Choice Healthcare 09/14/2017 $1,100 $1,100 $0

11 - Corpus

Christi

McAllen 002164 Health Care Unlimited Inc 02/23/2018 $3,000 $3,000 $0

11 - Corpus

Christi

McAllen 002388 Nurses That Care 01/12/2018 $1,000 $1,000 $0

11 - Corpus

Christi

McAllen 012598 Paz Home Health LLC 08/02/2017 $7,250 $7,250 $0

11 - Corpus

Christi

McAllen 017317 Re-nu Home Health Inc 12/11/2017 $2,800 $2,800 $0

11 - Corpus

Christi

McAllen 017317 Re-nu Home Health Inc 03/14/2018 $5,050 $0 $5,050

11 - Corpus

Christi

McAllen 017772 Spirit Alliance Home Health

Agency

08/24/2017 $2,100 $2,100 $0

D-43

Region City License

Number Agency

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11 - Corpus

Christi

McAllen 017772 Spirit Alliance Home Health

Agency

04/16/2018 $4,050 $4,050 $0

11 - Corpus

Christi

McAllen 011422 Superior Home Health Services

LLC

10/11/2017 $6,000 $6,000 $0

11 - Corpus

Christi

McAllen 008926 Thank You Nurses Ltd 01/26/2018 $7,050 $7,050 $0

11 - Corpus

Christi

McAllen 017450 Therapy Squad 03/21/2018 $1,450 $1,450 $0

11 - Corpus

Christi

Mission 016284 Allegiance Health Care Inc 03/16/2018 $2,200 $2,200 $0

11 - Corpus

Christi

Mission 006460 Angelitos Primary Home Care Inc 11/10/2017 $5,450 $5,450 $0

11 - Corpus

Christi

Mission 017460 Criterion Health Care Inc 03/16/2018 $6,900 $6,900 $0

11 - Corpus

Christi

Mission 017334 Summit Renal Services LLC 03/19/2018 $8,450 $0 $8,450

11 - Corpus

Christi

Pharr 017354 Bravo Home Care 12/28/2017 $2,500 $2,500 $0

11 - Corpus

Christi

Pharr 017675 Buena Suerte Home Health 04/11/2018 $500 $500 $0

11 - Corpus

Christi

Pharr 012825 Juanitas Angels Home Healthcare

LLC

12/22/2017 $1,800 $0 $1,800

11 - Corpus

Christi

Pharr 017174 Proactive Homecare 04/03/2018 $0 $500 -$500

11 - Corpus

Christi

San Benito 014978 Lemon Tree Home Care LLC 12/21/2017 $3,600 $0 $3,600

11 - Corpus

Christi

San Benito 010603 Stay Healthy Homecare Inc 04/13/2018 $1,500 $0 $1,500

D-44

Region City License

Number Agency

Visit Exit


11 - Corpus

Christi

Weslaco 009859 Balli Home Health Inc 01/10/2018 $6,200 $2,067 $4,133

11 - Corpus

Christi

Weslaco 017201 Five Star Quality Home Health Inc 09/13/2017 $3,700 $0 $3,700

11 - Corpus

Christi

Weslaco 011051 Regional Nursing Services Inc 12/20/2017 $700 $0 $700

Totals $1,379,642 $67,618 $751,758

699 Total home health agency administrative penalties imposed.

Notes:


amount. This is the amount due and payable if no alternative amount results from an appeal or if no settlement agreement reached.

2. The assessed column is the amount due after the appeal process has been completed (or an agreement to settle has been reached) and a

final amount and due date have been decided, or the person accepts the determination by the regulating agency or fails to respond to the

notice letter in a timely manner.

3. The collected column is the amount of money the facility has paid to the agency.


owe. The amounts can change based on a hearing or negotiated settlement. Since these amounts can change, this column is not totaled.

D-45

Hospice Administrative Penalties for FY 2018

Region City License

Number Agency

Visit Exit


01 - Lubbock Dalhart 005693 Coon Memorial Hospital Home

Care

04/19/2018 $2,250 $2,250 $0

01 - Lubbock Hereford 017957 Samaritan Hospice 08/17/2017 $750 $750 $0

01 - Lubbock Littlefield 009857 Legacy of Love Hospice 02/14/2018 $3,750 $3,750 $0

01 - Lubbock Lockney 012529 Hospice Hands of West Texas

Inc

12/13/2017 $7,500 $0 $7,500

01 - Lubbock Lubbock 005035 Kindred Hospice 01/30/2018 $750 $750 $0

02 - Abilene Abilene 014755 Kindred Hospice 02/08/2018 $2,250 $2,250 $0

02 - Abilene Brownwood 011763 Kindred Hospice 02/15/2018 $1,500 $1,500 $0

02 - Abilene Brownwood 011763 Kindred Hospice 02/01/2018 $750 $750 $0

02 - Abilene Graham 016109 Graham Regional Hospice 04/19/2018 $750 $750 $0

03 - Arlington Arlington 007850 Hospice Healthcare Network 09/07/2017 $2,000 $2,000 $0

03 - Arlington Azle 006257 Main Street Hospice 07/27/2017 $1,500 $1,500 $0

03 - Arlington Bedford 016498 Holy Savior Hospice 06/20/2017 $750 $750 $0

03 - Arlington Carrollton 015028 Esteem Hospice 10/12/2017 $1,500 $1,500 $0

03 - Arlington Dallas 017520 Alliance United Hospice Care

LLC

02/20/2018 $500 $0 $500

03 - Arlington Dallas 017537 Dignity Hospice 02/09/2018 $5,950 $5,950 $0

03 - Arlington Dallas 017372 Rockwal Hospice Inc 03/20/2018 $2,000 $2,000 $0

03 - Arlington Fort Worth 016699 Asana Hospice 03/14/2018 $1,250 $1,250 $0

03 - Arlington Fort Worth 015841 Encompass Health Hospice 02/08/2018 $500 $500 $0

03 - Arlington Fort Worth 012440 Grace Hospice of Fort Worth LLC 01/22/2018 $2,250 $0 $2,250

D-46

Region City License

Number Agency

Visit Exit


03 - Arlington Fort Worth 014639 St Gabriels Hospice and

Palliative Care LLC

12/11/2017 $1,750 $1,750 $0

03 - Arlington Fort Worth 006982 Vitas Healthcare of Texas LP 11/08/2017 $600 $600 $0

03 - Arlington Garland 017940 LMS Hospice Inc 08/29/2017 $2,000 $2,000 $0

03 - Arlington Greenville 008082 Kindred Hospice 02/16/2018 $3,500 $3,500 $0

03 - Arlington Hurst 009222 Alpha Omega Hospice LP 02/07/2018 $750 $750 $0

03 - Arlington Hurst 016724 Heritage Hospice of Texas 09/28/2017 $800 $0 $800

03 - Arlington Irving 015147 Smart Medi Care Health

Services Inc

07/07/2017 $2,250 $2,250 $0

03 - Arlington Mesquite 017047 Bella Hospice and Healthcare

LLC

08/24/2017 $250 $250 $0

03 - Arlington Mesquite 017047 Bella Hospice and Healthcare

LLC

08/07/2017 $2,000 $2,000 $0

03 - Arlington Mesquite 018239 Quality Care Hospice Inc 08/24/2017 $500 $500 $0

03 - Arlington Plano 009334 Grace Hospice 11/20/2017 $2,250 $0 $2,250

03 - Arlington Richardson 007562 Advance Hospice Care of

America Inc

02/15/2018 $1,500 $1,500 $0

03 - Arlington Richardson 018329 Visiting Angels 10/02/2017 $7,900 $7,900 $0

03 - Arlington Sunnyvale 016823 Peace Palliative and Hospice Inc 01/04/2018 $4,500 $4,500 $0

03 - Arlington Waxahachie 008430 Kindred Hospice 02/09/2018 $750 $750 $0

04 - Tyler Longview 003475 Lifecare Health Services 08/30/2017 $750 $750 $0

04 - Tyler Tyler 015986 Heart To Heart Hospice of Tyler

Ltd

10/19/2017 $750 $0 $750

04 - Tyler Tyler 016124 Hospice Connection 12/08/2017 $1,500 $1,500 $0

06 - Houston Baytown 012378 Harbor Hospice of Baytown LP 09/18/2017 $2,250 $2,250 $0

D-47

Region City License

Number Agency

Visit Exit


06 - Houston Houston 017331 ABIB Hospice Care Inc 09/27/2017 $1,500 $1,500 $0

06 - Houston Houston 016469 Attentive Hospice 09/28/2017 $1,500 $0 $1,500

06 - Houston Houston 014864 Circle of Care Hospice 09/29/2017 $4,350 $4,350 $0

06 - Houston Houston 016766 Del Cielo Hospice & Palliative

Care

04/11/2018 $1,500 $0 $1,500

06 - Houston Houston 016766 Del Cielo Hospice & Palliative

Care

04/02/2018 $1,500 $0 $1,500

06 - Houston Houston 016271 Featherland Hospice Inc 11/20/2017 $1,500 $1,500 $0

06 - Houston Houston 017414 Gentle Transition Hospice 11/08/2017 $2,950 $492 $2,458

06 - Houston Houston 015161 Good Shepherd Hospice of

Houston LLC

09/28/2017 $700 $700 $0

06 - Houston Houston 001994 Houston Hospice 11/17/2017 $750 $750 $0

06 - Houston Houston 017418 Nuestra Familia Hospice 11/14/2017 $1,400 $1,400 $0

06 - Houston Houston 016915 Sage Caregivers Inc 09/20/2017 $1,450 $0 $1,450

06 - Houston Humble 015585 Devinity Hospice 12/11/2017 $5,850 $0 $5,850

06 - Houston Katy 014626 Vantage Hospice 12/14/2017 $1,500 $1,500 $0

06 - Houston Kingwood 011779 Bethel Hospice of Houston Inc 06/08/2017 $1,450 $1,450 $0

06 - Houston Lake Jackson 008168 Helping Hands and Hearts

Hospice

07/12/2017 $3,650 $0 $3,650

06 - Houston Lake Jackson 009412 IPH Hospice Care Inc 12/22/2017 $1,500 $1,500 $0

06 - Houston Pasadena 015533 Excellence Hospice Care 12/07/2017 $10,350 $0 $10,350

06 - Houston Pasadena 015533 Excellence Hospice Care 10/05/2017 $5,800 $0 $5,800

06 - Houston Spring 017271 Millennium Hospice Agency LLC 03/29/2018 $750 $750 $0

06 - Houston Sugar Land 017625 Allstar Hospice 09/19/2017 $750 $750 $0

06 - Houston Sugar Land 014621 Altus Hospice 02/22/2018 $1,500 $1,500 $0

D-48

Region City License

Number Agency

Visit Exit


06 - Houston Sugar Land 011078 Gulf Coast Hospice of Houston

Ltd

02/22/2018 $1,500 $1,500 $0

06 - Houston Texas City 015315 A*Med Community Hospice 11/01/2017 $2,250 $2,250 $0

06 - Houston Texas City 001694 Hospice Care Team Inc 11/17/2017 $3,700 $3,700 $0

06 - Houston The

Woodlands

017134 Rose of Texas Hospice 10/03/2017 $750 $750 $0

06 - Houston Webster 016134 Promedic Hospice 12/01/2017 $6,000 $6,000 $0

07 - Austin Austin 014874 Brookdale Hospice Austin 11/09/2017 $750 $750 $0

07 - Austin Austin 017962 Cima Hospice 07/07/2017 $500 $500 $0

07 - Austin Austin 017023 Encompass Health Hospice 10/26/2017 $900 $900 $0

07 - Austin Austin 015952 Heart to Heart Hospice of Austin

Ltd

11/17/2017 $500 $500 $0

07 - Austin Austin 017517 New Century Hospice of Austin 03/15/2018 $1,500 $1,500 $0

07 - Austin Austin 017517 New Century Hospice of Austin 12/20/2017 $500 $500 $0

07 - Austin Austin 016740 Seton Hospice 09/27/2017 $2,000 $2,000 $0

07 - Austin Bryan 013721 Compassionate Care Hospice 12/19/2017 $750 $750 $0

07 - Austin Bryan 013721 Compassionate Care Hospice 03/29/2018 $750 $750 $0

07 - Austin College

Station

014287 Traditions Hospice 07/28/2017 $500 $500 $0

07 - Austin Dripping

Springs

017218 Blue Star Home Care 03/08/2018 $1,500 $1,500 $0

07 - Austin Georgetown 014240 Wesleyan Hospice 03/22/2018 $0 $3,500 $3,500 $0

07 - Austin Pflugerville 012962 Interim Hospice of San Antonio 09/15/2017 $550 $550 $0

07 - Austin Round Rock 016340 Altus Hospice of The Hills 03/09/2018 $500 $500 $0

07 - Austin San Marcos 004098 Kindred Hospice 04/19/2018 $750 $750 $0

D-49

Region City License

Number Agency

Visit Exit


07 - Austin Waco 014809 Interim Hospice of Granbury 01/19/2018 $500 $500 $0

07 - Austin Waco 007477 Providence Hospice 01/18/2018 $500 $500 $0

08 - San

Antonio

Eagle Pass 013706 Faith Home Hospice Care 09/22/2017 $3,700 $2,960 $0 $2,960

08 - San

Antonio

Eagle Pass 009852 Fort Duncan Home Health and

Hospice Care

06/09/2017 $4,100 $0 $4,100

08 - San

Antonio

Fredericksburg 007156 Hill Country Memorial Hospice 07/20/2017 $1,100 $1,100 $0

08 - San

Antonio

San Antonio 018098 Compassus - San Antonio 02/15/2018 $550 $550 $0

08 - San

Antonio

San Antonio 018098 Compassus - San Antonio 12/04/2017 $500 $500 $0

08 - San

Antonio

San Antonio 017178 Crossroads Hospice Inc 12/01/2017 $5,650 $5,650 $0

08 - San

Antonio

San Antonio 013573 Embrace Hospice LLC 12/12/2017 $1,500 $1,500 $0

08 - San

Antonio

San Antonio 015665 Guiding Light Hospice 09/22/2017 $2,400 $2,400 $0

08 - San

Antonio

San Antonio 015794 Harbor Hospice of Central San

Antonio LP

12/20/2017 $4,550 $4,550 $0

08 - San

Antonio

San Antonio 017259 Ikiru Hospice LLC 07/21/2017 $2,000 $0 $2,000

08 - San

Antonio

San Antonio 004072 Kindred Hospice 08/17/2017 $2,050 $2,050 $0

08 - San

Antonio

San Antonio 007712 Kindred Hospice 09/05/2017 $1,000 $1,000 $0

08 - San

Antonio

San Antonio 017528 La Diferencia Hospice LLC 08/23/2017 $2,500 $2,500 $0

D-50

Region City License

Number Agency

Visit Exit


08 - San

Antonio

San Antonio 018026 Opuscare of Texas 10/25/2017 $1,750 $1,750 $0

08 - San

Antonio

San Antonio 017562 Orenda Hospice 08/17/2017 $1,650 $1,650 $0

08 - San

Antonio

San Antonio 017211 Pietas Hospice LLC 07/26/2017 $2,050 $0 $2,050

08 - San

Antonio

San Antonio 017467 Tejas First Hospice LLC 07/19/2017 $500 $500 $0

08 - San

Antonio

San Antonio 007195 Vitas Healthcare of Texas LP 08/04/2017 $550 $550 $0

09 - Abilene Midland 002022 Hospice of Midland Inc 10/24/2017 $5,250 $0 $5,250

09 - Abilene Odessa 003840 Home Hospice 07/27/2017 $1,000 $1,000 $0

10 - El Paso El Paso 009845 Global Hospice Care Inc 11/29/2017 $500 $500 $0

10 - El Paso El Paso 007770 Kindred Hospice 07/06/2017 $2,000 $2,000 $0

11 - Corpus

Christi

Corpus Christi 008442 Legacy Home Health Agency Inc 03/05/2018 $700 $700 $0

11 - Corpus

Christi

Corpus Christi 006229 Nurses On Wheels Inc 11/03/2017 $6,950 $6,950 $0

11 - Corpus

Christi

Harlingen 012130 Kindred Hospice 08/17/2017 $2,700 $2,700 $0

11 - Corpus

Christi

Laredo 015081 Altus Hospice of South Texas LP 03/16/2018 $1,100 $0 $1,100

11 - Corpus

Christi

McAllen 017463 Eternal Serenity Hospice LLC 12/12/2017 $4,600 $4,600 $0

11 - Corpus

Christi

McAllen 012543 IPH Hospice Care Inc 03/22/2018 $3,450 $3,450 $0

D-51

Region City License

Number Agency

Visit Exit


11 - Corpus

Christi

McAllen 014420 Superior Hospice of McAllen LLC 04/03/2018 $3,850 $0 $3,850

11 - Corpus

Christi

McAllen 014420 Superior Hospice of McAllen LLC 10/10/2017 $5,150 $5,150 $0

11 - Corpus

Christi

McAllen 014420 Superior Hospice of McAllen LLC 04/03/2018 $1,750 $1,150 $600

11 - Corpus

Christi

San Benito 002159 Heart of the Valley Hospice 08/03/2017 $1,000 $0 $1,000

Totals $232,450 $6,460 $164,192

113 Total hospice agency administrative penalties imposed.

Notes


amount. This is the amount due and payable if no alternative amount results from an appeal or if no settlement agreement reached.


final amount and due date have been decided, or the person accepts the determination by the state or fails to respond to the notice letter

in a timely manner.

3. The collected column is the amount of money the facility has paid to the regulating agency.


owe. The amounts can change based on a hearing or negotiated settlement. Since these amounts may change, this column is not totaled.

D-52

Home and Community Support Services Agency Injunctive/Other

Relief and Civil Penalty Referrals to the Office of the Attorney General

for FY 2018

HHSC did not refer any home and community support services agency to the Office

of the Attorney General for injunctive/other relief in FY 2018.

Home Health Agency Denials of License Application for FY 2018

Region City Agency Denial

Date

03 - Arlington Denison A Family Member Homecare 06/25/2018

03 - Arlington Plano KM Infusion Service Inc 12/20/2017

06 - Houston Houston Skyline Senior Services LLC 04/09/2018

06 - Houston Katy Bexel Worldwide 01/28/2018

06 - Houston League City BHCS Brilliant Home Community Services 09/08/2017

06 - Houston Stafford Zeebamz Health Services 09/06/2017

07 - Austin Austin BTO Healthcare & Services 03/05/2018

07 - Austin Hewitt Firstlight Homecare of Waco 11/14/2017

09 - Abilene Midland Divine Integrity Allied Healthcare Services 02/13/2018

11 - Corpus Christi Edinburg St Jude Home Health 02/23/2018

10 Total home health agency denials of license application.

Hospice Agency Denials of License Application for FY 2018

Region City Agency Denial

Date

03 - Arlington Lewisville CareRite Home Health and Hospice

Services

11/02/2017


City

Amicable Palliative Care 05/25/2018

11 - Corpus Christi Port Isabel Angelito's Hospice, Inc 12/12/2017

3 Total hospice agency denials of license application.

Home Health Agency Denials of License Renewal for FY 2018

Region City License

Number Agency

Denial

Date

03 - Arlington Little Elm 016020 Zubic Home Health Services Inc 09/20/2017

D-53

Region City License

Number Agency

Denial

Date

06 - Houston Houston 016630 St Marys Healthcare Inc 01/18/2018

06 - Houston Sugar Land 013441 Healthcare Masters Inc 03/05/2018

06 - Houston Sugar Land 017028 Mabel Livinghome, Inc 12/05/2017

08 - San Antonio San Antonio 016197 A1 Ultra Homecare 07/19/2018

08 - San Antonio San Antonio 016598 Castle Homecare 4 Kids, LLC 09/05/2017

08 - San Antonio San Antonio 017501 Radiant Home Care 07/01/2018

11 - Corpus Christi Harlingen 017264 A Dream Come True Home Care 05/06/2018

8 Total home health agency denials of license renewal.

Hospice Agency Denials of License Renewal for FY 2018

HHSC did not deny renewal of any licenses for a hospice agency in FY 2018.

Home Health Agency Expirations of License (in Lieu of Further

Enforcement Action) for FY 2018

Region City License

Number Agency

Denial

Date

03 - Arlington Fort Worth 017368 BSN Home Health Care 04/20/2018

06 - Houston Houston 017077 1st Traditions Homecare LLC 12/13/2017

06 - Houston Houston 017055 Age in Place 09/30/2017

06 - Houston Houston 017053 Aide in Aid, LLC 10/20/2017

06 - Houston Houston 011783 Alpha Home Health Services 12/31/2017

06 - Houston Houston 017529 Stay at Home with Our Help 07/31/2018

06 - Houston Richmond 012441 AAA Healthcare Services Inc 01/11/2018

06 - Houston Richmond 014261 K Cn Home Care LLC 09/01/2017

06 - Houston Richmond 016909 Reke’s Healthcare Services, Inc 09/20/2017

06 - Houston Sugar Land 010043 Emex Home Health Agency Inc 11/10/2017

06 - Houston Wharton 016933 All Hope Home Health Agency

Inc

10/18/2017

08 - San Antonio San Antonio 017021 Questqual Pediatric Services 10/23/2017

08 - San Antonio San Antonio 016995 Stone Oak Home Health

Services

10/24/2017

D-54

Region City License

Number Agency

Denial

Date

11 - Corpus Christi Alton 015762 Sincere Health Care LLC 09/30/2017

11 - Corpus Christi Edinburg 008694 Ninos Home Care Inc 11/14/2017

11 - Corpus Christi Edinburg 011460 Valley Medcare Services 10/25/2017

16 Total home health agency expirations of license.

Hospice Agency Expirations of License (in Lieu of Further Enforcement

Action) for FY 2018

Region City License

Number Agency

Denial

Date

03 - Arlington Arlington 015907 Clearpath Hospice of Fort Worth

LLC

01/01/2018

06 - Houston Dallas 017395 Lifepointe Hospice Dallas

Metroplex LLC

04/16/2018

2 Total hospice agency expirations of license.

Home Health Agency Immediate Suspension Orders for FY 2018

HHSC did not issue any immediate suspension orders for a home health agency in

FY 2018.

Hospice Agency Immediate Suspension Orders for FY 2018

HHSC did not issue any immediate suspension orders for a hospice agency in FY

2018.

Home Health Agency Surrenders of License (in Lieu of Further

Enforcement Action) for FY 2018

Region City License

Number Agency

Surrender

Date

03 - Arlington Azle 017970 Dementia Specialist Home Care 01/10/2018

03 - Arlington Coppell 012795 Omega Home Healthcare

Agency

12/21/2017

03 - Arlington Dallas 012648 Texas Senior Homehealth Inc 11/30/2017

03 - Arlington Desoto 017701 In-depth Healthcare Services 09/06/2017

D-55

Region City License

Number Agency

Surrender

Date

03 - Arlington Garland 017821 Home Helpers Direct Link

#58871

09/08/2017

03 - Arlington Irving 017860 Pediatria Healthcare for Kids 09/28/2017

03 - Arlington McKinney 018305 Best Choice Senior Care 06/01/2018

03 - Arlington Murphy 015413 Bopim Healthcare Services

Limited

03/27/2018

03 - Arlington Rowlett 018095 Appraise Health Care 03/15/2018

04 – Tyler Tyler 018295 All Kidz Kan 04/17/2018

04 – Tyler White Oak 017917 Royal Caring Hands LLC 02/22/2018

05 - Beaumont Beaumont 018659 Texas Home Health of America 07/31/2018

06 – Houston Houston 016210 Clinical View Home Health 02/28/2018

06 – Houston Houston 010417 Faith in Him Health Services 05/25/2018

06 – Houston Houston 018369 Master Geriatric Care, LLC 06/29/2018

06 – Houston Houston 018492 SNG - Sohum Houston Dialysis

Center, LP

07/23/2018

06 – Houston Katy 017589 Advance Help Home Care 05/07/2018

06 – Houston Katy 017464 Covenant Premium Senior Care

LLC

01/04/2018

06 – Houston Katy 017534 Gentle Homekare LLC 03/09/2018

07 – Austin Austin 013142 MBF Agency 02/21/2018

07 – Austin College

Station

017989 Malixi Home Health Services LLC 01/04/2018

07 – Austin Killeen 017590 Compassionate Companions LLC 02/20/2018

07 – Austin Leander 008795 Central Texas Caregivers Inc 12/12/2017

11 - Corpus Christi Corpus

Christi

017388 Trio Home Health-rural Inc 05/14/2018

11 - Corpus Christi McAllen 018464 Pan De Vida Healthcare 08/14/2018

11 - Corpus Christi Rio Grande

City

009822 Perfect Choice Health Care

Services Inc

10/26/2017

11 - Corpus Christi San Benito 002790 Eldercare Home Health II 02/02/2018

27 Total home health agency surrenders of license.

D-56

Hospice Agency Surrenders of License (in Lieu of Further Enforcement

Action) for FY 2018

Region City License

Number Agency

Surrender

Date

03 - Arlington Irving 015147 Smart Medi Care Health

Services Inc

07/31/2018

06 - Houston Houston 016536 Seven Stars Hospice Inc 04/13/2018

06 - Houston Katy 018158 Pristine Healthcare Services Inc 05/13/2018

11 - Corpus Christi Rio Hondo 017586 Pride Hospice Care LLC 04/26/2018

11 - Corpus Christi San Benito 002159 Heart of The Valley Hospice 02/22/2018

5 Total hospice agency surrenders of license.

Home Health Agency Revocations of License for FY 2018

Region City License

Number Agency

Date

Revoked

03 - Arlington Cedar Hill 017982 Revitalizing Futures Healthcare

Services

01/06/2018

03 - Arlington Dallas 017759 Careone Caregiving Home

Health Agency

07/04/2018

03 - Arlington Dallas 017506 Homecareconnect 09/11/2017

03 - Arlington Dallas 018247 MDH Healthcare Agency LLC 05/02/2018

03 - Arlington Dallas 017996 Patient Consolidated Services

LLC

05/08/2018

03 - Arlington Decatur 017333 Solaris Home Health Inc 09/09/2017

03 - Arlington Glenn

Heights

017363 Residential Connection Home

Care Services LLC

09/08/2017

03 - Arlington McKinney 018101 Aviator Home Health 02/13/2018

03 - Arlington Richardson 012014 Morning Rose Home Health Care

LLC

05/19/2018

03 - Arlington Richardson 018028 Pure Happiness Home Health

LLC

01/06/2018

04 – Tyler New Boston 017469 Helping Hands Home Health 12/20/2017

05 - Beaumont Port Arthur 017953 Care Consultants of Southeast

Texas

05/21/2018

06 - Houston Houston 017936 Andtech Home Care Services

LLC

02/18/2018

06 - Houston Houston 018102 Envision for Life Healthcare 03/11/2018

06 - Houston Houston 018198 Home Care Assistance 04/08/2018

D-57

Region City License

Number Agency

Date

Revoked

06 - Houston Houston 017793 Odera Cares LLC 01/27/2018

06 - Houston Houston 018281 Presque Domicile LLC 05/11/2018

06 - Houston Houston 017661 Roluben Health Services LLC 05/13/2018

06 - Houston Houston 018396 Vigilant in Home Care LLC 07/01/2018

06 - Houston Kingwood 017728 Alliance Renal Solutions LLC 01/27/2018

06 - Houston Manvel 017827 Advancement Care LLC 12/20/2017


City

018344 Best Care in Home Service LLC 06/14/2018

06 - Houston Richmond 018407 Jescan Home Care Services 07/03/2018

06 - Houston Rosharon 018014 A Mother's Blessing Senior Care

LLC

03/21/2018

06 - Houston Splendora 018318 Hands of Love Inc 06/24/2018

06 - Houston Stafford 004976 Nationsmed Healthcare 11/19/2017

07 – Austin Austin 018152 Onehope Therapy Centers LLC 04/17/2018

07 – Austin Austin 017976 Vickie's Home Care LLC 05/21/2018

07 – Austin Cedar Park 018072 Kinesis Home Care LLC 03/30/2018

07 – Austin Temple 017796 Nurturing at Home Provider

Services

03/05/2018

08 - San Antonio San Antonio 018294 Capitol Senior Care 06/06/2018

08 - San Antonio San Antonio 017781 Here To Help A Happy Home

Care Company

12/25/2017

08 - San Antonio San Antonio 018134 Pro Re Nata Home Healthcare 03/11/2018

08 - San Antonio San Antonio 017443 Questqual Healthcare LLC 11/12/2017

08 - San Antonio San Antonio 017440 Sol Home Care LLC 05/28/2018

10 - El Paso Canutillo 018011 To the Moon and Back Personal

Care LLC

01/08/2018

11 - Corpus Christi Brownsville 017662 Jada Home Health 05/16/2018

11 - Corpus Christi Brownsville 018395 Triangle Specialized Home

Health Agency

06/20/2018

11 - Corpus Christi Edcouch 018181 Amanecer Health Care Services,

LLC

05/20/2018

11 - Corpus Christi Edinburg 018040 A Friendly Heart Home Care LLC 05/20/2018

11 - Corpus Christi Edinburg 017950 Pura Vida PHC LLC 05/17/2018

11 - Corpus Christi Edinburg 018333 Televida RGV 08/01/2018

11 - Corpus Christi Elsa 017741 Nyssa's Home Health Therapy

Services

05/20/2018

D-58

Region City License

Number Agency

Date

Revoked

11 - Corpus Christi McAllen 018383 High Point Therapy Center 07/26/2018

11 - Corpus Christi McAllen 018332 RGV Vital Connections LLC 06/28/2018

11 - Corpus Christi Pharr 012825 Juanitas Angels Home

Healthcare LLC

07/09/2018

46 Total home health agency revocations of license.

Hospice Agency Revocations of License for FY 2018

Region City License

Number Agency

Date

Revoked

03 - Arlington Fort Worth 012440 Grace Hospice of Fort Worth LLC 07/14/2018

03 - Arlington Fort Worth 017691 Knights of Comfort Hospice 09/08/2017

03 - Arlington Plano 009334 Grace Hospice 07/05/2018

06 - Houston Houston 018033 Champions Serene Comfort

Care Hospice

04/17/2018

06 - Houston Houston 018345 CNN Hospice 05/23/2018

06 - Houston Houston 018475 Oakwest Hospice 08/16/2018

06 - Houston Houston 016530 Pinnacle Hospice LLC 03/13/2018

06 - Houston Spring 017768 Avatar Hospice & Palliative Care

Agency LLC

12/25/2017

08 - San Antonio San Antonio 017244 Pallium Hospice LLC 10/18/2017

09 - Abilene Midland 017433 Merida Health Care Group 06/08/2018

11 - Corpus Christi Pharr 017607 San Jose Hospice Care 05/23/2018

11 Total hospice agency revocations of license.

D-59

Home and Community Support Services Agency

Complaint and Incident Intakes

Complaints

A complaint allegation is an assertion that a requirement of state licensure or

federal certification has been violated and can come directly from individuals or

residents, family members, health care providers, advocates, law enforcement, or

other state agencies. Report sources can be oral or written.

Incidents

An incident is an allegation of abuse, neglect, or misappropriation of property; an

allegation of conduct or a condition resulting in the exploitation of consumers; or

any act allegedly perpetrated by agency staff and reported by agency management

or other agency staff.

Priority Assignment

The long-term care regulatory intake unit evaluates each complaint or incident

based on its unique circumstances and assigns priorities accordingly. When

timeliness is crucial to the health and safety of a consumer(s), such as in a

situation of heating or air conditioner equipment failure (if the consumer is in an

inpatient hospice unit), alleged staff walkout, etc., an investigation can be initiated

immediately by telephone, regardless of the priority code assignment. After the

initial telephone contact, an on-site visit is conducted according to the timeframe

specified by the priority assignment. The priorities that can be assigned to a home

and community support services agency are:

● On or before two working days

● On or before 10 working days




● Next on-site

● Desk review

● Withdrawn

● Not applicable

D-60

On or Before Two Working Days

Immediate response by the regulatory agency is warranted because a home and

community support services agency provider allegedly created or allowed a present

and ongoing situation in which the provider’s noncompliance with one or more

requirements of licensure or certification has failed to protect consumers or has

caused, or is likely to cause, serious injury, harm, impairment, or death.

On or Before 10 Working Days

Alleged provider noncompliance might have or has a high potential to cause harm

that affects a consumer’s mental, physical, or psychosocial well-being and is of such

consequence that a rapid response by the regulatory agency is indicated. The

complaint allegation(s) asserts that one or more of the following exist:

● Nursing care was not delivered as planned to a consumer with present and

ongoing need for nursing care.

● There was a break in service for skilled services for Medicaid waiver

consumers.

● Home and community support services agency personnel were not available

to the consumers during normal operating hours.

● The consumer sustained harm from improper or inadequate care and service

provision.

● Immediate threat to health and safety has been removed, but the situation

poses a continued threat to consumers.


This priority applies only to Home and Community Support Services Agency Joint

Commission, Community Health Accreditation Program, or Accreditation

Commission for Health Care deemed agencies with Centers for Medicare and

Medicaid Services regional office authorization.


certification has a low potential for more than minimal harm or physical, mental, or

psychosocial harm that did not directly impact consumer or resident health and

safety and functional status; this priority may also be assigned for alleged violations

of regulations that do not directly impact consumer or resident health and safety.


The allegation(s) asserts that one or more of the following exist:

D-61

● Noncompliance with one or more requirements of licensure or certification

that has a low potential for more than minimal harm or resulted in physical,

mental, or psychosocial harm that did not directly impact consumer health

and safety

● Financial insolvency without alleged impact on consumers

● Inaccurate clinical records


The complaint allegation(s) asserts that an agency is providing home health

services (hiring and sending out nurses to provide skilled nursing services or hiring

and sending out aides to provide personal assistance services) without a license.

Next On-site

This priority replaced “on or before 120 working days” during FY 2008. The complaint

allegation(s) asserts that one or more of the following exist:

● Discharge without proper notice

● Illegal remuneration (i.e., solicitation or kickbacks)

● Personal assistance services not being provided when the situation does not

pose a serious threat to the consumer’s health and safety

● Consumer rights violations

● Billing irregularities

Desk Review

The regulatory agency uses desk reviews for off-site investigation of home and

community support services agency self-reported incidents. If further investigation

is warranted to ensure compliance with federal, state, or local laws, regional staff

schedule an on-site investigation. Whether investigation is by desk review or on-site,

it must be completed on or before 120 working days.

Withdrawn


complainant, except when abuse, neglect or exploitation is alleged. Please refer to



01.pdf).

https://www.hhsc.state.tx.us/providers/communications/2015/scc/SCC2015-01.pdf

https://www.hhsc.state.tx.us/providers/communications/2015/scc/SCC2015-01.pdf

D-62

Not Applicable


or when a report to another agency, board, or entity is required.

D-63

Home and Community Support Services Agency All Intakes by Priority and Region for FY 2018


On or before 2 working days 0 0 2 0 2 3 3 4 0 0 2 16


On or before 45 working days 21 23 312 49 36 227 102 173 16 38 210 1,207


Next on site 11 6 88 22 11 94 48 60 6 21 119 486

Desk review 150 318 1,343 539 251 714 663 783 159 169 1,437 6,526

Withdrawn 2 0 15 0 0 4 0 8 1 0 0 30

Not applicable 20 23 110 20 12 99 41 63 97 27 101 613

Total 207 372 1,926 644 325 1,188 879 1,122 284 261 1,883 9,091

Home and Community Support Services Agency Complaints by Priority and Region for FY 2018






Next on site 11 6 85 17 11 88 48 57 6 20 115 464

Withdrawn 2 0 15 0 0 4 0 8 1 0 0 30

Not applicable 2 0 11 0 0 4 1 1 0 0 2 21

Total 31 30 383 66 52 332 142 235 22 60 289 1,642

D-64

Home and Community Support Services Agency Incidents by Priority and Region for FY 2018





Next on site 0 0 3 5 0 6 0 3 0 1 4 22

Desk review 150 318 1,343 539 251 714 663 783 159 169 1,437 6,526

Not applicable 18 23 99 20 12 95 40 61 97 27 99 591

Total 176 342 1,543 578 273 856 737 886 262 201 1,594 7,448

E-1

Appendix E. Intermediate Care Facility for

Individuals with an Intellectual Disability

or Related Conditions (ICF/IID)

Intermediate Care Facility for Individuals with an

Intellectual Disability or Related Conditions Actions

The table on page E-5 contains information relating to Texas Health and Safety

Code, Title 4, Subtitle B, Chapter 252, Intermediate Care Facilities, for licensed

intermediate care facility for individuals with an intellectual disability or related

conditions actions, by category, for fiscal year (FY) 2018.


Basis for imposing

The long-term care regulatory agency can assess an administrative penalty against

a facility that violates Texas Health and Safety Code Chapter 252, or a rule,

standard, or order adopted, or license issued, under Texas Health and Safety Code

Chapter 252.

● Violates Texas Health and Safety Code Chapter 252 or a rule, standard, or

order adopted, or license issued, under Texas Health and Safety Code Chapter

252.


material fact:


to the application.

With respect to a matter under investigation by the state regulatory

agency.


A book, record, or file required to be maintained by a facility.

Any portion of the premises of a facility.

● Willfully interferes with the work of a representative of the state agency or

the enforcement of this chapter.

● Willfully interferes with a representative of the state preserving evidence of a

violation of a rule, standard or order adopted, or license issued, under Texas

Health and Safety Code Chapter 252.

E-2

● Fails to pay a penalty assessed by the state under Texas Health and Safety

Code Chapter 252, by the 10th day after the date the assessment of the

penalty becomes final.

● Fails to notify the state regulatory agency of a change of ownership before

the effective date of the change of ownership.

Imposed



review

● Regional or state office regulatory staff, considering the survey or

investigation findings or evaluating the facility’s history or performance


been reviewed and confirmed by state office staff. The facility is formally notified of

the administrative penalty citation and the penalty amount. Additionally, the notice

includes information about the appeal process available to the facility.

Assessed


completed (or an agreement to settle has been reached) and a final amount and

due date have been decided, or the person accepts the determination by the state

agency or fails to respond to the notice letter in a timely manner. The facility is

notified of the amount to be paid and the date payment is due. A lump-sum

payment or a monthly payment plan can be agreed upon during the appeal or

settlement process.

Injunctive/Other Relief and Civil Penalties

Injunctive/other relief and civil penalty cases are referred to the Office of the

Attorney General for action. When a case is resolved through settlement, a portion

of the payment is designated a civil penalty and normally deposited to general

revenue. The Office of the Attorney General receives the portion designated as

attorney fees and costs.

One or more survey or investigative visits may result in a recommendation for civil

penalties for a facility depending on the findings. These visits are generally

consolidated into one case per facility for referral.

E-3

A civil penalty may be awarded if the facility violates a licensing rule and the stat

determines that the violation creates a threat to the health and safety of a resident.


In certain situations, the commissioner of the agency can allow, in lieu of

demanding payment of an administrative penalty, the use (under the supervision of

the agency) of any portion of the penalty to ameliorate the violation or to improve


Trusteeships

The state regulatory agency, through the Office of the Attorney General, can

petition a court of competent jurisdiction for the involuntary appointment or

appointment by agreement of a trustee to operate a facility if one or more of the

following conditions exist:





● An emergency exists that presents an immediate threat to the health and

safety of the residents.

● The facility is closing (whether voluntarily or through an emergency closing

order), and arrangements for relocation of the residents to other

licensed/certified intermediate care facilities for individuals with an

intellectual disability or related conditions or into a waiver program have not

been made before closure.



of the facility if:

● The agency finds that the facility is operating in violation of licensure rules.


resident.


on the date the license holder receives written notice or on a later date specified in

the order. This suspension of a license may occur simultaneously with any other

E-4

enforcement provision available to state regulators. The order is effective for 10

days.

Denials of License

The regulatory agency can deny a facility’s license when the facility does not meet

licensure rules or when the facility fails to maintain compliance with these rules on

a continuous basis.

It can deny a facility’s license if an applicant, manager, or affiliate:

● Substantially fails to comply with licensure requirements or has violations

that posed or pose a serious threat to health and safety, or fails to maintain

compliance on a continuous basis.

● Aids, abets, or permits a substantial violation of Texas Health and Safety

Code Chapter 252.


application process or provides false or fraudulent information.


● Has had a license revoked, has been debarred or excluded, has an

unsatisfied final judgment, has been decertified or evicted, has a license

suspended, or has a criminal conviction.

● Is subject to denial or refusal as described in Texas Administrative Code,

Title 40, Part 1, Chapter 99, Denial or Refund of License.

Revocations of License

The state can revoke a facility’s license if it finds that the license holder has violated

the requirements established under Texas Health and Safety Code Chapter 252 and

that violation either jeopardizes the health and safety of residents, is repeated, or is

a substantial violation of Texas Health and Safety Code Chapter 252.

The state also can revoke a facility’s license if the license holder submitted false or

misleading statements in the application for license, used subterfuge or other

evasive means to obtain a license, concealed a material fact, or failed to disclose

information that would have been the basis for denial, or received monetary or

other remuneration from a person or agency that furnishes services or materials to

the facility for a fee.

The revocation of a license may occur simultaneously with any other enforcement

provision available to the state.

E-5

Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition Actions by

Region for FY 2018




Injunctive/other relief and

civil penalties (2)

Referred 0 0 1 0 0 0 0 0 0 0 0 1





closing orders

Ordered 0 0 0 0 0 0 0 0 0 0 0 0




Notes:


2. The state refers injunctive/other relief and civil penalty requests to the Office of the Attorney General.

3. Denied and revoked actions can include final actions on cases proposed in a previous fiscal year.

E-6

Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions

Administrative Penalties for FY 2018


ID Facility

Visit Exit


03 – Arlington Arlington 007302 Cedar Oaks Community Home 09/15/2017 $10,000 $10,000 $0 N

03 – Arlington Arlington 007563 Evergreen Endicott Community

Home

04/20/2018 $5,000 $0 $5,000 N

03 – Arlington Azle 007414 Lakeview Community Home 08/31/2017 $10,000 $6,500 $6,500 $0 Y

03 – Arlington Azle 007422 Lamplighter Community Home 03/22/2018 $15,000 $15,000 $0 N

03 – Arlington Bedford 007809 Walnut Community Home 08/19/2017 $5,000 $10,000 $0 N

03 – Arlington Dallas 100368 14 Ferris Creek 06/22/2018 $5,000 $0 $5,000 N

03 – Arlington Denton 007247 Educare Community Living

Corporation-Texas

09/30/2017 $10,000 $10,000 $0 N

04 – Tyler Elkhart 003868 Elkhart Inn Community Home 03/07/2018 $5,000 $5,000 $0 N

04 – Tyler Palestine 007294 Crestview Community Home 12/20/2017 $10,000 $10,000 $0 N

05 - Beaumont Beaumont 003692 Pinehaven Community Home 05/23/2018 $5,000 $0 $5,000 Y

05 - Beaumont Beaumont 003964 Cambridge Group Home 11/28/2017 $5,000 $5,000 $0 N

06 – Houston Houston 007616 Destiny House 03/02/2018 $5,000 $5,000 $0 N

07 – Austin Austin 007264 Delaware Court 02/13/2018 $20,000 $20,000 $0 N

07 – Austin Austin 007599 Blarwood 09/19/2017 $10,000 $10,000 $0 Y

07 – Austin Austin 007599 Blarwood 08/02/2017 $15,000 $15,000 $0 Y

07 – Austin Bertram 003675 Bertram Community Residence 06/07/2018 $10,000 $0 $10,000 Y

07 – Austin Cedar Park 007468 Driftwood Community Home 07/10/2017 $15,000 $0 $15,000 Y

07 – Austin Pflugerville 007633 Wildridge 03/12/2018 $20,000 $0 $20,000 Y

E-7


ID Facility

Visit Exit


08 - San

Antonio

San Antonio 003649 Pebble Bow 10/31/2017 $5,000 $5,000 $0 N

11 - Corpus

Christi

Alice 007295 Green Acres 05/10/2018 $1,000 $0 $1,000 N

Totals $186,000 $6,500 $126,500

20 Total intermediate care facilities for individuals with an intellectual disability or related conditions administrative penalties

imposed.

Notes:


amount. This is the amount due and payable if there is no alternative amount resulting from an appeal held or if no settlement agreement is

reached.



of the penalty.

3. The collected column is the amount of money the facility has paid to the state.




5. The “H” column stands for Hearing, and a “Y” in this column indicates the facility requested a hearing on the violation. Once a facility



E-8

Intermediate Care Facilities for Individuals with an Intellectual

Disability or Related Conditions Injunctive/Other Relief and Civil

Penalty Referrals to the Office of the Attorney General for FY 2018


ID Facility

Date

Referred

03 - Arlington Everman 007262 Chambers Creek Community Home 11/30/2017

1 Total intermediate care facilities for individuals with an intellectual disability or

related conditions injunctive/other relief and civil penalty referrals to the Office of

the Attorney General.


Disability or Related Conditions Amelioration of Violations for FY 2018

HHSC did not process any amelioration requests for intermediate care facilities for

individuals with an intellectual disability or related conditions in FY 2018.


Disability or Related Conditions Trusteeships for FY 2018

HHSC did not place a trustee in any intermediate care facilities for individuals with

an intellectual disability or related conditions in FY 2018.


Disability or Related Conditions Emergency Suspension and Closing

Orders for FY 2018

HHSC did not issue an emergency suspension and closing order in any intermediate

care facilities for individuals with an intellectual disability or related conditions in FY

2018.


Disability or Related Conditions License Denials and Revocations

Proposed for FY 2018


ID Facility

Proposed

Action

Revoked

Date

Denied

Date Status

06 -

Houston

Houston 007661 1801 Branard Deny 04/25/2018 License

Denied

1 Total intermediate care facilities for individuals with an intellectual disability or

related conditions license denials and revocations processed.

E-9

Notes:


1. License Denied - the application for a license was denied

E-10

Intermediate Care Facility for Individuals with an

Intellectual Disability or Related Conditions

Complaint and Incident Intakes

Complaints

A complaint allegation is an assertion that a requirement of state licensure or

federal certification has been violated and can come directly from individuals or

residents, family members, health care providers, advocates, law enforcement, or

other state agencies. Report sources can be oral or written.

Incidents

An incident is an official notification to the state survey agency by the facility

owner, administrator, designee, or any employee of the facility who has cause to

believe that the physical or mental health of an individual has been or may be

adversely affected by abuse, neglect, exploitation, or other unusual events or

occurrences in accordance with Texas Health and Safety Code Chapter 252; 40

Texas Administrative Code §90.212(b)(1) or the Memorandum of Understanding

between HHSC and the Texas Department of Family and Protective Services.

Priority Assignment

The regulatory agency’s complaint intake unit evaluates each complaint based on


crucial to the health and safety of a consumer(s), such as imminent transfer or

discharge, heating or air conditioner equipment failure, alleged staff walkout, etc.,

an investigation can be initiated immediately by telephone, regardless of the

priority code assignment. After the initial telephone contact, an on-site visit is

conducted according to the time frame specified by the priority assignment. The

priorities available for an intermediate care facility for individuals with an intellectual

disability or related conditions facility are:





● Financial

● Withdrawn

E-11

● Not required


Immediate response by the state is warranted because a provider allegedly created

or allowed a present and ongoing situation in which the provider’s noncompliance

with one or more requirements of licensure or certification has failed to protect

consumers from abuse, neglect, or mistreatment or has caused, or is likely to

cause, serious injury, harm, impairment, or death.



been removed. The consumer(s) is no longer in imminent danger; however, the



consumer’s mental, physical, or psychosocial status and is of such consequence that

a rapid response by the state survey agency is indicated. There is evidence or


specific rather than general information (e.g., descriptive identifiers, individual






mental, or psychosocial harm that did not directly impact consumer health and

safety and functional status. This priority also can be assigned for alleged violations

of regulations that do not directly impact consumer health and safety.

Professional Review

A professional review priority is assigned by Complaint Intake Call Center staff

when a provider self-reports an incident to the state in accordance with Texas

Health and Safety Code Chapter 252, 40 Texas Administrative Code §90.213 or 40

Texas Administrative Code §90.225 when the provider’s incident report indicates

the provider’s immediate corrective action is reasonably likely to ensure the safety

of individuals while the provider conducts its investigation and a Professional

Quality Assurance staff reviews the provider’s written investigation report.

E-12


warranted to assess whether the provider complies with regulatory requirements,

professional review staff will change the priority and send notification to the

regulatory regional staff to schedule an on-site investigation.

Financial

These investigations involve complaint allegations related to a consumer not having

access to their trust funds, failure to maintain trust funds for consumers, or failure

to transfer or release trust funds when a consumer is discharged or deceased.

Withdrawn

A complaint report filed with the state is withdrawn at the request of the complainant,

except when harm to a resident alleged. Please refer to Survey and Certification

Clarification 15-01

(https://www.dads.state.tx.us/providers/communications/2015/scc/SCC2015-

01.pdf).

Not Required




Disability or Related Conditions All Intakes by Priority and Region for

FY 2018


On or before 24

hours

0 0 3 2 1 2 1 2 4 0 0 15

On or before 14

days

27 16 46 14 26 39 48 48 59 5 35 363

On or before 45

days

44 26 61 7 21 56 68 69 100 10 44 506

Professional Review 14 12 17 2 9 17 30 5 39 2 12 159

Financial 0 0 1 0 1 0 1 4 0 0 1 8

Withdrawn 0 1 1 0 1 0 2 0 0 0 0 5

Not required 6 0 1 2 3 4 5 3 2 1 10 37

Total 91 55 130 27 62 118 155 131 204 18 102 1,093

https://www.dads.state.tx.us/providers/communications/2015/scc/SCC2015-01.pdf)

https://www.dads.state.tx.us/providers/communications/2015/scc/SCC2015-01.pdf)

E-13


Disability or Related Conditions Complaints by Priority and Region for

FY 2018


On or before 24

hours

0 0 3 1 0 2 0 2 3 0 0 11

On or before 14

days

6 5 17 7 8 10 12 21 8 2 14 110

On or before 45

days

8 5 37 4 6 14 20 42 25 7 18 186

Financial 0 0 1 0 1 0 1 4 0 0 1 8

Withdrawn 0 1 1 0 1 0 2 0 0 0 0 5

Not required 0 0 0 0 0 2 0 0 0 0 1 3

Total 14 11 59 12 16 28 35 69 36 9 34 323


Disability or Related Conditions Incidents by Priority and Region for FY

2018


On or before 24

hours

0 0 0 1 1 0 1 0 1 0 0 4

On or before 14

days

21 11 29 7 18 29 36 27 51 3 21 253

On or before 45

days

36 21 24 3 15 42 48 27 75 3 26 320


Not required 6 0 1 2 3 2 5 3 2 1 9 34

Total 77 44 71 15 46 90 120 62 168 9 68 770

F-1

Appendix F. Nursing Facility (NF)

Nursing Facility Actions

The table on page F-7 contains information relating to Texas Health and Safety

Code, Title 4, Subtitle B, Chapter 242, Convalescent and Nursing Homes and

Related Institutions, nursing facility actions, by category, for fiscal year (FY) 2018.


The long-term care regulatory agency can assess administrative penalties for each

violation of the statutes or rules, including each violation found in a single survey. A

violation that is the subject of a penalty is presumed to continue on each successive

day until it is corrected. The date of correction alleged by the facility in its written

plan of correction will be presumed to be the actual date of correction unless it is

later determined by the state that the correction was not made by that day or was

not satisfactory.

The state regulatory agency can impose an administrative penalty against:

● An applicant for a license

● A license holder

● A partner, officer, director, or managing employee of an applicant or a license

holder

● A person who controls a nursing facility

Basis for Imposing

The long-term care regulatory agency can impose an administrative penalty when a

facility licensed under Texas Health and Safety Code Chapter 242, fails to meet

specified rules and requirements found in Texas Administrative Code, Title 40, Part

1, Chapter 19, Nursing Facility Requirements for Licensure and Medicaid

Certification.

The agency can assess an administrative penalty against a person who:

● Violates Texas Health and Safety Code Chapter 242 or a rule, standard, or

order adopted, or license issued, under Texas Health and Safety Code Chapter

242.


material fact:

F-2


to the application.

With respect to a matter under investigation by the state regulatory

agency.


A book, record, or file required to be maintained by a facility.

Any portion of the premises of a facility.

● Willfully interferes with the work of a representative of the state agency or

the enforcement of this chapter.

● Willfully interferes with a representative of the state preserving evidence of a

violation of a rule, standard or order adopted, or license issued, under Texas

Health and Safety Code Chapter 242.

● Fails to pay a penalty assessed by the state under Texas Health and Safety

Code Chapter 242, by the 10th day after the date the assessment of the

penalty becomes final.

● Fails to notify the state regulatory agency of a change of ownership before

the effective date of the change of ownership.

No facility will be penalized because of a physician’s or consultant’s nonperformance

beyond the facility’s control or if documentation clearly indicates the violation is

beyond the facility’s control.

Imposed



review.

● Regional or state office regulatory staff, considering the survey or

investigation findings or evaluating the facility’s history and performance.


been reviewed and confirmed by state office staff. The facility is formally notified of

the administrative penalty citation, the penalty amount and the due date.

Additionally, the notice includes information about the appeal process available to

the facility.

Assessed



F-3

been decided, or the facility consents to the administrative penalty, fails to respond

to the state agency’s notice letter in a timely manner, or fails to correct the violation

to the state’s satisfaction. The facility is notified of the amount to be paid and the

date payment is due. A lump-sum payment or a monthly payment plan can be

agreed upon during the appeal or settlement process.

Injunctive/Other Relief and Civil Penalties

The long-term care regulatory agency refers injunctive/other relief and civil penalty

cases to the Office of the Attorney General for action. A civil penalty may be

awarded if a facility violates a licensing rule and the state survey agency

determines the violation threatens the health and safety of a resident. When a case

is resolved through settlement, a portion of the payment is designated a civil

penalty and normally deposited to general revenue. The Office of the Attorney

General collects attorney fees and costs for civil penalty cases.

One or more survey or investigative visits for a facility can be referred for civil

penalty. These multiple visits are generally consolidated into one case per facility for

referral.


In certain situations, the commissioner of the state agency can allow, in lieu of

demanding payment of an administrative penalty, the use (under the supervision of

the agency) of any portion of the penalty to ameliorate the violation or to improve


Trusteeships

The state regulatory agency, through the Office of the Attorney General, can

petition a court of competent jurisdiction for the involuntary appointment of a

trustee to operate a facility if one or more of the following conditions exist:





● An emergency exists that presents an immediate threat to the health and

safety of the residents.

● The facility is closing and arrangements for relocation of the residents to

other licensed institutions have not been made before closure.

F-4


The state can suspend a facility’s license or order an immediate closing of all or part

of the facility if:

● It finds the facility is operating in violation of licensure rules.


resident.


on the date the license holder receives a written notice or on a later date specified

in the order. This suspension of a license may occur simultaneously with any other

enforcement provision available to the state. The order is valid for 10 days.

Suspension of Admissions

If the state agency finds that a facility has committed an act for which a civil

penalty can be imposed under Texas Health and Safety Code §242.065, the

executive commissioner can order the facility to immediately suspend admissions.

Denial of License

The state can deny a facility’s license when the facility does not meet licensure

rules or when the facility does not have a satisfactory history of compliance with

state and federal nursing facility regulations.

It can deny a facility’s license if the applicant or controlling party:

● Does not have a satisfactory history of compliance.


application process.

● Has had a license revoked, has allowed a license to expire or surrendered a

license when revocation action was pending, has been debarred or excluded,

has an unsatisfied final judgment, has been decertified or evicted, has had a

license suspended, or has a criminal conviction.

● Violated Texas Health and Safety Code Chapter 242 or a rule, standard, or

order adopted, or license issued, under Texas Health and Safety Code

Chapter 242, in either a repeated or substantial manner, or aids, abets, or

permits a substantial violation of Texas Health and Safety Code Chapter 242.



§242.066(a)(2)-(6).

F-5

● Fails to comply with Texas Health and Safety Code §242.074.

● Fails to meet the minimum standards of financial condition.

● Fails to notify the state survey agency of a significant adverse change in

financial condition.

● Is subject to denial or refusal as described in Texas Administrative Code, Title

40, Part 1, Chapter 99, Denial or Refusal of License.


The state can revoke a license if the license holder (or other person described in

Texas Health and Safety Code §242.032(d)):

● Violated Texas Health and Safety Code Chapter 242 or a rule, standard, or

order adopted, or license issued, under Texas Health and Safety Code

Chapter 242, in either a repeated or substantial manner.


§242.066(a)(2)-(6).

● Failed to comply with Texas Health and Safety Code §242.074.

The revocation of a license can occur simultaneously with any other enforcement

provision available to the state.

Civil Money Penalties

To participate in the Medicare or Medicaid program, or both, long-term care

facilities must be certified as meeting federal participation requirements. Long-term

care facilities include skilled nursing facilities for Medicare and nursing facilities for

Medicaid. Among the remedies available to the secretary of the Centers for

Medicare and Medicaid Services (CMS) and the state under the Social Security Act

to address facility noncompliance is a civil money penalty (CMP). CMPs can be

imposed to remedy noncompliance at amounts not to exceed $20,965 per day. The

statute additionally permits the secretary and the state to impose a CMP for past

instances of noncompliance even if a facility is in compliance at the time of a current

survey. In accordance with Code of Federal Regulations, Title 42, Chapter IV,

Subchapter G, Part 488, Subpart F, Section 488.436, CMPs: waiver of hearing,

reduction of penalty amount, if the facility waives the right to a hearing, in writing,

within 60 days from the date of the notice imposing the civil money penalty, CMS or

the state reduces the civil money penalty amount by 35 percent.

Federal regulations allow for penalties to be imposed, in varying increments, in the

following amounts:

F-6

● $6,394 to $10,494 per day for deficiencies constituting immediate jeopardy

● $205 to $2,055 per day when immediate jeopardy does not exist, but the

violation either caused actual harm or caused no actual harm but has the

potential for more than minimal harm

CMS and the state regulatory agency can also impose penalties on a “per-instance”

basis of noncompliance; the penalties range between $10,000 to $20,000 per

instance.

In determining the amount of penalty, CMS or the state must take into account:

● The facility’s history of noncompliance, including repeated deficiencies

● The facility’s financial condition

● The factors specified in 42 CFR §488.404 (regarding the seriousness of the

deficiency)

● The facility’s degree of culpability

CMS can impose CMPs against Medicare or Medicare/Medicaid-certified nursing

facilities. The state can impose CMPs only against Medicaid-certified nursing facilities.

F-7

Nursing Facility Actions by Region for FY 2018



Administrative penalties (1)

Assessed 1 0 1 3 4 2 1 3 2 0 0 17


penalties (2)

Referred 0 0 0 0 0 0 0 0 0 0 0 0




Closures under trusteeship Accomplished 0 0 0 0 0 0 0 0 0 0 0 0

Emergency suspension and closing

orders

Ordered 0 0 0 0 0 0 0 0 0 0 0 0

Suspensions of admission Ordered 0 0 0 0 0 0 0 0 0 0 0 0

Denials of license (3)

Proposed 0 0 0 0 0 2 1 0 0 0 0 3

Denials of license (3)

Denied 0 0 0 0 0 0 0 0 0 0 0 0

Revocations of license (4)

Proposed 0 0 1 1 0 3 0 1 0 0 0 6

Revocations of license (4)

Revoked 0 0 0 0 0 0 0 0 0 0 0 0

Civil money penalties Imposed 14 37 82 79 9 86 34 24 16 15 20 416

Notes:


2. HHSC refers injunctive/other relief and civil penalties to the Office of the Attorney General.

3. HHSC may propose to deny renewal of a license for many reasons. However, if a facility has been cited for one or more violations of the

licensing rules and those violations have not been determined to have been corrected by the date the facility’s license is due for renewal,

F-8

HHSC may propose to deny the application. If the facility subsequently corrects the violation(s), HHSC may withdraw its proposal to deny

the application for license renewal. Denied actions may also include final actions on cases proposed in a previous fiscal year.

4. Revoked actions may include final actions on cases proposed in a previous fiscal year.

Nursing Facility Administrative Penalties for FY 2018


ID Facility

Visit Exit


03 - Arlington Carrollton 005122 Heritage Gardens

Rehabilitation and Healthcare

$15,210 $0 $9,887 N

03 - Arlington Cleburne 005185 Heritage Trails Nursing and

Rehabilitation Center

07/21/2017 $20,964 $0 $13,627 N

03 - Arlington Denton 101682 Senior Care at Denton Post

Acute Care

07/31/2017 $200,737 $0 $130,479 N

03 - Arlington Euless 005041 Legend Oaks Health and

Rehabilitation - Euless

07/27/2017 $115,855 $104,270 $104,270 $0 Y

03 - Arlington Gainesville 004335 Renaissance Care Center 06/29/2017 $7,152 $4,649 $0 N

03 - Arlington Granbury 005296 Granbury Rehab & Nursing $15,005 $0 $15,005 N

03 - Arlington Grapevine 005052 Woodridge Nursing &

Rehabilitation

07/27/2017 $27,218 $21,774 $21,774 $0 Y

03 - Arlington Irving 101460 Northgate Plaza Nursing &


05/26/2017 $40,322 $0 $40,322 N

03 - Arlington Rockwall 106108 Highland Meadows Health &

Rehab

02/17/2017 $1,493 $1,493 $0 N

04 - Tyler Athens 004009 Athens Healthcare and


04/27/2017 $73,500 $15,000 $15,000 $0 Y

04 - Tyler Jacksonville 004986 Gardendale Rehabilitation

and Nursing Center

07/03/2017 $70,280 $0 $70,280 N

04 - Tyler Jacksonville 004986 Gardendale Rehabilitation

and Nursing Center

10/23/2017 $248,000 $0 $248,000 Y

F-9


ID Facility

Visit Exit


04 - Tyler Sulphur

Springs

004740 Sulphur Springs Health and

Rehabilitation

02/22/2017 $4,000 $8,784 -$4,784

N

04 - Tyler Texarkana 005345 Heritage Plaza Nursing Center 06/28/2017 $6,962 $0 $6,962

N

04 - Tyler Texarkana 005346 Reunion Plaza Senior Care

and Rehabilitation Center

08/15/2017 $177,630 $0 $177,630 N

04 - Tyler Texarkana 101006 MSHC The Waterton at

Cowhorn Creek LLC

04/13/2018 $81,000 $0 $81,000 Y

05 -

Beaumont

Beaumont 103768 Summer Place Nursing &

Rehabilitation

10/20/2017 $460,000 $17,500 $17,500 $0 Y

05 -

Beaumont

Lufkin 101371 Castle Pines Health and

Rehabilitation

07/07/2017 $77,510 $50,382 $17,729 $35,458 Y

05 -

Beaumont

Port Arthur 004630 Senior Rehabilitation &

Skilled Nursing Center

$20,000 $0 $13,000 N

06 - Houston Baytown 005057 Focused Care at Allenbrook 08/16/2017 $175,000 $35,000 $35,000 $0 Y

06 - Houston Baytown 100001 Baytown Nursing & Rehab

Center

08/03/2017 $3,800 $3,800 $0 N

06 - Houston Conroe 004500 Conroe Health Care Center 05/15/2017 $306,733 $0 $210,478 N

06 - Houston Deer Park 004966 San Jacinto Manor 11/09/2017 $3,200 $0 $3,200 N

06 - Houston Houston 000184 The Vosswood Nursing Center 02/08/2018 $16,800 $16,800 $0 N

06 - Houston Houston 004371 Woodridge Nursing &

Rehabilitation

02/01/2018 $2,800 $2,800 $0 N


Rehabilitation

03/14/2018 $12,500 $12,500 $0 N

F-10


ID Facility

Visit Exit


06 - Houston Houston 004610 Brookhollow Heights

Transitional Care Center

02/23/2018 $9,600 $0 $9,600 N

06 - Houston Houston 004823 Jacinto Nursing &

Rehabilitation Center, LLC

04/06/2018 $17,400 $0 $17,400 N

06 - Houston Houston 004826 Winterhaven Healthcare

Residence

12/07/2017 $1,400 $0 $1,400 N

06 - Houston Houston 005056 Westchase Health and


03/16/2018 $29,400 $29,400 $0 N

06 - Houston Houston 005137 Northwest Health and


04/27/2018 $15,000 $15,000 $0 N

06 - Houston Houston 005316 Focused Care at Beechnut 06/16/2017 $1,400 $1,400 $0 N

06 - Houston Houston 005367 The Westbury Place $59,750 $0 $59,750 N

06 - Houston Houston 005367 The Westbury Place 05/25/2017 $85,412 $145,162 -$59,750 N

06 - Houston Houston 102294 Park Manor of Westchase 02/23/2018 $7,200 $0 $7,200 N

06 - Houston Houston 103626 Grace Care Center of Cypress 07/18/2017 $20,000 $0 $20,000 N

06 - Houston Houston 103626 Grace Care Center of Cypress 05/17/2017 $16,800 $16,800 $0 N

06 - Houston Katy 103520 Heritage Park of Katy Nursing

and Rehabilitation

01/19/2018 $9,000 $0 $9,000 N

06 - Houston The

Woodlands

104661 Park Manor of The Woodlands 05/18/2017 $3,000 $0 $0 N

06 - Houston The

Woodlands

104661 Park Manor of The Woodlands 12/29/2017 $2,400 $2,400 $0 N

06 - Houston Tomball 005135 Lawrence Street Health Care

Center

07/27/2017 $13,305 $0 $13,305 N

06 - Houston Tomball 104224 Grace Care Center at

Northpointe

02/02/2018 $4,800 $4,800 $0 N

F-11


ID Facility

Visit Exit


06 - Houston Tomball 105652 The Heights of Tomball 01/04/2018 $7,200 $0 $7,200 Y

06 - Houston Wharton 005227 Avalon Place Wharton 09/21/2017 $3,800 $3,800 $0 N

07 - Austin Austin 000230 Buckner Villa Siesta Home 12/14/2017 $1,500 $1,500 $0 N

07 - Austin Austin 004118 Retirement and Nursing

Center Austin

04/09/2018 $44,100 $0 $44,100 Y

07 - Austin Austin 004118 Retirement and Nursing

Center Austin

05/17/2018 $43,500 $0 $43,500 N

07 - Austin Austin 104663 Senior Care of Onion Creek 06/02/2017 $1,500 $1,500 $0 N

07 - Austin San Saba 106549 Shady Shores of San Saba 03/22/2018 $18,000 $0 $18,000 Y

08 - San

Antonio

Fredericksburg 004204 Tristar Care Center Inc 06/21/2017 $227,675 $0 $227,675 N

08 - San

Antonio

Poteet 004544 Poteet Manor 06/12/2017 $14,505 $9,428 $0 $9,428 Y

08 - San

Antonio

San Antonio 004579 Alamo Heights Health and


10/27/2017 $12,900 $12,900 $0 N

08 - San

Antonio

San Antonio 004754 Mesa Vista Inn Health Center 03/09/2018 $90,000 $0 $90,000 N

08 - San

Antonio

San Antonio 005109 Senior Care of Windcrest 02/16/2018 $90,000 $0 $90,000 N

08 - San

Antonio

San Antonio 104934 The Rio at Mission Trails 08/25/2017 $8,400 $8,400 $0 N

08 - San

Antonio

San Marcos 005265 Hays Nursing & Rehab Center 03/09/2018 $6,300 $6,300 $0 N

09 - Abilene Midland 004280 Hogan Park Nursing &

Rehabilitation

08/18/2017 $60,749 $60,749 $0 N

09 - Abilene Ozona 005064 Crockett County Care Center 03/02/2018 $20,965 $13,627 $0 N

F-12


ID Facility

Visit Exit


10 - El Paso El Paso 005086 Vista Hills Health Care Center 08/22/2017 $20,000 $13,000 $0 N

10 - El Paso Socorro 106362 Las Ventanas De Socorro $17,500 $0 $17,500 N

11 - Corpus

Christi

Hebbronville 005389 Meridian Care of Hebbronville $64,005 $0 $64,005 N

11 - Corpus

Christi

Laredo 004758 Retama Manor Nursing

Center/Laredo-West

06/28/2017 $318,729 $0 $213,151 N

11 - Corpus

Christi

McAllen 005341 Las Palmas Healthcare Center 09/28/2017 $4,200 $4,200 $0 N

11 - Corpus

Christi

Premont 004487 Premont Rehab and Nursing

Center

08/24/2017 $10,000 $0 $10,000 N

Totals $3,565,066 $253,354 $603,037

64 nursing facility administrative penalties imposed.

Notes:


amount. This is the amount due and payable if no alternative amount results from an appeal held or settlement agreement reached.


final amount has been decided, or the facility consents to the administrative penalty, fails to respond to the agency’s notice letter in a

timely manner, or fails to correct the violation to the agency’s satisfaction.

3. The collected column is the amount of money the facility has paid to the state.






indicates no hearing was requested by the facility.

F-13

Nursing Facility Injunctive/Other Relief and Civil Penalty Referrals to

the Office of the Attorney General for FY 2018

HHSC did not refer any nursing facilities for injunctive/other relief and civil penalty

referrals to the Office of the Attorney General in FY 2018.

Nursing Facility Amelioration of Violations for FY 2018


ID Facility Decision

Decision

Date

Amount

Ameliorated

01 -

Lubbock

Lubbock 004235 Southern Specialty

Rehab & Nursing

Approved 06/18/2018 $12,600

01 -

Lubbock

Slaton 004321 Slaton Care Center Approved

in Part

02/15/2018 $40,900

06 -

Houston

Houston 005383 Spring Branch

Transitional Care

Center

Denied 03/22/2018

06 -

Houston

La Marque 005379 Bayou Pines Care

Center

Approved

in Part

11/28/2017 $42,436

06 -

Houston

The

Woodlands

104661 Park Manor of the

Woodlands

Approved 01/30/2018 $3,000

08 - San

Antonio

Eagle Pass 102925 Maverick Nursing

and Rehabilitation

Center

Approved 01/19/2018 $9,096

6 Total nursing facility ameliorations processed.

Nursing Facility Trusteeships for FY 2018

HHSC did not order any trustees placed in nursing facilities in FY 2018.

Nursing Facility Closures Under Trusteeship for FY 2018

HHSC did not close any nursing facilities under trusteeship in FY 2018.

Nursing Facility Emergency Suspension and Closing Orders for FY

2018

HHSC did not issue any emergency suspension or closing orders to a nursing facility

in FY 2018.

F-14

Nursing Facility Suspensions of Admission for FY 2018

HHSC did not issue any suspension of admission orders to a nursing facility in FY

2018.

F-15

Nursing Facility License Denials and Revocations Proposed for FY 2018


ID Facility

Proposed

Action

Revoked

Date

Denied

Date Status

03 - Arlington Benbrook 004606 Benbrook Nursing & Rehabilitation

Center

Revoke Rescinded

04 - Tyler Jacksonville 004986 Gardendale Rehabilitation and Nursing

Center

Revoke Hearing

06 - Houston Friendswood 004286 Friendship Haven Healthcare and


Deny Rescinded

06 - Houston Houston 005403 Willowbrook Residence and


Revoke Rescinded

06 - Houston Rosenberg 005112 Rosenberg Health & Rehabilitation

Center

Revoke Rescinded

06 - Houston Sugar Land 106119 The Medical Resort at Sugar Land Revoke IR Letter

06 - Houston Texas City 105868 The Rio at Mainland Center Deny Rescinded

07 - Austin Madisonville 005342 Riverwood Healthcare Deny Hearing

08 - San Antonio Fredericksburg 004204 Tristar Care Center Inc Revoke Hearing

9 Total nursing facility license denials and revocations proposed.

Notes:



2. IR Letter - the facility has requested an informal review.


F-16

Nursing Facility Civil Money Penalties for FY 2018


ID Facility Visit Date Imposed Assessed

Balance

Due IA

01 - Lubbock Amarillo 004604 Georgia Manor Nursing Home 01/30/2018 $20,705 F

01 - Lubbock Amarillo 004348 Legacy Rehabilitation and Living 10/25/2017 $10,000 F

01 - Lubbock Amarillo 005231 Plum Creek Healthcare Residence 02/26/2018 $179,820 $116,883 F



01 - Lubbock Borger 105467 Caprock Nursing & Rehabilitation 01/11/2018 $21,090 F

01 - Lubbock Denver City 104320 Shinnery Oaks Community 05/25/2018 $10,000 F

01 - Lubbock Farwell 005093 Farwell Care and Rehabilitation

Center

11/16/2017 $8,500 F

01 - Lubbock Farwell 005093 Farwell Care and Rehabilitation

Center

11/16/2017 $8,500 F

01 - Lubbock Hale Center 004882 Hale Center Health and

Rehabilitation

06/06/2018 $10,000 $10,000 F

01 - Lubbock Lubbock 004072 Bender Terrace of Lubbock 03/21/2018 $15,805 F

01 - Lubbock Lubbock 004072 Bender Terrace of Lubbock 03/21/2018 $15,805 F

01 - Lubbock Lubbock 005338 Heritage Oaks Nursing and


06/24/2018 $20,965 F

01 - Lubbock Plainview 005328 Prairie House Living Center 06/28/2018 $15,000 F

02 - Abilene Abilene 106765 Brightpointe at Lytle Lake 05/26/2017 $13,805 $45,454 F

02 - Abilene Abilene 106765 Brightpointe at Lytle Lake 05/26/2017 $46,623 F

02 - Abilene Abilene 106765 Brightpointe at Lytle Lake 05/26/2017 $7,695 $7,695 F

02 - Abilene Abilene 005378 Mesa Springs Healthcare Center 08/21/2017 $40,160 F

02 - Abilene Abilene 005378 Mesa Springs Healthcare Center 08/21/2017 $47,796 F

F-17



Balance

Due IA

02 - Abilene Abilene 004681 Northern Oaks Living &


09/06/2017 $81,030 F

02 - Abilene Abilene 004681 Northern Oaks Living &


09/06/2017 $19,310 $80,272 F

02 - Abilene Abilene 106050 Silver Spring 10/02/2017 $58,985 $29,493 $29,493 F

02 - Abilene Abilene 106050 Silver Spring 10/02/2017 $118,590 $59,295 $53,053 F

02 - Abilene Abilene 005033 The Oaks at Radford Hills 04/17/2018 $106,020 F

02 - Abilene Abilene 004205 Willow Springs Health &


11/01/2017 $10,805 F

02 - Abilene Abilene 004205 Willow Springs Health &


12/12/2017 $16,505 F

02 - Abilene Ballinger 004445 Ballinger Healthcare and


11/18/2017 $13,635 F

02 - Abilene Ballinger 004445 Ballinger Healthcare and


11/18/2017 $25,576 F

02 - Abilene Brownwood 004881 Brownwood Nursing and

Rehabilitation LP

05/03/2018 $10,000 F

02 - Abilene Brownwood 004881 Brownwood Nursing and

Rehabilitation LP

05/03/2018 $10,965 F

02 - Abilene Brownwood 005309 Songbird Lodge 09/22/2017 $11,005 F

02 - Abilene Cisco 004250 Cisco Nursing & Rehabilitation 05/10/2018 $35,340 $22,971 F

02 - Abilene Cisco 004250 Cisco Nursing & Rehabilitation 06/12/2018 $1,515 $985 F

02 - Abilene Cisco 004250 Cisco Nursing & Rehabilitation 06/12/2018 $76,728 $49,873 F

02 - Abilene Comanche 004230 Western Hills Healthcare

Residence

01/29/2018 $3,765 $3,765 F

F-18



Balance

Due IA


Residence

01/29/2018 $203,133 $207,595 F


Residence

02/01/2018 $4,620 $4,620 F

02 - Abilene Eastland 004933 Eastland Nursing & Rehabilitation 02/14/2018 $10,480 $6,812 F

02 - Abilene Eastland 004933 Eastland Nursing & Rehabilitation 02/14/2018 $10,480 $6,996 F

02 - Abilene Hamlin 004399 Homeplace Manor 11/06/2017 $18,000 F




02 - Abilene Nocona 004817 Grace Care Center of Nocona 10/31/2017 $12,005 F

02 - Abilene Ranger 004253 Ranger Care Center 11/07/2017 $12,500 F

02 - Abilene Ranger 004253 Ranger Care Center 11/07/2017 $8,400 F

02 - Abilene Snyder 005133 Snyder Oaks Care Center 06/11/2018 $77,724 F

02 - Abilene Snyder 005133 Snyder Oaks Care Center 06/11/2018 $84,085 F

02 - Abilene Vernon 004345 Advanced Rehabilitation and

Healthcare of Vernon

03/14/2018 $10,805 $7,023 $7,023 F

02 - Abilene Wichita Falls 005155 Midwestern Healthcare Center 05/29/2018 $13,500 $13,500 F

02 - Abilene Winters 004358 Winters Healthcare Residence 07/20/2018 $10,000 $10,000 F

03 - Arlington Arlington 004239 Arlington Villa Retirement

Community

04/19/2018 $20,965 F

03 - Arlington Azle 004984 Azle Manor Health Care and

Rehabilitation

02/13/2018 $10,000 F

03 - Arlington Balch Springs 005105 Balch Springs Nursing Home 03/13/2018 $11,005 F

03 - Arlington Bedford 000268 Parkwood Healthcare Community 11/30/2017 $1,010 $1,010 F

F-19



Balance

Due IA

03 - Arlington Bedford 000268 Parkwood Healthcare Community 11/30/2017 $156,588 $156,588 F


Center

08/04/2017 $16,000 $16,000 F


Center

03/09/2018 $20,000 $20,000 F

03 - Arlington Carrollton 005122 Heritage Gardens Rehabilitation

and Healthcare

07/12/2017 $15,210 F

03 - Arlington Carrollton 005122 Heritage Gardens Rehabilitation

and Healthcare

04/28/2018 $11,000 F

03 - Arlington Carrollton 102861 The Madison on Marsh 09/28/2017 $10,605 F



07/21/2017 $10,482 F



07/21/2017 $10,482 F

03 - Arlington Corinth 105150 Corinth Rehabilitation Suites on

The Parkway

02/10/2018 $23,735 F


The Parkway

02/10/2018 $9,699 F


The Parkway

04/13/2018 $77,020 F

03 - Arlington Dallas 105408 Remarkable Healthcare of Dallas,

LP

12/08/2017 $138,320 $138,320 F


LP

01/18/2018 $4,095 $4,095 F


LP

07/16/2018 $23,708 $23,708 F

F-20



Balance

Due IA


LP

07/16/2018 $57,575 $57,575 F

03 - Arlington Dallas 005054 Senior Care Health and

Rehabilitation Center - Dallas

07/07/2017 $8,649 F

03 - Arlington Dallas 004755 Skyline Nursing Center 06/05/2018 $13,500 $13,500 F

03 - Arlington Dallas 004432 The Lennwood Nursing and

Rehabilitation

03/12/2018 $34,512 $7,433 F

03 - Arlington Dallas 004432 The Lennwood Nursing and

Rehabilitation

03/12/2018 $11,025 $7,166 F

03 - Arlington Decatur 004945 The Hills Nursing & Rehabilitation 01/05/2018 $12,500 F

03 - Arlington Denison 004344 Beacon Hill 06/29/2017 $12,005 F

03 - Arlington Ennis 104339 Legend Oaks Healthcare and

Rehabilitation - Ennis

05/17/2018 $11,000 F

03 - Arlington Fort Worth 005018 Arlington Heights Health and


02/07/2018 $10,000 F

03 - Arlington Fort Worth 005018 Arlington Heights Health and


02/07/2018 $10,000 F

03 - Arlington Fort Worth 005121 Estates Healthcare and


02/03/2018 $176,953 F

03 - Arlington Fort Worth 005121 Estates Healthcare and


02/03/2018 $9,595 F

03 - Arlington Fort Worth 005197 Ft Worth Southwest Nursing

Center

02/03/2018 $32,630 $21,536 $21,536 F


Center

02/03/2018 $232,029 $153,139 $164,191 F


Center

03/09/2018 $32,320 $21,331 $21,331 F

F-21



Balance

Due IA

03 - Arlington Fort Worth 102497 Kindred Transitional Care and

Rehabilitation-Ridgmar

04/20/2018 $10,000 $6,500 F

03 - Arlington Fort Worth 005388 Marine Creek Nursing and

Rehabilitation LP

04/12/2018 $10,605 $6,893 $6,893 F

03 - Arlington Fort Worth 104767 Remarkable Healthcare of Fort

Worth

11/29/2017 $7,500 $7,500 F


Worth

11/29/2017 $7,500 $7,500 F


Worth

06/01/2018 $17,000 $17,000 F

03 - Arlington Fort Worth 004980 Trinity Healthcare Residence 07/30/2018 $810 $810 F

03 - Arlington Fort Worth 004980 Trinity Healthcare Residence 07/30/2018 F

03 - Arlington Fort Worth 004980 Trinity Healthcare Residence 07/30/2018 $52,816 $52,816 F

03 - Arlington Fort Worth 004980 Trinity Healthcare Residence 07/30/2018 $52,470 $52,470 F

03 - Arlington Granbury 005296 Granbury Rehab & Nursing 09/15/2017 $15,005 F

03 - Arlington Irving 101460 Northgate Plaza Nursing &


05/26/2017 $20,965 $13,627 F

03 - Arlington Lake Worth 005038 Lake Worth Nursing Home 05/17/2018 $47,245 $47,245 F

03 - Arlington Lake Worth 005038 Lake Worth Nursing Home 05/17/2018 $2,205 $2,205 F

03 - Arlington Lancaster 005115 Lancaster Nursing & Rehabilitation

Center

08/23/2017 $20,965 F

03 - Arlington Leonard 004448 Leonard Manor Nursing and

Rehabilitation LP

11/14/2017 $5,205 F

03 - Arlington Lewisville 102004 Vista Ridge Nursing &


10/27/2017 $10,805 F

F-22



Balance

Due IA

03 - Arlington Mansfield 102788 Kindred Transitional Care and

Rehabilitation-Mansfield

03/06/2018 $14,805 $9,623 F

03 - Arlington McKinney 004589 North Park Health and


09/29/2017 $1,255 F

03 - Arlington McKinney 004589 North Park Health and


09/29/2017 $236,578 F

03 - Arlington Mesquite 004971 Christian Care Center 08/12/2017 $108,698 $108,698 F



03 - Arlington Mesquite 105263 Edgewood Rehabilitation and Care

Center

02/02/2018 $17,000 F


Center

02/02/2018 $17,000 F


Center

02/02/2018 $17,000 F

03 - Arlington Mesquite 106781 Palomino Place 04/25/2018 $8,899 F

03 - Arlington Mesquite 106781 Palomino Place 05/31/2018 $53,025 F

03 - Arlington Mineral Wells 004735 Palo Pinto Nursing Center 09/30/2017 $82,720 $82,720 F

03 - Arlington Mineral Wells 004735 Palo Pinto Nursing Center 09/30/2017 $12,249 $12,249 F

03 - Arlington North Richland

Hills

102789 Emerald Hills Rehabilitation and

Healthcare Center

12/01/2017 $47,690 $30,999 $30,999 F


Hills

102789 Emerald Hills Rehabilitation and

Healthcare Center

12/01/2017 $1,700,804 $1,105,523 $1,169,607 F


Hills

004741 Manorcare Health Services 01/20/2018 $31,375 F

F-23



Balance

Due IA


Hills

004741 Manorcare Health Services 01/20/2018 $83,952 F

03 - Arlington Richardson 104410 San Remo 07/27/2018 $29,097 $29,097 F

03 - Arlington Richardson 104410 San Remo 07/27/2018 F

03 - Arlington Royse City 103804 Royse City Medical Lodge 10/19/2017 $10,605 F

03 - Arlington Sherman 004864 Focused Care at Sherman 05/08/2018 $19,505 $19,505 F

03 - Arlington Sherman 004346 Texoma Healthcare Center 09/26/2017 $20,965 F

03 - Arlington Stephenville 004962 Mulberry Manor 02/26/2018 $57,590 $37,434 F

03 - Arlington Watauga 004240 North Pointe Nursing and

Rehabilitation LP

11/04/2017 $20,005 F


Rehabilitation LP

11/04/2017 $20,005 F


Rehabilitation LP

11/04/2017 $20,005 F


Rehabilitation LP

11/04/2017 $20,005 F


Rehabilitation LP

11/04/2017 $20,005 F


Rehabilitation LP

03/30/2018 $13,500 F

03 - Arlington Weatherford 103708 College Park Rehabilitation and

Care Center

04/11/2018 $36,012 $36,012 F

03 - Arlington Weatherford 103708 College Park Rehabilitation and

Care Center

04/11/2018 $17,170 $17,170 F

03 - Arlington Whitesboro 004209 Whitesboro Health and


11/14/2017 $17,000 F

F-24



Balance

Due IA

03 - Arlington Whitesboro 004209 Whitesboro Health and


11/14/2017 $17,000 F



08/22/2017 $35,700 F



04/13/2018 $35,840 $1,314 F

04 - Tyler Elkhart 005034 Elkhart Oaks Care Center 10/11/2017 $84,255 F

04 - Tyler Elkhart 005034 Elkhart Oaks Care Center 10/11/2017 $81,545 F

04 - Tyler Emory 005184 Senior Suite Care & Rehab LLC 09/27/2017 $13,215 $4,295 F

04 - Tyler Gilmer 005293 Focused Care of Gilmer 04/05/2018 $10,000 $6,600 $6,600 F



04 - Tyler Gilmer 004470 Gilmer Nursing and Rehabilitation

LP

03/15/2018 $20,000 F

04 - Tyler Gilmer 004470 Gilmer Nursing and Rehabilitation

LP

03/15/2018 $20,965 F

04 - Tyler Henderson 004555 Henderson Health & Rehabilitation

Center

01/11/2018 $5,000 $5,000 F

04 - Tyler Henderson 004555 Henderson Health & Rehabilitation

Center

01/12/2018 $16,505 $16,505 F

04 - Tyler Jacksonville 005275 Bonner Street Plaza Healthcare &

Rehabilitation

06/27/2017 $6,405 F

04 - Tyler Jacksonville 005275 Bonner Street Plaza Healthcare &

Rehabilitation

06/27/2017 $6,405 F

04 - Tyler Jacksonville 004986 Gardendale Rehabilitation and

Nursing Center

07/03/2017 $83,724 $35,380 $44,065 F

F-25



Balance

Due IA


Nursing Center

07/03/2017 $70,280 $29,699 $29,699 F


Nursing Center

09/21/2017 $28,600 $22,880 $22,880 F


Nursing Center

09/21/2017 $326,400 $261,120 $341,134 F


Nursing Center

10/23/2017 $394,400 $315,520 $315,520 F

04 - Tyler Jacksonville 004369 Jacksonville Healthcare Center 10/25/2017 $6,000 F

04 - Tyler Jacksonville 004369 Jacksonville Healthcare Center 10/25/2017 $6,000 F

04 - Tyler Jacksonville 102529 Senior Care of Jacksonville 11/08/2017 $14,505 F

04 - Tyler Jefferson 005288 Magnolia Place 06/07/2018 $7,905 $7,905 F

04 - Tyler Jefferson 005288 Magnolia Place 06/07/2018 $18,405 $18,405 F

04 - Tyler Kilgore 004515 Kilgore Health & Rehabilitation 11/30/2017 $11,415 $11,415 F

04 - Tyler Kilgore 101801 Willow Rehab & Nursing 08/01/2018 $20,965 $20,965 F

04 - Tyler Lindale 005213 Colonial Nursing & Rehabilitation

Center

12/01/2017 $11,000 $7,150 F


Center

12/22/2017 $20,965 $13,627 $14,351 F


Center

12/22/2017 $5,000 $3,250 $2,150 F

04 - Tyler Longview 005015 Havencare Nursing and

Rehabilitation Center LLC

02/23/2018 $11,605 F

04 - Tyler Longview 005015 Havencare Nursing and

Rehabilitation Center LLC

04/05/2018 $15,805 F

F-26



Balance

Due IA

04 - Tyler Longview 005129 Heritage at Longview Healthcare

Center

05/11/2018 $10,000 F

04 - Tyler Longview 004160 Highland Pines Nursing Home 10/23/2017 $11,210 $7,287 F



04 - Tyler Longview 005374 Whispering Pines Lodge 05/18/2018 $20,965 F

04 - Tyler Marshall 103421 Heritage House of Marshall Health

& Rehabilitation

04/27/2018 $29,760 F

04 - Tyler Mineola 004396 Wood Memorial Nursing and


05/25/2018 $9,504 $9,504 F

04 - Tyler Mineola 004396 Wood Memorial Nursing and


05/25/2018 $45,955 $45,955 F

04 - Tyler Mount Pleasant 005192 Pleasant Springs Healthcare

Center

02/15/2018 $11,605 F

04 - Tyler Mount Pleasant 005192 Pleasant Springs Healthcare

Center

06/01/2018 $20,965 F

04 - Tyler Mount Vernon 004659 Mission Manor Healthcare

Residence

09/22/2017 $148,980 $96,837 F


Residence

11/16/2017 $20,965 $13,627 F


Residence

11/16/2017 $20,965 $13,627 F


Residence

11/16/2017 $20,965 $16,701 F


Residence

11/16/2017 $20,965 $13,627 F

04 - Tyler New Boston 004185 Inspire New Boston 04/26/2018 $20,965 $20,965 F

F-27



Balance

Due IA






04 - Tyler Paris 004958 Brentwood Terrace Healthcare

and Rehabilitation

12/14/2017 $20,965 F

04 - Tyler Paris 004586 Paris Healthcare Center 08/24/2017 $6,300 F

04 - Tyler Paris 004586 Paris Healthcare Center 08/24/2017 $51,840 F

04 - Tyler Pittsburg 004749 Pittsburg Nursing Center 06/07/2018 $8,585 $8,585 F

04 - Tyler Pittsburg 004749 Pittsburg Nursing Center 06/07/2018 $163,264 $163,264 F

04 - Tyler Rusk 004304 Cherokee Trails Nursing Home 09/08/2017 $59,085 F

04 - Tyler Rusk 005238 The Arbors Healthcare and


08/17/2017 $23,845 F



08/17/2017 $128,010 $80,519 F



08/17/2017 $27,508 F

04 - Tyler Sulphur

Springs

103979 Rock Creek Health and

Rehabilitation LLC

03/23/2018 $13,305 F

04 - Tyler Sulphur

Springs

004740 Sulphur Springs Health and

Rehabilitation

06/20/2018 $13,305 F

04 - Tyler Sulphur

Springs

005060 Sunny Springs Nursing & Rehab 09/19/2017 $6,605 F

04 - Tyler Texarkana 005345 Heritage Plaza Nursing Center 06/28/2017 $20,965 F

F-28



Balance

Due IA

04 - Tyler Texarkana 101006 MSHC The Waterton at Cowhorn

Creek LLC

04/13/2018 $42,670 $42,670 F


Creek LLC

04/13/2018 $91,343 $91,343 F


Creek LLC

06/12/2018 $12,500 F

04 - Tyler Texarkana 005346 Reunion Plaza Senior Care and


08/15/2017 $177,630 $106,148 $56,178 F



10/26/2017 $143,136 $143,136 F



10/26/2017 $79,065 $79,065 F

04 - Tyler Tyler 005390 Park Place Nursing &


06/14/2018 $10,805 F

04 - Tyler Tyler 005181 Pinecrest Nursing & Rehabilitation

Center

10/06/2017 $77,010 $77,010 F


Center

10/06/2017 $96,024 $96,024 F


Center

02/07/2018 $3,840 F

04 - Tyler Tyler 104599 The Heights of Tyler 07/17/2018 $15,805 $15,805 F

04 - Tyler Tyler 103323 The Waterton Healthcare &

Rehabilitation

06/06/2018 $20,505 $13,328 F

04 - Tyler Wills Point 004777 Free State Crestwood 05/02/2018 $14,140 F

04 - Tyler Wills Point 004777 Free State Crestwood 05/02/2018 $19,818 F

05 - Beaumont Beaumont 004472 Spring Creek Nursing and

Rehabilitation LP

01/25/2018 $47,770 F

F-29



Balance

Due IA

05 - Beaumont Beaumont 103768 Summer Place Nursing &

Rehabilitation

10/20/2017 $20,505 $13,328 F

05 - Beaumont Crockett 005125 Winfield Rehab & Nursing 01/11/2018 $8,999 $6,299 F

05 - Beaumont Crockett 005125 Winfield Rehab & Nursing 01/11/2018 $93,465 $65,426 F

05 - Beaumont Huntington 103330 Huntington Health Care &


10/18/2017 $10,841 F

05 - Beaumont Kirbyville 005201 Avalon Place Kirbyville 07/25/2018 $10,805 $7,023 F

05 - Beaumont Orange 102551 The Meadows of Orange 09/25/2017 $10,805 F

05 - Beaumont Silsbee 005340 Pine Arbor 09/26/2017 $83,700 F

05 - Beaumont Silsbee 005083 Silsbee Oaks Health Care LLP 09/28/2017 $10,805 F

06 - Houston Baytown 100001 Baytown Nursing & Rehab Center 06/06/2018 $14,505 F

06 - Houston Baytown 103620 Cedar Bayou Nursing & Rehab

Center

05/01/2018 $2,310 F

06 - Houston Baytown 103620 Cedar Bayou Nursing & Rehab

Center

05/01/2018 $233,120 F

06 - Houston Baytown 005057 Focused Care at Allenbrook 08/16/2017 $72,790 $72,790 F

06 - Houston Baytown 005057 Focused Care at Allenbrook 08/16/2017 $77,994 $80,662 F

06 - Houston Houston 004774 Afton Oaks Nursing Center 08/22/2017 $59,245 F

06 - Houston Houston 004774 Afton Oaks Nursing Center 08/22/2017 $26,355 F

06 - Houston Houston 004611 Briarwood Nursing &

Rehabilitation

06/19/2018 $42,220 F

06 - Houston Houston 004611 Briarwood Nursing &

Rehabilitation

06/19/2018 $5,265 F

06 - Houston Houston 004446 Galleria Residence and


07/05/2018 $43,796 $43,796 F

F-30



Balance

Due IA

06 - Houston Houston 004446 Galleria Residence and


07/05/2018 $5,565 $5,565 F

06 - Houston Houston 104360 Grace Care Center at Veterans

Memorial

09/20/2017 $2,097 $1,625 F

06 - Houston Houston 103626 Grace Care Center of Cypress 07/18/2017 $10,000 F




06 - Houston Houston 103626 Grace Care Center of Cypress 07/26/2018 $13,305 $8,648 F

06 - Houston Houston 004062 Highland Park Care Center 07/19/2018 $10,805 $7,023 F

06 - Houston Houston 004823 Jacinto Nursing & Rehabilitation

Center, LLC

05/10/2018 $20,965 F

06 - Houston Houston 104200 Legend Oaks Healthcare and

Rehabilitation -

North/Willowbrooke

01/12/2018 $17,005 F


Rehabilitation -

North/Willowbrooke

01/12/2018 $17,005 F


Rehabilitation -

North/Willowbrooke

04/24/2018 $20,965 F


Rehabilitation -

North/Willowbrooke

04/24/2018 $20,965 F



10/14/2017 $295,623 F

F-31



Balance

Due IA



10/14/2017 $7,530 F

06 - Houston Houston 101489 Park Manor of Cypress Station 08/23/2017 $10,850 F

06 - Houston Houston 005400 Park Manor of South Belt 04/10/2018 $13,305 F

06 - Houston Houston 106120 Pathways Memory Care at Villa

Toscana

03/22/2018 $10,000 F

06 - Houston Houston 000191 Royal Oaks Residence and


05/21/2018 $20,965 F

06 - Houston Houston 004000 Seven Acres Jewish Senior Care

Services, Inc

03/28/2018 $13,305 F

06 - Houston Houston 105634 Silverado Hermann Park 05/04/2018 $18,498 $12,024 $12,024 F



06 - Houston Houston 000217 The Forum at Memorial Woods

Healthcare Center

07/25/2018 $21,715 $14,115 F

06 - Houston Houston 000217 The Forum at Memorial Woods

Healthcare Center

07/25/2018 $19,208 $12,485 F

06 - Houston Houston 005367 The Westbury Place 05/25/2017 $43,925 F





06 - Houston Houston 103799 Villa Toscana at Cypress Woods 12/21/2017 $13,505 $13,505 F



F-32



Balance

Due IA



02/09/2018 $37,647 $24,471 F



02/09/2018 $9,780 $6,357 F



03/23/2018 $29,565 $29,565 F



04/27/2018 $17,170 $17,170 F



06/12/2018 $4,800 $4,800 F


Rehabilitation

02/21/2018 $10,805 F


Rehabilitation

03/14/2018 $11,805 F

06 - Houston Humble 104541 Deerbrook Skilled Nursing and

Rehab Center

09/29/2017 $20,000 F


Rehab Center

11/02/2017 $20,000 F


Rehab Center

11/02/2017 $20,000 F

06 - Houston Humble 005208 Oakmont Healthcare and

Rehabilitation Center of Humble

06/14/2018 $128,010 $83,207 F

06 - Houston Humble 005208 Oakmont Healthcare and

Rehabilitation Center of Humble

06/14/2018 $36,012 F

06 - Houston Huntsville 004943 Focused Care at Huntsville 01/04/2018 $20,965 $23,329 F

06 - Houston Huntsville 004943 Focused Care at Huntsville 01/04/2018 $20,965 $20,965 F

06 - Houston Huntsville 005190 MRC Creekside 02/01/2018 $12,005 F

F-33



Balance

Due IA

06 - Houston Huntsville 005190 MRC Creekside 02/01/2018 $5,000 F

06 - Houston Katy 103520 Heritage Park of Katy Nursing and

Rehabilitation

09/21/2017 $10,405 F

06 - Houston Katy 103520 Heritage Park of Katy Nursing and

Rehabilitation

04/20/2018 $15,805 $10,397 F

06 - Houston Katy 005196 Oakmont Healthcare and

Rehabilitation Center of Katy

09/26/2017 $13,305 F

06 - Houston Katy 106784 Sterling Oaks Rehabilitation 03/02/2018 $11,205 $11,205 F

06 - Houston La Porte 004145 LaPorte Healthcare Center 04/10/2018 $194,987 F




06 - Houston Missouri City 105225 Chelsea Gardens 06/10/2017 $20,000 $20,000 F



06 - Houston Missouri City 105892 Windsor Quail Valley Post-Acute

Healthcare

10/13/2017 $10,484 F

06 - Houston Pasadena 103086 The Courtyards at Pasadena 03/01/2018 $10,905 F

06 - Houston Pasadena 105427 The Medical Resort at Bay Area 02/08/2018 $11,005 F


Center

01/12/2018 $174,286 $113,286 $113,286 F


Center

01/12/2018 $56,475 $36,709 $36,709 F

06 - Houston Sugar Land 106119 The Medical Resort at Sugar Land 03/06/2018 $21,715 $21,715 F


F-34



Balance

Due IA



06 - Houston Texas City 005368 Oceanview Healthcare and

Rehabilitation

07/15/2018 $23,908 $23,908 F

06 - Houston Texas City 005368 Oceanview Healthcare and

Rehabilitation

07/15/2018 $15,060 $15,060 F

06 - Houston The Woodlands 105818 The Broadmoor at Creekside Park 07/19/2018 $12,005 $7,803 F

06 - Houston Tomball 104224 Grace Care Center at Northpointe 07/31/2018 $13,305 F


Center

07/27/2017 $13,305 F


Center

05/21/2018 $14,505 F

06 - Houston Wharton 004115 Wharton Nursing and


06/05/2018 $15,805 $15,805 F

07 - Austin Austin 005261 Gracy Woods Nursing Center 10/12/2017 $5,000 F



07 - Austin Austin 104003 Legend Oaks Healthcare and

Rehabilitation – North Austin

08/03/2017 $208,640 F

07 - Austin Belton 005235 Park Place Manor Inc 11/15/2017 $17,305 $10,482 F

07 - Austin Bremond 005161 Bremond Nursing and


02/08/2018 $19,105 F

07 - Austin Bryan 101864 Lampstand Nursing and

Rehabilitation LP

11/18/2017 $33,885 F


Rehabilitation LP

11/18/2017 $45,312 F

F-35



Balance

Due IA


Rehabilitation LP

07/30/2018 $11,605 F

07 - Austin Caldwell 103889 Copperas Hollow Nursing &


06/07/2018 $2,100 $2,100 F

07 - Austin Caldwell 103889 Copperas Hollow Nursing &


06/07/2018 $59,940 $59,940 F

07 - Austin Centerville 004907 Centerville Healthcare Center 09/22/2017 $8,000 F

07 - Austin Copperas Cove 004037 Hill Country Rehab and Nursing

Center

07/19/2018 $19,695 $19,695 F

07 - Austin Copperas Cove 004037 Hill Country Rehab and Nursing

Center

07/19/2018 $489,445 $489,445 F

07 - Austin Georgetown 104710 Estrella Oaks Rehabilitation and

Care Center

04/12/2018 $18,005 F

07 - Austin Georgetown 104710 Estrella Oaks Rehabilitation and

Care Center

04/12/2018 $18,005 F

07 - Austin Harker Heights 000232 Indian Oaks Living Center 11/03/2017 $10,805 F

07 - Austin Lampasas 004906 Regal Healthcare Residence 02/23/2018 $10,482 $10,482 F

07 - Austin Lampasas 004906 Regal Healthcare Residence 02/23/2018 $10,482 $10,482 F

07 - Austin Madisonville 004314 Madisonville Care Center 12/13/2017 $10,000 F

07 - Austin San Saba 106549 San Saba Rehabilitation LP 03/22/2018 $10,000 F

07 - Austin San Saba 106549 San Saba Rehabilitation LP 03/22/2018 $10,000 F

07 - Austin Temple 005132 Senior Care of Marlandwood East 11/05/2017 $18,905 $12,288 F

07 - Austin Temple 005132 Senior Care of Marlandwood East 11/05/2017 $18,905 $12,288 F

07 - Austin Temple 005268 Senior Care of Western Hills 10/30/2017 $2,020 $1,212 F

07 - Austin Temple 005268 Senior Care of Western Hills 10/30/2017 $159,850 $95,910 F

F-36



Balance

Due IA

07 - Austin Temple 004260 Wellington Rehabilitation and

Healthcare

10/13/2017 $10,000 F

07 - Austin Temple 004260 Wellington Rehabilitation and

Healthcare

10/13/2017 $10,000 F

07 - Austin Valley Mills 004824 Valley Mills Nursing and

Rehabilitation LP

09/21/2017 $5,500 F

07 - Austin Valley Mills 004824 Valley Mills Nursing and

Rehabilitation LP

09/21/2017 $5,500 F

07 - Austin Whitney 004809 Town Hall Estates Whitney Inc 10/19/2017 $20,965 $10,059 F




08 - San

Antonio

Boerne 004736 Town and Country Manor 11/10/2017 $13,305 F

08 - San

Antonio

Fredericksburg 004204 Tristar Care Center Inc 06/21/2017 $21,715 $21,715 F

08 - San

Antonio


08 - San

Antonio


08 - San

Antonio


08 - San

Antonio

Ganado 004883 Ganado Nursing and


10/14/2017 $6,752 F

08 - San

Antonio

Ganado 004883 Ganado Nursing and


10/14/2017 $6,752 F

F-37



Balance

Due IA

08 - San

Antonio

Lytle 004149 Lytle Nursing Home 04/05/2018 $1,515 $985 $985 F

08 - San

Antonio

Lytle 004149 Lytle Nursing Home 04/05/2018 $48,872 $31,767 $32,752 F

08 - San

Antonio

New Braunfels 004533 Colonial Manor Care Center 11/03/2017 $59,108 F

08 - San

Antonio


08 - San

Antonio


08 - San

Antonio


08 - San

Antonio

San Antonio 005254 Heartland of San Antonio 08/17/2017 $11,745 F

08 - San

Antonio

San Antonio 005254 Heartland of San Antonio 08/17/2017 $27,998 F

08 - San

Antonio

San Antonio 102734 Legend Oaks Healthcare and

Rehabilitation Center – San

Antonio

06/16/2017 $12,500 F

08 - San

Antonio

San Antonio 005058 Meridian Care at Grayson Square 11/20/2017 $105,000 $56,636 $22,629 F

08 - San

Antonio

San Antonio 005058 Meridian Care at Grayson Square 11/20/2017 $74,045 $39,939 $45,385 F

08 - San

Antonio

San Antonio 004754 Mesa Vista Inn Health Center 10/31/2017 $66,515 F

08 - San

Antonio

San Antonio 004754 Mesa Vista Inn Health Center 10/31/2017 $76,643 F

F-38



Balance

Due IA

08 - San

Antonio

San Antonio 101669 Mystic Park Nursing & Rehab

Center

11/21/2017 $12,625 F

08 - San

Antonio

San Antonio 101669 Mystic Park Nursing & Rehab

Center

11/21/2017 $272,571 F

08 - San

Antonio

San Antonio 005233 Sunrise Nursing & Rehab Center 09/18/2017 $13,305 F

08 - San

Antonio

San Antonio 105220 Trisun Care Center - Lakeside 12/16/2017 $11,205 F

09 - Abilene Crane 004272 Crane Nursing & Rehabilitation

Center

09/22/2017 $23,845 F

09 - Abilene Crane 004272 Crane Nursing & Rehabilitation

Center

09/22/2017 $76,643 F

09 - Abilene Junction 004838 Hill Country Care Center 06/27/2018 $20,965 $13,627 F


Rehabilitation

08/18/2017 $47,690 F


Rehabilitation

08/18/2017 $13,059 F


Rehabilitation

01/17/2018 $2,525 $1,641 F


Rehabilitation

01/17/2018 $90,000 $63,498 F

09 - Abilene Midland 103255 Senior Care of Midland 04/16/2018 $20,965 $21,230 F

09 - Abilene Midland 005136 Terrace West Nursing and

Rehabilitation LP

12/15/2017 $26,260 F


Rehabilitation LP

12/15/2017 $16,665 F

F-39



Balance

Due IA


Rehabilitation LP

12/15/2017 $40,618 F


Rehabilitation LP

12/15/2017 $40,618 F

09 - Abilene Odessa 004351 Buena Vida Nursing and Rehab

Odessa

12/22/2017 $20,965 F

09 - Abilene Ozona 005064 Crockett County Care Center 03/02/2018 $20,965 S

09 - Abilene San Angelo 004815 Arbor Terrace Healthcare Center 08/06/2018 $20,505 $20,505 F

09 - Abilene San Angelo 000170 Senior Care of Meadow Creek 07/27/2018 $20,505 $20,505 F

10 - El Paso El Paso 102314 Ambrosio Guillen Texas State

Veterans Home

07/30/2018 $5,555 $3,611 F

10 - El Paso El Paso 102314 Ambrosio Guillen Texas State

Veterans Home

07/30/2018 $37,062 $24,090 F

10 - El Paso El Paso 004619 Oasis Nursing & Rehabilitation

Center

07/31/2017 $20,500 F


Center

11/16/2017 $5,405 F


Center

11/16/2017 $15,815 F


Center

11/16/2017 $5,405 F

10 - El Paso El Paso 005404 Regent Care Center of El Paso 08/14/2017 $242,592 $39,303 $16,944 F

10 - El Paso El Paso 005404 Regent Care Center of El Paso 08/14/2017 $4,305 $697 $697 F

10 - El Paso El Paso 105607 St. Teresa Nursing and


03/15/2018 $13,305 F

10 - El Paso El Paso 106895 Vibralife of El Paso Rehabilitation

Center

07/23/2018 $12,005 F

F-40



Balance

Due IA

10 - El Paso El Paso 005086 Vista Hills Health Care Center 08/22/2017 $10,000 F

10 - El Paso El Paso 005086 Vista Hills Health Care Center 08/22/2017 $10,000 F

10 - El Paso Socorro 106362 Las Ventanas De Socorro 08/23/2017 $17,500 F



11 - Corpus

Christi

Corpus Christi 004567 Retama Manor Nursing Center 09/28/2017 $78,324 F

11 - Corpus

Christi

Corpus Christi 004567 Retama Manor Nursing Center 09/28/2017 $42,670 F

11 - Corpus

Christi

Corpus Christi 004894 The Palms Nursing &

Rehabilitation

07/21/2018 $13,635 F

11 - Corpus

Christi

Corpus Christi 004894 The Palms Nursing &

Rehabilitation

07/21/2018 $108,432 F

11 - Corpus

Christi

Corpus Christi 005006 Trisun Care Center-Westwood 02/28/2018 $16,500 F

11 - Corpus

Christi

Corpus Christi 005006 Trisun Care Center-Westwood 03/01/2018 $16,500 F

11 - Corpus

Christi

Falfurrias 004951 Falfurrias Nursing and

Rehabilitation LP

06/22/2018 F

11 - Corpus

Christi

Falfurrias 004951 Falfurrias Nursing and

Rehabilitation LP

06/22/2018 $38,562 $38,562 F

11 - Corpus

Christi

Hebbronville 005389 Meridian Care of Hebbronville 07/12/2017 $11,745 F

11 - Corpus

Christi

Hebbronville 005389 Meridian Care of Hebbronville 07/13/2017 $27,610 F

11 - Corpus

Christi

Kingsville 004571 Kleberg County Nursing and

Rehabilitation LP

04/28/2018 $13,500 F

F-41



Balance

Due IA

11 - Corpus

Christi

Laredo 005303 Regent Care Center of Laredo 10/26/2017 $12,150 F

11 - Corpus

Christi

Laredo 005303 Regent Care Center of Laredo 10/26/2017 $17,908 F

11 - Corpus

Christi

Laredo 004758 Retama Manor Nursing

Center/Laredo-West

09/29/2017 $17,005 F

11 - Corpus

Christi

Laredo 005042 Retama Manor/Laredo South 03/11/2018 $36,395 F

11 - Corpus

Christi

Laredo 005042 Retama Manor/Laredo South 03/11/2018 $51,816 F

11 - Corpus

Christi

Portland 005391 Trisun Care Center-Coastal Palms 11/20/2017 $42,220 F

11 - Corpus

Christi

Portland 005391 Trisun Care Center-Coastal Palms 11/20/2017 $7,530 F

11 - Corpus

Christi

Premont 004487 Premont Nursing and

Rehabilitation

08/24/2017 $10,000 $6,500 F

11 - Corpus

Christi

Robstown 004818 Robstown Nursing and


04/06/2018 $8,785 F

Totals $16,388,750 $2,928,917 $7,356,631

416 Total nursing facility civil money penalties imposed.

Notes:

1. The imposed column is the total amount of penalty after the review and confirmation of the civil money penalty citation and amount. This

is the amount due and payable if no alternative amount results from an appeal held, waiver, or if no settlement agreement reached.


final amount has been decided, or the facility consents to the administrative penalty, fails to respond to the department’s notice letter in a

timely manner, or fails to correct the violation to the department’s satisfaction.

F-42

3. The balance column is the amount of penalty the facility owes. The amount in this column does not necessarily reflect the final amount the

facility may owe. The amounts can change based on a hearing or negotiated settlement. Since these amounts may change, there is no

total for this column. This amount may include 35% reduction due to the acceptance of a waiver.

4. The “IA” column indicates the imposing authority. An “F” (federal) appears for Centers for Medicare and Medicaid Services-imposed

penalties and an “S” (state) appears for state-imposed penalties. The state imposes civil money penalties on Medicaid-only facilities.

F-43

Nursing Facility Complaint and Incident Intakes

Complaints

A complaint is any allegation received by the state regulatory agency other than an

incident reported by the facility. Such allegations include, but are not limited to,

abuse, neglect, exploitation, or violation of state or federal standards and can be

reported by residents, family members or others.

Incidents

An incident is an official notification to the state survey agency from a nursing

facility provider that the physical or mental health or welfare of a resident has been

or might be adversely affected by mistreatment, neglect, or abuse. These reports

also include injuries of unknown source and exploitation or misappropriation of

resident property.

Priority Assignment

The regulatory agency’s intake unit evaluates each complaint or incident based on


crucial to the health and safety of a resident(s), such as in a situation of heating or

air conditioner equipment failure, alleged staff walkout, etc., an investigation can be

initiated immediately by telephone, regardless of the priority code assignment. After

the initial telephone contact, an on- site visit is conducted according to the

timeframe specified by the priority assignment. The priorities available for a nursing

facility are:






● Financial (Medicaid facilities only)

● Withdrawn

● Not required


Immediate response by the state agency is warranted because a provider allegedly

created or allowed a present and ongoing situation in which the provider’s

F-44


to protect residents from abuse, neglect, or mistreatment or has caused, or is likely

to cause, serious injury, harm, impairment, or death to a resident.



been removed. The resident is no longer in imminent danger; however, the



resident’s mental, physical, or psychosocial status and is of such consequence that a

rapid response by the state is indicated. There is evidence or suspicion that

system(s) failure contributed to or brought on the threat. Usually, specific rather

than general information (e.g., descriptive identifiers, individual names, date, time,

location of occurrence, description of harm) will factor into the assignment of this

level of priority.




not significantly impair the resident’s mental, physical, or psychosocial status.




mental, or psychosocial harm that did not directly affect consumer or resident

health and safety and functional status. This priority also can be assigned for

alleged violations of regulations that do not directly impact resident health and

safety.

Professional Review

A provider who has cause to believe that the physical or mental health or welfare of

a resident has been or may be adversely affected by mistreatment, neglect, or

abuse must self-report to the state survey agency immediately upon learning of the


and exploitation/ misappropriation of resident property.

F-45

Complaint and incident intake unit staff assign a professional review priority when a

provider self- reports an incident and indicates that the provider’s immediate

corrective action is reasonably likely to ensure that abuse, neglect, mistreatment,

or injury to the resident will not occur again, or at least not while the provider

conducts its investigation and an intake specialist reviews the provider’s written

investigation report.



compliance with regulatory requirements, the intake unit will send notification to

regulatory regional staff to schedule an on-site investigation.

Financial (Medicaid Facilities Only)

These investigations involve complaint allegations related to a Medicaid-certified

nursing facility’s failure to appropriately manage resident trust funds or applied

income, or failure to reimburse prorated refunds due to a resident when the resident

is admitted to a Medicaid bed or has been discharged.

Withdrawn


complainant, except when abuse, neglect, or exploitation is alleged. Please refer to


(https://www.HHSC.state.tx.us/providers/communications/2015/scc/SCC2015-01.pdf).

Not Required




F-46

Nursing Facility All Intakes by Priority and Region for FY 2018



On or before 14 days 329 225 1,667 582 362 1,067 770 860 127 116 369 6,474

On or before 30 days 276 266 2,085 596 345 1,227 918 916 142 130 368 7,269

On or before 45 days 304 314 2,336 719 343 978 878 925 176 91 315 7,379


Financial 215 194 1,707 592 250 561 524 463 103 57 160 4,826

Withdrawn 4 2 35 6 2 14 9 18 2 4 5 101

Not required 5 2 30 15 19 13 5 4 0 1 2 96

Total 1,192 1,051 8,234 2,591 1,386 4,085 3,270 3,424 581 418 1,291 27,523

Nursing Facility Complaints by Priority and Region for FY 2018



On or before 14 days 122 105 824 254 164 604 410 487 64 56 150 3,240

On or before 30 days 148 146 1,181 305 182 779 558 566 80 80 210 4,235

On or before 45 days 66 86 644 163 98 335 305 344 37 34 130 2,242

Financial 27 19 205 34 34 97 87 147 18 11 32 711

Withdrawn 0 0 1 0 0 0 0 1 0 0 1 3

Not required 5 2 30 15 19 13 5 4 0 1 2 96

Total 398 385 3,043 817 524 1,951 1,441 1,637 210 190 564 11,160

F-47

Nursing Facility Incidents by Priority and Region for FY 2018



On or before 14 days 207 120 843 328 198 463 360 373 63 60 219 3,234

On or before 30 days 128 120 904 291 163 448 360 350 62 50 158 3,034

On or before 45 days 238 228 1,692 556 245 643 573 581 139 57 185 5,137

Professional review 215 194 1,707 592 250 561 524 463 103 57 160 4,826

Financial 0 0 3 0 0 1 0 0 0 0 0 4

Not required 4 2 34 6 2 14 9 17 2 4 4 98

Total 794 666 5,191 1,774 862 2,134 1,829 1,787 371 228 727 16,363

G-1

Appendix G. Trends

Trends in Long-Term Care Facilities, Home and

Community Support Services Agencies, and Waiver

Programs

HHSC Regions in Texas

Regions and the Counties They Serve

Region 1: High Plains

Armstrong, Bailey, Briscoe, Carson, Castro, Childress, Cochran, Collingsworth,

Crosby, Dallam, Deaf Smith, Dickens, Donley, Floyd, Garza, Gray, Hale, Hall,

Hansford, Hartley, Hemphill, Hockley, Hutchinson, King, Lamb, Lipscomb,

G-2

Lubbock, Lynn, Moore, Motley, Ochiltree, Oldham, Parmer, Potter, Randall,

Roberts, Sherman, Swisher, Terry, Wheeler, Yoakum

Region 2: Northwest Texas

Archer, Baylor, Brown, Callahan, Clay, Coleman, Comanche, Cottle, Eastland,

Fisher, Foard, Hardeman, Haskell, Jack, Jones, Kent, Knox, Mitchell, Montague,

Nolan, Runnels, Scurry, Shackelford, Stonewall, Stephens, Taylor,

Throckmorton, Wichita, Wilbarger, Young

Region 3: Metroplex

Collin, Cooke, Dallas, Denton, Ellis, Erath, Fannin, Grayson, Hood, Hunt, Johnson,

Kaufman, Navarro, Palo Pinto, Parker, Rockwall, Somervell, Tarrant, Wise

Region 4: Upper East Texas

Anderson, Bowie, Camp, Cass, Cherokee, Delta, Franklin, Gregg, Harrison,

Henderson, Hopkins, Lamar, Marion, Morris, Panola, Rains, Red River, Rusk, Smith,

Titus, Upshur, Van Zandt, Wood

Region 5: Southeast Texas

Angelina, Hardin, Houston, Jasper, Jefferson, Nacogdoches, Newton, Orange, Polk,

Sabine, San Augustine, San Jacinto, Shelby, Trinity, Tyler

Region 6: Gulf Coast

Austin, Brazoria, Chambers, Colorado, Fort Bend, Galveston, Harris, Liberty,

Matagorda, Montgomery, Walker, Waller, Wharton

Region 7: Central Texas

Bastrop, Bell, Blanco, Bosque, Brazos, Burleson, Burnet, Caldwell, Coryell, Falls,

Fayette, Freestone, Grimes, Hamilton, Hays, Hill, Lampasas, Lee, Leon, Limestone,

Llano, Madison, McLennan, Milam, Mills, Robertson, San Saba, Travis, Washington,

Williamson

Region 8: Upper South Texas

Atascosa, Bandera, Bexar, Calhoun, Comal, DeWitt, Dimmit, Edwards, Frio, Gillespie,

Goliad, Gonzales, Guadalupe, Jackson, Karnes, Kendall, Kerr, Kinney, La Salle,

Lavaca, Maverick, Medina, Real, Uvalde, Val Verde, Victoria, Wilson, Zavala

Region 9: West Texas

Andrews, Borden, Coke, Concho, Crane, Crockett, Dawson, Ector, Gaines,

Glasscock, Howard, Irion, Kimble, Loving, Martin, Mason, McCulloch, Menard,

G-3

Midland, Pecos, Reagan, Reeves, Schleicher, Sterling, Sutton, Terrell, Tom Green,

Upton, Ward, Winkler

Region 10: Upper Rio Grande

Brewster, Culberson, El Paso, Hudspeth, Jeff Davis, Presidio

Region 11: Lower South Texas

Aransas, Bee, Brooks, Cameron, Duval, Hidalgo, Jim Hogg, Jim Wells, Kenedy,

Kleberg, Live Oak, McMullen, Nueces, Refugio, San Patricio, Starr, Webb, Willacy,

Zapata

G-4

HHSC Waiver Contract Areas

Waiver Contract Areas and the Counties They Serve

Area 1

Armstrong, Bailey, Briscoe, Carson, Castro, Cochran, Collingsworth, Crosby,

Dallam, Deaf Smith, Donley, Floyd, Gray, Hale, Hall, Hansford, Hartley,

Hemphill, Hockley, Hutchinson, Lamb, Lipscomb, Lubbock, Lynn, Moore, Motley,

Ochiltree, Oldham, Parmer, Potter, Randall, Roberts, Sherman, Swisher, Wheeler

Area 2

Archer, Baylor, Brown, Callahan, Childress, Clay, Coleman, Comanche, Cottle,

Dickens, Eastland, Erath, Foard, Hardeman, Haskell, Hood, Jack, Johnson,

Jones, King, Knox, McCulloch, Mills, Montague, Palo Pinto, Parker, San Saba,

Shackelford, Somervell, Stephens, Stonewall, Tarrant, Taylor, Throckmorton,

Wichita, Wilbarger, Wise, Young

G-5

Area 3

Collin, Cooke, Dallas, Denton, Fannin, Grayson

Area 4

Anderson, Angelina, Bowie, Camp, Cass, Chambers, Cherokee, Delta, Ellis, Franklin,

Gregg, Hardin, Harrison, Henderson, Hopkins, Houston, Hunt, Jasper, Jefferson,

Kaufman, Lamar, Liberty, Marion, Montgomery, Morris, Nacogdoches, Navarro,

Newton, Orange, Panola, Polk, Rains, Red River, Rockwall, Rusk, Sabine, San

Augustine, San Jacinto, Shelby, Smith, Titus, Trinity, Tyler, Upshur, Van Zandt,

Walker, Wood

Area 5

Austin, Brazoria, Colorado, Fort Bend, Galveston, Harris, Matagorda, Waller,

Wharton

Area 6

Bastrop, Bell, Bosque, Brazos, Burleson, Burnet, Caldwell, Coryell, Falls, Fayette,

Freestone, Gonzales, Grimes, Guadalupe, Hamilton, Hill, Lampasas, Lee, Leon,

Limestone, Madison, McLennan, Milam, Robertson, Travis, Washington, Williamson

Area 7

Atascosa, Bandera, Bexar, Blanco, Calhoun, Comal, De Witt, Dimmit, Edwards, Frio,

Gillespie, Goliad, Hays, Jackson, Karnes, Kendall, Kerr, Kimble, Kinney, La Salle,

Lavaca, Llano, Mason, Maverick, McMullen, Medina, Menard, Real, Refugio,

Schleicher, Sutton, Uvalde, Val Verde, Victoria, Wilson, Zavala

Area 8

Andrews, Borden, Brewster, Coke, Concho, Crane, Crockett, Culberson, Dawson,

Ector, El Paso, Fisher, Gaines, Garza, Glasscock, Howard, Hudspeth, Irion, Jeff

Davis, Kent, Loving, Martin, Midland, Mitchell, Nolan, Pecos, Presidio, Reagan,

Reeves, Runnels, Scurry, Sterling, Terrell, Terry, Tom Green, Upton, Ward, Winkler,

Yoakum

G-6

Area 9

Aransas, Bee, Brooks, Cameron, Duval, Hidalgo, Jim Hogg, Jim Wells, Kenedy,

Kleberg, Live Oak, Nueces, San Patricio, Starr, Webb, Willacy, Zapata

G-7

Regulated Facilities

The following tables and charts represent snapshots of regulated long-term care

facility counts and occupancy numbers. Occupancy numbers reflect the facility

census from the most recent visit and include all residents and occupants, whether

they receive benefits from Medicare or Medicaid, or are private pay.

Facility and Occupancy Counts by Program Type

Program Count % of all

Facilities Occupancy

% of all

Occupants

Assisted Living 1,964 43.9% 45,546 27.1%

DAHS 458 10.2% 22,368 13.3%

ICF/IID 805 18.0% 7,915 4.7%

Nursing 1,250 27.9% 92,121 54.8%

PPECC 1 0.0% 3 0.0%

Total 4,478 NA 167,953 NA

G-8

Facilities in Texas by Program and Region

Region

Asst.

Living

Count

% of all

Asst.

Living

DAHS

Count

% of all

DAHS

ICF/IID

Count

% of all

ICF/IID

Nursing

Count

% of all

Nursing

PPECC

Count

% of All

PPECC

Total

Count % of Total

01 93 4.7% 6 1.3% 30 3.7% 71 5.7% 0 0.0% 200 4.5%

02 45 2.3% 1 0.2% 41 5.1% 75 6.0% 0 0.0% 162 3.6%

03 615 31.3% 38 8.3% 208 25.8% 286 22.9% 0 0.0% 1,147 25.6%

04 99 5.0% 7 1.5% 71 8.8% 106 8.5% 0 0.0% 283 6.3%

05 42 2.1% 8 1.7% 46 5.7% 75 6.0% 0 0.0% 171 3.8%

06 494 25.2% 54 11.8% 119 14.8% 175 14.0% 0 0.0% 842 18.8%

07 186 9.5% 4 0.9% 99 12.3% 149 11.9% 0 0.0% 438 9.8%

08 284 14.5% 52 11.4% 119 14.8% 174 13.9% 0 0.0% 629 14.0%

09 22 1.1% 1 0.2% 31 3.9% 43 3.4% 0 0.0% 97 2.2%

10 46 2.3% 31 6.8% 11 1.4% 19 1.5% 0 0.0% 107 2.4%

11 38 1.9% 256 55.9% 30 3.7% 77 6.2% 1 100.0% 402 9.0%

Total 1,964 NA 458 NA 805 NA 1,250 NA 1 NA 4,478 NA

G-9

Facility Visits/Contacts by HHSC Surveyors by Region

Region Assisted

Living DAHS ICF/IID Nursing PPECC Unlicensed Total

01 177 16 70 629 0 2 894

02 99 2 127 619 0 0 847

03 1,401 49 561 3,189 0 46 5,246

04 383 12 162 1,177 0 1 1,735

05 95 8 139 668 0 9 919

06 1,017 120 379 1,844 0 76 3,436

07 518 14 334 1,390 0 19 2,275

08 307 44 304 970 0 8 1,633

09 71 0 117 321 0 0 509

10 89 26 40 147 0 4 306

11 79 370 100 542 3 5 1,099

Total 4,236 661 2,333 11,496 3 170 18,899

Notes:

1. Visits/contacts consist of all on-site, off-site, and combination inspections and

investigations done by regulatory survey staff.

2. The unlicensed column includes visits to locations without a state license. During the visit,

regulatory staff will determine if the location is providing services in violation of state

licensing rules, providing services that have no licensure requirements, or not providing

services.

Facility Visits/Contacts Compared to the Number of Facilities

Facility Type Facility Count % of All

Facilities

Facility Visits/

Contacts

% of All Visits/

Contacts

Assisted Living 1,964 42.4% 4,236 22.4%

DAHS 458 9.9% 661 3.5%

ICF/IID 805 17.4% 2,333 12.3%

Nursing 1,250 27.0% 11,496 60.8%

PPECC 1 0.0% 3 0.0%

Unlicensed 149 3.2% 170 0.9%

Total 4,627 NA 18,899 NA

G-10

Notes:

1. Visits/contacts consist of all on-site, off-site, and combination inspections and


2. The unlicensed row includes visits to locations without a state license. During the visit,



services.

G-11

Changes in Regulated Facilities

Facility and Occupancy Counts in FY 2014 and FY 2018

Program FY 2014 Count FY 2014

Occupancy FY 2018 Count

FY 2018

Occupancy

Assisted Living 1,771 39,435 1,964 45,546

DAHS 478 22,174 458 22,368

ICF/IID 863 8,803 805 7,915

Nursing 1,224 94,591 1,250 92,121

PPECC 0 0 1 3

Total 4,336 165,003 4,478 167,953

Facility and Occupancy by Percentage in FY 2014 and FY 2018

Program FY 2014 % of

Total Facilities

FY 2014 %

of Total

Occupancy

FY 2018 % of

Total Facilities

FY 2018 %

of Total

Occupancy

Assisted Living 40.8% 23.9% 43.9% 27.1%

DAHS 11.0% 13.4% 10.2% 13.3%

ICF/IID 19.9% 5.3% 18.0% 4.7%

Nursing 28.2% 57.3% 27.9% 54.8%

PPECC 0.0% 0.0% 0.0% 0.0%

G-12

Assisted Living Facility Trends

Fiscal Year Number of

Facilities

Facilities:

Percent

Growth/

Loss

Number of

Licensed or

Certified

Beds

Licensed or

Certified

Beds:

Percent

Growth/Loss

Number of

Occupants

Occupants:

Percent

Growth/Loss

Occupancy

Rates

2014 1,771 -1.2% 60,369 +3.8% 39,435 +5.0% 65.3%

2015 1,829 +3.3% 63,949 +5.9% 40,845 +3.6% 63.9%

2016 1,864 +1.9% 67,647 +5.8% 42,782 +4.7% 63.2%

2017 1,888 +1.3% 70,750 +4.4% 44,520 +3.9% 62.9%

2018 1,964 +4.0% 73,988 +4.6% 45,546 +2.3% 61.6%

Percent

Change FY

2014 to 2018

NA +10.9% NA +22.6% NA +15.5% NA

Day Activity and Health Services Facility Trends


Facilities

Facilities:

Percent

Growth/

Loss

Number of

Licensed or

Certified

Beds

Licensed or

Certified

Beds:

Percent

Growth/Loss

Number of

Occupants

Occupants:

Percent

Growth/Loss

Occupancy

Rates

2014 478 -0.2% 43,402 +1.9% 22,174 +1.1% 51.1%

2015 481 +0.6% 44,385 +2.3% 22,493 +1.4% 50.7%

2016 466 -3.1% 43,660 -1.6% 22,443 -0.2% 51.4%

2017 465 -0.2% 44,269 +1.4% 22,651 +0.9% 51.2%

2018 458 -1.5% 43,644 -1.4% 22,368 -1.2% 51.3%

G-13


Facilities

Facilities:

Percent

Growth/

Loss

Number of

Licensed or

Certified

Beds

Licensed or

Certified

Beds:

Percent

Growth/Loss

Number of

Occupants

Occupants:

Percent

Growth/Loss

Occupancy

Rates

Percent

Change FY

2014 to 2018

NA -4.2% NA +0.6% NA +0.9% NA

Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition

Trends


Facilities

Facilities:

Percent

Growth/

Loss

Number of

Licensed or

Certified

Beds

Licensed or

Certified

Beds:

Percent

Growth/Loss

Number of

Occupants

Occupants:

Percent

Growth/Loss

Occupancy

Rates

2014 863 +0.1% 11,862 -1.1% 8,803 -3.9% 74.2%

2015 847 -1.9% 11,730 -1.1% 8,401 -4.6% 71.6%

2016 828 -2.2% 11,505 -1.9% 8,132 -3.2% 70.7%

2017 810 -2.2% 11,367 -1.2% 7,937 -2.5% 69.8%

2018 805 -0.6% 11,333 -0.3% 7,915 -0.3% 69.8%

Percent

Change FY

2014 to 2018

NA -6.7% NA -4.5% NA -10.1% NA

Note:

The number of certified beds reflects the number of intermediate care facilities for individuals with an intellectual disability or

related conditions beds authorized by the Centers for Medicare and Medicaid Services for participation in the Medicaid program.

Occupancy rates do not reflect funded capacity.

G-14

State-Operated Intermediate Care Facilities for Individuals with an Intellectual Disability or

Related Condition Trends


Facilities

Facilities:

Percent

Growth/

Loss

Number of

Licensed or

Certified

Beds

Licensed or

Certified

Beds:

Percent

Growth/Loss

Number of

Occupants

Occupants:

Percent

Growth/Loss

Occupancy

Rates

2014 15 0.0% 5,995 0.0% 3,372 -5.2% 56.2%

2015 15 0.0% 5,995 0.0% 3,195 -5.2% 53.3%

2016 15 0.0% 5,995 0.0% 3,112 -2.6% 51.9%

2017 15 0.0% 5,995 0.0% 3,016 -3.2% 50.3%

2018 15 0.0% 5,995 0.0% 2,979 -1.2% 49.7%

Percent

Change FY

2014 to 2018

NA 0.0% NA 0.0% NA -11.7% NA

Note:

The number of certified beds reflects the number of intermediate care facilities for individuals with an intellectual disability or

related conditions beds authorized by the Centers for Medicare and Medicaid Services for participation in the Medicaid program.

Occupancy rates do not reflect funded capacity.

G-15

Private and Community-operated Intermediate Care Facilities for Individuals with an

Intellectual Disability or Related Condition Trends


Facilities

Facilities:

Percent

Growth/

Loss

Number of

Licensed or

Certified

Beds

Licensed or

Certified

Beds:

Percent

Growth/Loss

Number of

Occupants

Occupants:

Percent

Growth/Loss

Occupancy

Rates

2014 848 +0.1% 5,867 -2.1% 5,431 -3.1% 92.6%

2015 832 -1.9% 5,735 -2.2% 5,206 -4.1% 90.8%

2016 813 -2.3% 5,510 -3.9% 5,020 -3.6% 91.1%

2017 795 -2.3% 5,372 -2.6% 4,921 -2.0% 91.6%

2018 790 -0.6% 5,338 -0.6% 4,936 +0.3% 92.5%

Percent

Change FY

2014 to 2018

NA -6.8% NA -9.0% NA -9.1% NA

Nursing Facility Trends


Facilities

Facilities:

Percent

Growth/

Loss

Number of

Licensed or

Certified

Beds

Licensed or

Certified

Beds:

Percent

Growth/Loss

Number of

Occupants

Occupants:

Percent

Growth/Loss

Occupancy

Rates

2014 1,224 +0.5% 136,856 +0.7% 94,591 +0.9% 69.1%

2015 1,223 -0.1% 137,335 +0.4% 93,588 -1.1% 68.1%

2016 1,228 +0.4% 137,975 +0.5% 92,943 -0.7% 67.4%

2017 1,242 +1.1% 139,452 +1.1% 93,106 +0.2% 66.8%

2018 1,250 +0.6% 140,509 +0.8% 92,121 -1.1% 65.6%

G-16


Facilities

Facilities:

Percent

Growth/

Loss

Number of

Licensed or

Certified

Beds

Licensed or

Certified

Beds:

Percent

Growth/Loss

Number of

Occupants

Occupants:

Percent

Growth/Loss

Occupancy

Rates

Percent

Change FY

2014 to 2018

NA +2.1% NA +2.7% NA -2.6% NA

Note:

The number of licensed or certified beds includes all types - Medicare, Medicaid and private pay.

G-17

Facility Visits/Contacts by Regulatory Surveyors for FY 2014-18

Facility Type FY 2014 FY 2015 FY 2016 FY 2017 FY 2018

Assisted Living 4,946 4,883 5,578 5,589 4,236

DAHS 1,015 871 1,069 844 661

ICF/IID 2,339 2,412 2,524 2,342 2,333

Nursing 11,683 12,228 12,395 12,944 11,496

PPECC 0 0 0 0 3

Unlicensed 290 241 296 255 170

Totals 20,273 20,635 21,862 21,974 18,899

Notes:

1. Visits/contacts consist of all on-site, off-site and combination inspections and


2. The unlicensed row includes visits to locations without a state license. During the visit,



services.

G-18

Regulated Home and Community Support Services Agencies

Home and Community Support Services Agency Counts by Agency

Type

Agency Type Count % of All

Agencies

Consumers for

FY 2017 and

FY 2018

% of All

Consumers

Home health and hospice

parents

5,339 86.7% 1,246,313 98.3%

Home health branches 613 10.0% 14,989 1.2%

Alternate delivery sites 203 3.3% 6,863 0.5%

Total 6,155 NA 1,268,165 NA

Note:

Consumer counts are the number of unduplicated consumers reported by each agency on its

license renewal application.

Home and Community Support Services Agency Counts by HHSC

Region

Region Parent

Count

% of

Parent

Total

Branch

Count

% of

Branch

Total

Alternate

Delivery

Site

Count

% of

Alternate

Delivery

Site

Total

Total

Count

% of

Total

01 96 1.8% 42 6.9% 8 3.9% 146 2.4%

02 80 1.5% 26 4.2% 16 7.9% 122 2.0%

03 1,598 29.9% 113 18.4% 48 23.6% 1,759 28.6%

04 171 3.2% 47 7.7% 32 15.8% 250 4.1%

05 116 2.2% 32 5.2% 12 5.9% 160 2.6%

06 1,572 29.4% 58 9.5% 21 10.3% 1,651 26.8%

07 328 6.1% 78 12.7% 26 12.8% 432 7.0%

08 435 8.1% 88 14.4% 18 8.9% 541 8.8%

09 67 1.3% 21 3.4% 6 3.0% 94 1.5%

10 167 3.1% 13 2.1% 2 1.0% 182 3.0%

11 709 13.3% 95 15.5% 14 6.9% 818 13.3%

Totals 5,339 NA 613 NA 203 NA 6,155 NA

G-19

Home and Community Support Services Agency Visits/Contacts by

Regulatory Surveyors by Region

Region HCSSA

01 121

02 99

03 1,077

04 202

05 130

06 1,162

07 359

08 456

09 62

10 126

11 706

Total 4,500

Note:

Visits/contacts consist of all on-site, off-site, and combination inspections and investigations

done by regulatory survey staff.

Home and Community Support Services Agency Counts by Category of

Service

Category of Service Parent Branch Alternate

Delivery Site

Licensed and certified home health 2,231 249 NA

Licensed and certified home health w/ dialysis 1 0 NA

Licensed home health services 2,878 468 NA

Licensed home health w/ dialysis 37 1 NA

Personal assistance services 3,662 366 NA

Hospice 815 NA 203

Note:

Home and community support services agencies can provide more than one category of

service from the same parent or branch.

G-20

Home and Community Support Services Agency Counts by Category of Service by HHSC Region

Category of Service 01 02 03 04 05 06 07 08 09 10 11 Total

Parent: licensed and

certified home health

46 49 742 89 61 625 108 138 32 66 275 2,231

Parent: licensed home

health

52 41 900 106 67 879 154 201 32 73 373 2,878

Parent: licensed home

health with dialysis

0 0 7 1 0 25 1 1 0 0 2 37

Parent: personal

assistance

42 38 1,141 80 55 1,183 190 239 34 118 542 3,662

Parent: hospice 25 13 236 35 26 197 63 102 13 22 83 815

Parent: licensed and


with dialysis

0 0 0 0 0 0 0 0 0 0 1 1

Branch: licensed and


21 16 55 35 20 24 29 16 12 0 21 249

Branch: licensed home

health

41 23 88 37 21 41 58 63 14 11 71 468

Branch: licensed home

health with dialysis

0 0 1 0 0 0 0 0 0 0 0 1

Branch: personal

assistance

26 14 61 22 19 30 34 63 12 8 77 366

Alternative delivery site:

hospice

8 16 48 32 12 21 26 18 6 2 14 203

Note:

Home and community support services agencies can provide more than one category of service from the same parent or

branch.

G-21

Changes in Regulated Home and Community Support Services

Agencies

Home and Community Support Services Agency Counts for FY 2014

and FY 2018

Agency Type FY 2014 Count FY 2018 Count

Home health and hospice parents 5,413 5,339

Home health branches 769 613

Alternate delivery sites 170 203

Total 6,352 6,155

G-22

Home and Community Support Services Agency Trends


Parents

Parents:

Percent

Growth/

Loss

Number of

Branches

Branches:

Percent

Growth/

Loss

Number of

Alternate

Delivery

Sites

Alternate

Delivery

Sites:

Percent

Growth/Loss

Total

Number of

Agencies

All:

Percent

Growth/

Loss

2014 5,413 +1.4% 769 -1.4% 170 -4.0% 6,352 +0.9%

2015 5,426 +0.2% 730 -5.1% 187 +10.0% 6,343 -0.1%

2016 5,402 -0.4% 701 -4.0% 189 +1.1% 6,292 -0.8%

2017 5,396 -0.1% 657 -6.7% 209 9.6% 6,262 -0.5%

2018 5,339 -1.1% 613 -6.7% 203 -2.9% 6,155 -1.7%

Percent

Change FY

2014 to

2018

NA -1.4% NA -20.3% NA +19.4% NA -3.1%

Home and Community Support Services Agency Visits/Contacts by Regulatory Surveyors for FY

2014-18

Agency

Type FY 2014 FY 2015 FY 2016 FY 2017 FY 2018

HCSSA 3,874 3,470 2,885 3,851 4,500

Note:

Visits/contacts consist of all on-site, off-site and combination inspections and investigations done by regulatory survey staff.

G-23

Regulated Waiver Programs

Waiver Program and Consumer Counts

Program Type

Count of

Waiver

Contracts

% of all

Contracts Consumers

% of All

Consumers

Home and Community-

based Services

842 69.6% 26,206 84.2%

Texas Home Living 367 30.4% 4,902 15.8%

Total 1,209 NA 31,108 NA

Contracts in Texas by Waiver Program and Contract Area

Waiver

Contract

Area

HCS

Contracts

% of All

HCS

Contracts

TxHmL

Contracts

% of All

TxHmL

Contracts

Total

Contracts

% of All

Contracts

1 15 1.8% 8 2.2% 23 1.9%

2 111 13.2% 56 15.3% 167 13.8%

3 146 17.3% 72 19.6% 218 18.0%

4 112 13.3% 39 10.6% 151 12.5%

5 240 28.5% 98 26.7% 338 28.0%

6 72 8.6% 26 7.1% 98 8.1%

7 75 8.9% 27 7.4% 102 8.4%

8 23 2.7% 15 4.1% 38 3.1%

9 48 5.7% 26 7.1% 74 6.1%

Total 842 NA 367 NA 1,209 NA

Reviews of Waiver Programs by State Reviewers by Contract Area

Waiver

Contract

Area

Home and

Community-

based

Services

Texas Home

Living Total

1 28 8 36

2 138 50 188

3 146 60 206

4 118 36 154

5 240 88 328

6 101 25 126

G-24

Waiver

Contract

Area

Home and

Community-

based

Services

Texas Home

Living Total

7 103 32 135

8 28 15 43

9 49 22 71

Total 951 336 1,287

Reviews of Waiver Programs Compared to the Number of Waiver

Programs

Program Type Contract Count % of All

Contracts

% of All

Reviews

Home and Community-based

Services

842 69.6% 73.9%

Texas Home Living 367 30.4% 26.1%

Total 1,209 NA NA

Note:

Reviews consist of all certification, intermittent and follow-up reviews, or visits by regulatory

waiver survey and certification staff.

Home and Community-based Services Residential Category Consumer

Counts

Residential Category Consumers % of

Consumers

Own home or family home 3,858 14.7%

Foster care 13,761 52.5%

Three-person group home 4,089 15.6%

Four-person group home 4,498 17.2%

Total 26,206 NA

G-25

Home and Community-based Services Residential Reviews

Residential Category Reviews

Completed

% of All

Reviews

Own home or family home NA NA

Foster care 12,319 81.5%

Three-person group home 1,583 10.5%

Four-person group home 1,218 8.1%

Total 15,120 NA

G-26

Changes in Waiver Programs

Waiver Program Contract and Consumer Counts for FY 2014 and FY

2018

Program Type FY 2014

Contracts

FY 2014

Consumers

FY 2018

Contracts

FY 2018

Consumers

Home and Community-

based Services

767 21,334 842 26,206

Texas Home Living 374 5,955 367 4,902

Total 1,141 27,289 1,209 31,108

Waiver Program Contract and Consumers by Percentage in FY 2014 -

2018

Program Type

FY 2014 %

of All

Contracts

FY 2014 %

of All

Consumers

FY 2018 %

of All

Contracts

FY 2018 %

of All

Consumers

Home and Community-

based Services

67.2% 78.2% 69.6% 84.2%

Texas Home Living 32.8% 21.8% 30.4% 15.8%

Home and Community-based Services Trends

Fiscal Year

Number of

HCS

Contracts

HCS: %

Growth/Loss

HCS

Consumers

HCS

Consumers:

% Growth/

Loss

2014 767 +4.1% 21,334 +2.7%

2015 791 +3.1% 24,608 +15.3%

2016 811 +2.5% 26,081 +6.0%

2017 823 +1.5% 27,896 +6.5%

2018 842 +2.3% 26,206 -6.1%

Percent

Change

FY 2014 to

2018

NA +9.8% NA +22.8%

Note:

Home and Community-based Services contract counts include only contracts through which

at least one consumer is provided services.

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Texas Home Living Trends

Fiscal Year

Number of

TxHmL

Contracts

TxHmL: %

Growth/Loss

TxHmL

Consumers

TxHmL

Consumers:

% Growth/

Loss

2014 374 +14.4% 5,955 +3.5%

2015 423 +13.1% 7,358 +23.6%

2016 403 -4.7% 6,989 -5.0%

2017 393 -2.5% 5,385 -29.8%

2018 367 -6.6% 4,902 -9.0%

Percent

Change

FY 2014 to

2018

NA -1.9% NA -17.7%

Reviews of Waiver Programs by Regulatory Reviewers for FY 2014 -

2018

Facility Type FY 2014 FY 2015 FY 2016 FY 2017 FY 2018

Home and Community-

based Services

1,014 960 1,202 994 951

Texas Home Living 425 396 477 413 336

Totals 1,439 1,356 1,679 1,407 1,287

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Comparisons to Other States

In Centers for Medicare and Medicaid Services Region VI (which includes Arkansas,

Louisiana, New Mexico, Oklahoma, and Texas) for FY 2018, Texas accounts for:

● 64 percent of all active certified facilities and agencies

● 64 percent of all nursing facility federal enforcement cases

● 49 percent of all immediate jeopardy situations

● 30 percent of all past noncompliance cases

Nationwide, Texas accounts for:

● 18 percent of all certified home and community support services agencies

● 13 percent of all intermediate care facilities for individuals with an intellectual

disability or related condition

● 8 percent of all certified nursing facilities

● 13 percent of all state survey agency hours spent on investigations at nursing

facilities

● 9 percent of all nursing facility federal enforcement cases

● 11 percent of all immediate jeopardy situations

● 8 percent of all past noncompliance cases

Overview of Enforcement Activities


During FY 2018, HHSC imposed 944 administrative penalties against facilities and

agencies, including:

● 812 against home and community support services agencies

● 64 against nursing facilities

● 42 against assisted living facilities

● 20 against intermediate care facilities for individuals with an intellectual

disability or related conditions

● 6 against day activity and health services facilities

Facility Referrals to the Office of the Attorney General

During FY 2018, HHSC referred the following facilities for injunctive/other relief and

civil penalties:

● 6 unlicensed facilities

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● 1 intermediate care facilities for individuals with an intellectual disability or

related conditions

Facility Amelioration Requests

In certain situations, the agency commissioner can allow, in lieu of demanding

payment of an administrative penalty, the use (under agency’s supervision) of any

portion of the penalty to ameliorate the violation. The amelioration plan must

improve services (other than administrative services) or quality of care of residents

in the nursing facility, intermediate care facilities for individuals with an intellectual

disability or related condition, or assisted living facilities affected by the violation.

Approved amelioration amounts:

● $42,435.82 for the purchase and installation of EMAR system, bathing

system, kitchen rollup doors, bladder scanner, PIR alert system and VitaStem

Plus system.

● $40,900.01 for the installation of a therapeutic garden program, purchase of

62 smart TVs and installation of internet WiFi.

● $12,600.00 for the addition of quilted bed spreads for every bed, purchase of

TV's and mounts for sitting area and install lobby TV and chairs.

● $9,095.74 for an Internet café and vital sign attendant monitor with oral

temperature.

● $3,000.00 for the purchase of outdoor furniture to use on the front porch.

During FY 2018, HHSC denied 36 initial and renewal applications for licensure for

facilities and agencies, including:

● 21 home and community support services agencies

● 9 assisted living facilities

● 5 day activity and health services facilities

● 1 intermediate care facility for individuals with an intellectual disability or

related conditions

License Revocations

During FY 2018, HHSC revoked 57 facility and agency licenses, including:

● 57 home and community support services agencies

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Home and Community Support Services Agency Expiration of Licenses

(in Lieu of Enforcement Actions)

Instead of pursuing additional enforcement actions, the state regulatory agency can

allow a home and community support services agency to let its license expire.

During FY 2018, 19 of these agencies were allowed to expire their license in lieu of

further enforcement actions.

Home and Community Support Services Agency Surrender of Licenses

(in Lieu of Enforcement Actions)

At the state’s discretion, an agency can be offered the option to surrender its

license, instead of receiving additional enforcement actions. In FY 2018, 32 home

and community support services agencies surrendered their license in lieu of further

enforcement actions.

Vendor Holds

During FY 2018, HHSC placed 1 waiver contract on vendor hold.

Denial of Certification

During FY 2018, HHSC did not deny any certifications to waiver contracts.

Unlicensed Facilities

The long-term care regulatory program addresses violators of state licensing laws

who operate facilities without a required license. The agency responds to complaints

from the public and other entities alleging facilities are operating without a license

and, if the agency finds a facility is in violation of licensure laws, it can refer a

facility to the Office of the Attorney General or the local county or district attorney

for relocation of residents, injunctive relief, and/or civil penalties.

During FY 2018, HHSC referred 6 unlicensed facilities for injunctive/other relief and

civil penalties. Of those, all 6 referrals were to the Office of the Attorney General.

Trust Fund Monitoring

The long-term care regulatory program routinely monitors resident funds in

Medicaid contracted nursing facilities and intermediate care facilities for individuals

with intellectual disabilities for compliance with state and federal guidelines. They

also perform change of ownership/closure audits on outgoing ownership, and

investigate financial complaints referred by intake staff.

During FY 2018, HHSC completed:

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● 685 financial investigations resulting in $2,677,094.82 in resident refunds

● Routine monitoring visits resulting in $2,023,059.78 in resident refunds

● Change of ownership/closure audits resulting in $976,374.54 in resident

refunds

Nursing Facility Civil Money Penalties

The federal Centers for Medicare and Medicaid Services (CMS) or the state regulatory

program can impose a civil money penalty (CMP) for the number of days that a skilled

nursing or nursing facility is not in substantial compliance with one or more of the

conditions to participate in Medicare or Medicaid, or for each instance that a facility is

not in substantial compliance — regardless of whether the deficiencies constitute

immediate jeopardy. CMS or the state also can impose a CMP for the number of days

of previous noncompliance since the last standard survey, including the number of

days of immediate jeopardy.

In FY 2018, CMS imposed 415 CMPs against facilities participating in the Medicare

program; HHSC imposed one CMP against facilities that contracted for Medicaid only.

Regulatory Penalty Receipts for FY 2013–2018

Fiscal

Year


Amount Received

(All Facility Types)

Civil Money Penalties

Amount Received

(Nursing Facilities)

2013 $394,675.00 $2,979,482.94

2014 $685,391.00 $3,673,288.69

2015 $489,417.01 $4,252,411.81

2016 $928,287.99 $5,153,955.58

2017 $762,338.09 $8,433,374.78

2018 $793,348.00 $8,218,224.00

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Top 10 Rankings

Certification Deficiencies and Licensure Violations

Top 10 Violations Cited During Inspections for FY 2018: Assisted Living

Facilities

1. Sprinkler Systems: 40 TAC §92.62(f)(2) - The facility failed to ensure the

required sprinkler system was inspected, tested, and maintained in compliance

with National Fire Protection Association 25. (Tied for No. 1 in FY 2017)

2. General Safety: Building in Good Repair: 40 TAC §92.62(i)(2) - The

facility failed to ensure that the building was kept in good repair. (Ranked No. 2

in FY 2017)

3. Resident Assessment Service Plan: 40 TAC §92.41(c)(2) - The facility

failed to ensure that the service plan was approved and signed by the resident

or a person responsible for the resident's health care decisions, or that it was

updated annually and upon a significant change in condition, based upon an

assessment of the resident, or that care was provided to the resident based on

that assessment. (Tied for No. 5 in FY 2017)

4. [TIE] Fire Alarm-Sprinkler Systems: Contract to Maintain Alarm System:

40 TAC §92.62(f)(1)(E) - The facility failed to provide a written contract with

a fire alarm firm to perform inspections, testing, and maintenance of the system

at least every six months. (Tied for No. 5 in FY 2017)

[TIE] Operations: Fire Drills: 40 TAC §92.62(c)(2) - The facility failed to

ensure fire drills were conducted and documented to be in compliance with

licensing standards for assisted living facilities. (Tied for No. 5 in FY 2017)

6. Fire Alarm-Sprinkler Systems: Fire Alarm and Sprinkler Systems: 40 TAC

§92.62(f)(1) - The facility failed to ensure that the fire alarm and smoke

detection system was in compliance with licensing standards for assisted living

facilities. (Ranked No. 3 in FY 2017)

7. General Safety: Adequate Light Levels: 40 TAC §92.62(i)(11) – The

facility failed to ensure lighting levels were in compliance with licensing

standards for assisted living facilities and the Illumination Engineering Society of

North America. (Ranked No. 10 in FY 2017)

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8. S - H: Fac. Clean and in Good Repair: 40 TAC §92.62(h)(8) - The facility

failed to maintain the building free of accumulations of dirt, rubbish, dust, and

hazards. (Not ranked in FY 2017)

9. Requirements: Other Chapters, Sec etc. of NFPA 101: 40 TAC

§92.61(b)(4)(E) - The facility failed to ensure the building and structure

complied with other applicable chapters of the Life Safety Code, NFPA 101.

(Ranked No. 4 in FY 2017)

10. Construction: Interior Wall and Ceiling Surfaces: 40 TAC §92.62(e)(2) -

The facility failed to ensure interior walls and/or ceilings were constructed with a

material having at least a 20-minute fire rating, or at least 3/8 gypsum board.

(Not ranked in FY 2017)

Top 10 Violations Cited During Inspections for FY 2018: Day Activity

and Health Services Facilities

1. Sanitation/Kitchen-Food Service Sanitation: 40 TAC § 98.43(b)(1) - The

facility failed to observe state requirements and local health ordinances relating

to Texas food establishments. (Ranked No. 1 in FY 2017)

2. Sanitation/General-Odors/Refuse/Hazards: 40 TAC §98.43(a)(7) - The

facility failed to keep the building clean and well maintained. (Ranked No. 2 in

FY 2017)

3. Communicable Diseases/Staff Health: 40 TAC §98.62(c) - The facility

failed to ensure that its employees were free of communicable diseases, through

tuberculosis screening or through excluding them from work while

communicable. (Ranked No. 3 in FY 2017)

4. Personal Safety/Fire-Smoking Regulations: 40 TAC §98.42(c)(1)(G)(iv)

- The facility failed to provide the proper containers to allow for the emptying of

ashtrays in smoking areas. (Ranked No. 4 in FY 2017)

5. [TIE] Personal Safety/Fire Extinguishers-Monthly Inspection: 40 TAC

§98.42(c)(1)(M)(i) - The facility staff did not inspect the portable fire

extinguishers on a monthly basis or maintain them in proper condition and

working order. (Not ranked in FY 2017)

[TIE] Personal Safety/ General-Outdoor Recreation Area: 40 TAC

§98.42(c)(2)(L) - The facility failed to provide a walled or fenced outdoor area

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that was directly accessible from the facility and was suitably furnished. (Not

ranked in FY 2017)

7. Personal Safety/Fire-Smoking Regulations: 40 TAC §98.42(c)(1)(G)(iii)

- The facility failed to provide the proper ashtrays in areas where smoking is

permitted. (Tied for No. 7 in FY 2016)

8. Sanitation/ General-Rest Room Facilities: 40 TAC §98.43(a)(8) - The

facility failed to provide adequate restrooms for men and women. (Not ranked in

FY 2017)

9. Staff Qualifications/Director: 40 TAC §98.62(a)(1)(A)(B) - The facility

failed to assure that its director met the mandatory qualifications for a director.


10. [TIE] Personal Safety/Fire-Building in Good Repair: 40 TAC

§98.42(c)(1)(C) - The facility failed to keep the building in good repair.


[TIE] Emergency Preparedness & Response/Administration: 40 TAC

§98.64(b)(3) - The facility failed to evaluate and change the emergency

preparedness and response plan as needed within 30 days after an emergency

situation, remodeling or adding on to the facility, or at least annually. (Not

ranked in FY 2017)

Top 10 Deficiencies Cited During Inspections for FY 2018: Home

Health Agencies

1. Plan of Care Must Include the Following: 42 CFR 484.60(a)(2)(i-xvi),

TAG 0574 – The agency failed to include any of the following in the plan of

care: all pertinent diagnoses; patient's mental, psychosocial and cognitive

status; types of services/equipment needed; frequency an duration of visits;

prognosis, functional limitations; activities permitted; nutritional requirements;

all medications/treatments; safety measures against injury; patient's risk for

emergency department visits and hospital re-admission including interventions;

training to patient and caregiver for timely discharge; patient-specific

interventions, education and goals; information on advance directives; and

additional items from the agency or physician. (Not ranked in FY 2017)

2. Acceptance of Patients, Plan of Care, Medical Supervision: 42 CFR

484.18, TAG 0158 - The agency failed to ensure the care follows a written plan

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of care established and periodically reviewed by a doctor of medicine,

osteopathy, or podiatric medicine. (Ranked No. 1 in FY 2017)

3. Administrator: 42 CFR 484.14(c), TAG 0133 - The administrator, who may

also be the supervising physician or registered nurse required under paragraph

(d) of this section, failed to organize and direct the agency's ongoing functions;

maintains ongoing liaison among the governing body, the group of professional

personnel, and the staff. (Ranked No. 2 in FY 2017)

4. Plan of Care: 42 CFR 484.18(a), TAG 0159 - The agency failed to ensure the

plan of care developed in consultation with the agency staff covers all pertinent

diagnoses, including mental status, types of services and equipment required,

frequency of visits, prognosis, rehabilitation potential, functional limitations,

activities permitted, nutritional requirements, medications and treatments, any

safety measures to protect against injury, instructions for timely discharge or

referral, and any other appropriate items. (Ranked No. 3 in FY 2017)

5. Clinical Records: 42 CFR 484.48, TAG 0236 - The agency failed to maintain

a clinical record containing pertinent past and current findings in accordance

with accepted professional standards is maintained for every patient receiving

home health services. In addition to the plan of care, the record contains

appropriate identifying information; name of physician; drug, dietary, treatment,

and activity orders; signed and dated clinical and progress notes; copies of

summary reports sent to the attending physician; and a discharge summary.


6. Plan of Care: 42 CFR 484.60(a)(1), TAG 0572 – The agency failed to

identify changes in health or functional status in the individualized plan of care,

or review every 60 days or more frequently when indicated and signed by the

physician. (Not ranked in FY 2017)

7. Responsible for All Day to Day Operations: 42 CFR 484.105(b)(1)(ii),

TAG 0948 - The agency's administrator failed to manage the day-to-day

operations. (Not ranked in FY 2017)

8. Coordination of Patient Services: 42 CFR 484.14(g), TAG 0143 - The

agency failed to ensure all personnel furnishing services maintain liaison that

their efforts are coordinated effectively and support the objectives outlined in

the plan of care. (Ranked No. 6 in FY 2017)

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9. Provide Services in the Plan of Care: 42 CFR 484.75(b)(3), TAG 0710 -

The agency failed to provide services that are ordered by the physician as

indicated by the plan of care. (Not ranked in FY 2017)

10. Encoding OASIS Data: 42 CFR 484.20(a), TAG 0321 - The agency failed to

encode and be capable of transmitting OASIS data for each agency patient

within 30 days of completing an OASIS data set. (Ranked No. 5 in FY 2017)

Top 10 Violations Cited During Inspections for FY 2018: Home Health

Agencies

1. Self-Reported Incidents of Abuse, Neglect and Exploitation – Level B: 40

TAC §97.249(c) - The agency failed to immediately report within 24 hours,

knowledge of an alleged act of abuse, neglect or exploitation of a client by an

agency employee, contractor or volunteer, to the Texas Department of Family

and Protective Services and to HHSC. (Ranked No. 2 in FY 2017)

2. Quality Assessment/Performance Improvement – Level B: 40 TAC

§97.287(a)(1) - The agency failed to have, implement, and review a quality

assessment and performance improvement program consistent with state

requirements. (Tied for No. 5 in FY 2017)

3. Management Responsibility Supervising Nurse – Level B: 40 TAC

§97.243(c)(2)(A)(iii) - The supervising nurse or the alternate supervising

nurse failed to make sure that care was provided according to a client's needs as

written in the plan of care or care plan. (Ranked No. 1 in FY 2017)

4. Management Responsibility Administrator – Level A and Level B: 40 TAC

§97.243(b)(1)(D) - The administrator failed to supervise to ensure

implementation of agency policy and procedures. (Ranked No. 10 in FY 2017)


§97.243(b)(1)(B) - The agency administrator failed to carry out, organize,

and supervise ongoing work under the agency's administrative policies. (Ranked

No. 3 in FY 2017)

6. Verify Employability/Use Unlicensed Personnel – Level B: 40 TAC

§97.247(a)(3) - The agency employed an unlicensed person with face-to-face

client contact before it searched the nurse aide and employee misconduct

registries as required or employed an unlicensed person who was listed in either

registry as unemployable. (Ranked No. 7 in FY 2017)

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§97.243(b)(1)(A) - The agency administrator failed to manage the daily

operations of the agency. (Ranked No. 4 in FY 2017)

8. Emergency Preparedness Planning and Implementation – Level A and

Level B: 40 TAC §97.256(k) - The agency failed to test the response phase of

its emergency preparedness and response plan by conducting a planned drill

consistent with state licensing rules as part of its annual review of the plan.

(Tied for No. 5 in FY 2017)

9. Agency Investigations - Level B: 40 TAC §97.250(b)(3) - The agency

failed to send its investigation report form no later than 10 days after reporting

abuse, neglect, or exploitation of a client by an agency employee, contractor, or

volunteer to the Department of Family and Protective Services and HHSC. (Not

ranked in FY 2017)

10. Quality Assessment/Performance Improvement - Level B: 40 TAC

§97.287(c) - The agency failed to make sure its quality assessment and

performance improvement committee met at least twice a year to address

identified problems and concerns in service delivery. (Not ranked in FY 2017)

Top 10 Deficiencies Cited During Inspections for FY 2018: Hospice

Agencies

1. Plan of Care: 42 CFR 418.56(b), TAG 0543 - The hospice failed to ensure all

hospice care and services furnished to patients and their families must follow an

individualized written plan of care established by the hospice interdisciplinary

group in collaboration with the attending physician (if any), the patient or

representative, and the primary caregiver in accordance with the patient's needs

if any of them so desire. (Ranked No. 1 in FY 2017)

2. Supervision of Hospice Aides: 42 CFR 418.76(h)(1)(i), TAG 0629 - The

hospice failed to ensure that the registered nurse make an on-site visit to the

patient's home no less frequently than every 14 days to assess the quality of

care and services provided by the hospice aide and to ensure that services

ordered by the hospice interdisciplinary group meet the patient's needs. The

hospice aide does not have to be present during this visit. (Ranked No. 3 in FY

2017)

3. Clinical Records: 42 CFR 418.104, TAG 0671 - The hospice failed to ensure

a clinical record containing past and current findings is maintained for each

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hospice patient. The clinical record must contain correct clinical information that

is available to the patient's attending physician and hospice staff. The clinical

record may be maintained electronically. (Ranked No. 2 in FY 2017)

4. Level of Activity: 42 CFR 418.78(e), TAG 0647 - The hospice failed ensure

volunteers must provide day-to-day administrative and/or direct patient care

services in an amount that, at a minimum, equals 5 percent of the total patient

care hours of all paid hospice employees and contract staff. The hospice must

maintain records on the use of volunteers for patient care and administrative

services, including the type of services and time worked. (Not ranked in FY

2017)

5. Coordination of Services: 42 CFR 418.56(e)(4), TAG 0557 - The hospice

failed to develop and maintain a system of communication and integration, in

accordance with the hospice's own policies and procedures, to provide for and

ensure the ongoing sharing of information between all disciplines providing care

and services in all settings, whether the care and services are provided directly

or under arrangement. (Ranked No. 4 in FY 2017)

6. Content of Plan of Care: 42 CFR 418.56(c)(4), TAG 0549 – The hospice

failed to provide the patient with effective pain management by providing drugs

and treatment necessary to meet the patient's needs. (Not ranked in FY 2017)

7. Governing Body and Administrator: 42 CFR 418.100(b), TAG 0651 - The

hospice failed to ensure a governing body (or designated persons so functioning)

assumes full legal authority and responsibility for the management of the

hospice, the provision of all hospice services, its fiscal operations, and

continuous quality assessment and performance improvement. A qualified

administrator appointed by and reporting to the governing body is responsible

for the day-to-day operation of the hospice. The administrator must be a

hospice employee and possess education and experience required by the

hospice's governing body. (Tied for No. 6 in FY 2017)

8. Quality Assessment & Performance Improvement: 42 CFR 418.58, TAG

0560 - The hospice failed to develop, implement, and maintain an effective,

ongoing, hospice-wide data-driven quality assessment and performance

improvement program. The hospice's governing body must ensure that the

program: reflects the complexity of its organization and services; involves all

hospice services (including those services furnished under contract or

arrangement); focuses on indicators related to improved palliative outcomes;

and takes actions to demonstrate improvement in hospice performance. The

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hospice failed to maintain documentary evidence of its quality assessment and

performance improvement program and be able to demonstrate its operation to

the Centers for Medicare and Medicaid Services. (Tied for No. 6 in FY 2017)

9. CONTENT OF PLAN OF CARE: 42 CFR 418.56(c), TAG 0545 - The hospice

failed to develop an individualized written plan of care for each patient. The plan

of care must reflect patient and family goals and interventions based on the

problems identified in the initial, comprehensive, and updated comprehensive

assessments. The plan of care must include all services necessary for the

palliation and management of the terminal illness and related conditions. (Not

ranked in FY 2017)

10. Content of Plan of Care: 42 CFR 418.56(c)(5), TAG 0550 - The hospice

failed to include in the plan of care all services necessary for the palliation and

management of the terminal illness and related conditions, including the

following: medical supplies and appliances necessary to meet the needs of the

patient. (Not ranked in FY 2017)

Top 10 Violations Cited During Inspections for FY 2018: Hospice

Agencies

1. Self-Reported Incidents of Abuse, Neglect and Exploitation - Level B: 40

TAC §97.249(c) - The hospice failed to immediately report within 24 hours,

knowledge of an alleged act of abuse, neglect or exploitation of a client by an

agency employee, contractor or volunteer, to the Texas Department of Family

and Protective Services and to HHSC. (Ranked No. 2 in FY 2017)

2. Hospice Plan of Care - Level B: 40 TAC §97.821(c) - The hospice failed to

provide care and services according to the Interdisciplinary Team’s written plan

of care. (Ranked No. 1 in FY 2017)


§97.243(b)(1)(A) - The administrator failed to manage the daily operations of

the agency. (Tied for No. 6 in FY 2017)

4. Management Responsibility Administrator - Level A and Level B:

§97.243(b)(1)(B), TAG 0130 - The administrator failed to carry out,

organize, and supervise ongoing work under the agency's administrative

policies. (Not ranked in FY 2017)

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§97.243(b)(1)(D) - The administrator failed to supervise to ensure

implementation of agency policy and procedures. (Tied for No. 6 in FY 2017)

6. Agency Investigations-Level B: 40 TAC §97.250(b)(3), TAG 0237 - The

Hospice failed to send its investigation report form no later than 10 days after

reporting abuse, neglect, or exploitation of a client by an agency employee,

contractor, or volunteer to the Department of Family and Protective Services

and HHSC. (Not ranked in FY 2017)

7. Client Records – Level A: 40 TAC §97.301(a)(7), TAG 0471 - The hospice

failed to keep client record entries current, accurate, signed, dated, and free of

corrections or alterations made by any means other than strikethroughs

properly identifying the person making each change. (Ranked No. 5 in FY 2017)

8. Management Responsibility Administrator - Level B: 40 TAC

§97.243(b)(1)(C), TAG 0132 - The administrator failed to administratively

supervise the provision of quality care to clients. (Not ranked in FY 2017)

9. Emergency Preparation Planning & Implementation - Level B: 40 TAC

§97.256(k), TAG 0302 - The Hospice failed to test the response phase of its

emergency preparedness and response plan by conducting a planned drill

consistent with state licensing rules as part of its annual review of the plan. (Not

ranked in FY 2017)

10. Client Records - Level A: 40 TAC §97.301(a), TAG 0475 - The hospice

failed to establish and maintain a client record system needed for the proper

documentation of client care and services and to facilitate the retrieval of

information. (Not ranked in FY 2017)

Top 10 Deficiencies Cited During Inspections for FY 2018:


Disability or Related Conditions - Health

1. Governing Body: 42 CFR 483.410(a)(1), TAG 0104 - The governing body

failed to provide operating direction over the facility’s policies, procedures, and

budget. (Ranked No. 1 in FY2017)

2. Qualified Intellectual Disability Professional: 42 CFR 483.430(a), TAG

0159 - The Qualified Intellectual Disability Professional failed to coordinate and

monitor individuals' program plans. (Ranked No. 3 in FY2017)

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3. Evacuation Drills: 42 CFR 483.470(i)(1), TAGS 0440 and 0441 - The

facility failed to hold fire drills under varied conditions, at least quarterly for

each shift of personnel. (Not ranked in FY2017)

4. Program Monitoring and Change: 42 CFR 483.440(f)(3)(ii), TAG 0263 -

The specially constituted committee failed to obtain individuals’ or guardians’

written informed consent for individual program plans that include restrictive

practices. (Ranked No. 5 in FY2017)

5. Physician Services: 42 CFR 483.460(a)(3), TAG 0322 - The facility failed to

provide preventive and general health care services. (Ranked No. 2 in FY2017)

6. Program Implementation: 42 CFR 483.440(d)(1), TAG 0249 - The facility

failed to implement continuous active treatment programs immediately after

individuals’ program plans were developed. (Ranked No. 9 in FY2017)

7. Infection Control: 42 CFR 483.470(I)(1), TAGS 0454 and 0455 - The

facility failed to maintain a program for prevention, control, and investigation of

infections as well as provide a sanitary environment to avoid infections. (Tag

0454 Ranked No. 10 in FY2017, tag 0455 not ranked in FY2017)

8. Drug Administration: 42 CFR 483.460(k)(2), TAG 0369 - The facility failed

to ensure there were no medication errors. (Ranked No. 8 in FY2017)

9. Program Monitoring and Change: 42 CFR 483.440(f)(3)(i), TAG 0262 -

The specially constituted committee failed to review, approve, and monitor

individual program plans that include restrictive practices involving risks to client

protections and rights. (Ranked No. 4 in FY2017)

10. Nursing Services: 42 CFR 483.460(c), TAG 0331 - The facility failed to

provide nursing services in accordance with individuals’ needs. (Ranked No. 7 in

FY2017)

Top 10 Deficiencies Cited During Inspections for FY 2018:


Disability or Related Conditions - Life Safety Code

1. Corridor - Doors: National Fire Protection Association 101, TAG S363 -

The facility failed to comply with requirements related to corridor doors. (Ranked

No. 1 in FY2017)

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2. Utilities - Gas and Electric: NFPA 101, TAG S511 - The facility failed to

comply with requirements for gas equipment, gas piping, or electrical wiring.

(Ranked No. 2 in FY2017)

3. Sprinkler System - Maintenance and Testing: NFPA 101, TAG S353 - The

facility failed to comply with requirements for testing, maintaining, and

inspecting a sprinkler system. (Ranked No. 4 in FY2017)

4. Fire Alarm System - Testing and Maintenance: NFPA 101, TAG S345 - The

facility failed to comply with requirements related to the testing and

maintenance of a fire alarm system or for retaining records related to the fire

alarm system. (Ranked No. 3 in FY2017)

5. Means of Escape - General: NFPA 101, TAG S211 - The facility failed to

comply with the requirements for a designated means of escape, which will be

continuously maintained clear of obstructions and impediments to full instant

use in the case of fire or emergency. (Ranked No. 7 in FY2017)

6. Evacuation and Relocation Plan: NFPA 101, TAG S711 - The facility failed

to comply with emergency evacuation and relocation plan requirements,

including maintaining a written emergency plan, training staff and residents on

the plan, or ensuring appropriate parties have access to the plan. (Ranked No. 8

in FY2017)

7. Smoking Regulations: NFPA 101, TAG S741 - The facility failed to comply

with requirements for smoking regulations, including adopting a plan to address

where smoking is permitted, or failed to provide noncombustible safety type

ashtrays or receptacles in convenient locations. (Ranked No. 9 in FY2017)

8. Fire Drills: NFPA 101, TAG S712 - The facility failed to comply with

requirements for conducting fire drills or ensuring staff are familiar with the

procedures. (Not ranked in FY2017)

9. Fire Alarm System - Installation: NFPA 101, TAG S341 – The facility failed

to comply with requirements for fire alarm installation. (Not ranked in FY2017)

10. Egress - Doors: NFPA 101, TAG S222 - The facility failed to comply with

requirements for egress doors including latches or locks (Ranked No. 6 in

FY2017)

G-43

Top 10 Deficiencies Cited During Inspections for FY 2018: Nursing

Facilities - Health

A new federal regulation set for Life Safety Code in this facility type went into effect

January 22, 2018. FY 2017 rankings will not be available for these new tags.

1. Infection Prevention and Control: 42 CFR 483.80(a)(1)(2)(4)(e)(f), TAG

0880 - The facility failed to comply with requirements related to an infection

prevention and control program.

2. Food Procure, Store/Prepare/Serve - Sanitary: 42 CFR 483.60(i)(1)(2),

TAG 0812 - The facility failed to comply with certain requirements related to

food sources, storage, and safe handling.

3. Develop/Implement Comprehensive Care Plan: 42 CFR 483.21(b)(1),

TAG 0656 - The facility failed to comply with certain requirements related to

the development and implementation of a person-centered care plan.

4. Pharmacy Services/Procedures/Pharmacist/Records: 42 CFR

483.45(a)(b)(1)-(3), TAG 0755 - The facility failed to comply with

requirements related to the provision of pharmaceutical services.

5. Free of Accident Hazards/Supervision/Devices: 42 CFR

483.25(d)(1)(2), TAG 0689 - The facility failed to comply with accident

prevention requirements.

6. Bowel/Bladder Incontinence, Catheter, UTI: 42 CFR 483.25(e)(1)-(3),

TAG 0690 - The facility failed to comply with requirements related to bowel and

bladder incontinence.

7. ADL Care Provided for Dependent Residents: 42 CFR 483.24(a)(2), TAG

0677 - The facility failed to comply with requirements for providing assistance

with daily living care for dependent residents.

8. Competent Nursing Staff: 42 CFR 483.35(a)(3)(4)(c), TAG 0726 - The

facility failed to comply with certain requirements related to the proficiency and

competency of the nursing staff.

9. Resident Records- Identifiable Information: 42 CFR 483.20(f)(5);

483.70(i)(1)-(5), TAG 0842 - The facility failed to comply with resident-

identifiable information and medical records requirements.

G-44

10. Develop/Implement Abuse/Neglect Policies: 42 CFR 483.12(b)(1)-(3),

TAG 0607 - The facility failed to comply with requirements related to the

development and implementation of written policies and procedures on abuse,

neglect, and exploitation of residents and misappropriation of resident property.

Top 10 Deficiencies Cited During Inspections for FY 2018: Nursing

Facilities - Life Safety Code

1. Heating Ventilation and Air Conditioning: National Fire Protection

Association (NFPA) 101, TAG 0521 - The facility failed to comply with Life

Safety Code requirements for heating, ventilation, and air conditioning systems.


2. Sprinkler System - Maintenance and Testing: NFPA 101, TAG 0353 - The

facility failed to comply with requirements for testing, maintaining, and

inspecting a sprinkler system or for retaining records related to the sprinkler

system. (Ranked No. 3 in FY 2017)

3. Subdivision of Building Spaces - Smoke Barrier Construction: NFPA 101,

TAG 0372 - The facility failed to construct smoke barriers in accordance to

certain Life Safety Code requirements or with the required resistance ratings.


4. Means of Egress - General: NFPA 101, TAG 0211 - The facility failed to

comply with requirements for egress, including aisles, passageways, corridors,

exit discharges, or exit locations. (Ranked No. 5 in FY 2017)

5. Hazardous Areas - Enclosure: NFPA 101, TAG 0321 - The facility failed to

comply with requirements related to the protection of hazardous areas. (Ranked

No. 4 in FY 2017)

6. Electrical Systems - Essential Electrical System Maintenance and

Testing: NFPA 101, TAG 0918 - The facility failed to test and maintain the

generator or alternate power source as required by the Health Care Facilities

Code. (Ranked No. 9 in FY 2017)

7. Corridor – Doors: NFPA 101, TAG 0363 - The facility failed to comply with

requirements related to corridor doors, including door construction and fire

rating, means for keeping doors closed, clearance beneath doors, impediments

to closure of doors, use of roller latches, or construction and labeling of door

frames. (Tied for No. 7 in FY 2017)

G-45

8. Cooking Facilities: NFPA 101, TAG 0324 - The facility failed to comply with

requirements related to cooking facilities or cooking equipment. (Tied for No. 7

in FY 2017)

9. Utilities - Gas and Electric: NFPA 101, TAG 0511 - The facility failed to

comply with the National Fuel Gas Code or the National Electric Code related to

equipment using gas or related gas piping. (Ranked No. 10 in FY 2017)

10. Egress Doors: NFPA 101, TAG 0222 - The facility failed to comply with

requirements for latches, locks, or special locking arrangements on egress

doors. (Not ranked in FY 2017)

Principles

Top 10 Principles Cited During Reviews for FY 2018: Home and

Community-based Services

1. Critical Incident in Data System: 40 TAC §9.178(y) - The program provider

failed to enter critical incident data in the HHSC data system no later than 30

calendar days after the last day of the month being reported. (Ranked No. 1 in

FY 2017)

2. Nursing - Monitoring Medications: 40 TAC §9.174(a)(31)(B) - The

program provider failed to ensure monitoring of medications. (Ranked No. 4 in

FY 2017)

3. Staff Training on Individual Needs: 40 TAC §9.177(d)(01)(A) - The

program provider failed to conduct initial and periodic training that ensured staff

members and service providers were qualified to deliver services as required by

the current needs and characteristics of the individuals to whom they delivered

services, including the use of restraint. (Ranked No. 3 in FY 2017)

4. Nursing - Comprehensive Assessments: 40 TAC §9.174(a)(31)(J)(ii) -

The program provider failed to ensure the RN performed comprehensive

assessments of individuals. (Ranked No. 6 in FY 2017)

5. Share with Service Coordinator: 40 TAC §9.178(c)(2) – The program

provider failed to ensure that the service coordinator was provided with a copy

of the results of the on-site inspection within five calendar days after completing

the inspection. (Ranked No. 2 in FY 2017)

G-46

6. Background Checks: 40 TAC §9.177(n) - The program provider failed to

complete the required background checks for employees. (Ranked No. 8 in FY

2017)

7. Training on Reporting Abuse, Neglect and Exploitation: 40 TAC

§9.177(d)(1)(B) - The program provider failed to o conduct initial and periodic

training that ensured staff members, service providers, and volunteers were

knowledgeable about the requirements for Abuse, Neglect and Exploitation as

noted in 40 TAC §49.310(3)(A). (Ranked No. 5 in FY 2017)

8. DFPS Report to DADS in 14 Days: 40 TAC §9.178(m)(2) – The program

provider failed to report the provider's response to findings of all DFPS

investigations of abuse, neglect, or exploitation to HHSC within 14 calendar days

of the provider's receipt of the investigation findings. (Ranked No. 10 in FY

2017)

9. Agree in Writing to Charges: 40 TAC §9.178(s) - The program provider

failed to ensure that an individual or Legally Authorized Representative agreed in

writing to all charges assessed by the program provider against the individual's

personal funds before the charges were assessed. (Not ranked in FY 2017)

10. Provide Nursing Services: 40 TAC §9.174(a)(31)(J)(iv) – The program

provider failed to ensure that nursing was provided in accordance with the

individual’s individual plan of care, person-directed plan, and applicable laws and

regulations. (Not ranked in FY 2017)

Top 10 Principles Cited During Reviews for FY 2018: Texas Home

Living

1. Report Critical Incident Data: 40 TAC §9.580(r) - The program provider

failed to enter critical incident data in the HHSC data system no later than 30

calendar days after the last calendar day of the month being reported. (Ranked

No. 1 in FY 2017)

2. Person Directed Plan Service Training: 40 TAC §9.579(d)(2) - The

program provider failed to ensure that a staff member who participates in

developing an implementation plan for Consumer First Choice Personal

Attendant Services/Habilitation completes person-centered service planning

training approved by HHSC. (Not ranked in FY 2017)

G-47

3. Background Checks: 40 TAC §9.579(r) - The program provider failed to

complete the required background checks for employees. (Ranked No. 4 in FY

2017)

4. TxHmL Services Provided: 40 TAC §9.578(d)(1) - The program provider

failed to provide Texas Home Living Program Services in accordance with an

individual's Person Directed Plan, Individual Plan of Care, Transportation Plan,

and Appendix C of the Texas Home Living Program Waiver Application. (Ranked

No. 5 in FY 2017)

5. Staff Knowledge/Report Abuse/Neglect: 40 TAC §9.579(d)(01)(B) - The

program provider failed to obtain the signature of a third-party witness

acknowledging that the provider obligations had been shared with the individual

or Legally Authorized Representative. (Ranked No. 6 in FY 2017)

6. Person Directed Plan Service Training: 40 TAC §9.579(d)(2)(A) - The

program provider failed to ensure that a staff member who was hired on or

before June 1, 2015 and participates in developing an implementation plan for

Consumer First Choice Personal Attendant Services/Habilitation completes

person-centered service planning training approved by HHSC by June 1, 2017.

(Not ranked in FY 2017)

7. Signed by Witness: 40 TAC §9.580(a)(21)(C) - The program provider failed

to obtain the signature of a third-party witness acknowledging that the provider

obligations had been shared with the individual or Legally Authorized

Representative. (Ranked No. 7 in FY 2017)

8. Program Documentation in Measurable Terms: 40 TAC §9.578(f) - The

program provider failed to ensure that an individual's progress or lack of

progress toward achieving identified outcomes was documented in observable,

measurable terms of specific outcome addressed and reviewed by the service

coordinator. (Ranked No. 9 in FY 2017)

9. No Nursing on Plan of Care: 40 TAC §9.578(q)(1) - The program provider

failed to determine that an individual did not require a nursing assessment when

nursing services were not on the individual's plan of care and the program

provider determined that no nursing task would be performed by unlicensed

service providers. (Ranked No. 8 in FY 2017)

10. Staff Training: 40 TAC §9.579(d)(1)(A) - The program provider failed to

conduct initial and periodic training that ensured staff members and service

providers are trained and qualified to deliver services as required by the current

G-48

needs and characteristics of the individual to whom they deliver services.


H-1

Appendix H. Waiver Programs - Home and Community-

based Services (HCS) and Texas Home Living (TxHmL)

Home and Community-based Services and Texas

Home Living Contracts

The tables below contain information relating to the Home and Community-based

Services and Texas Home Living waiver programs, by category, for fiscal year (FY)

2018.

Vendor Hold

If the state regulatory agency determines that the program provider is not in

compliance at the end of the follow-up review, it places a vendor hold on payments

due to the program provider. The state conducts a second on-site follow-up review

between 30 and 45 calendar days after the effective date of the vendor hold.

Denial of Certification

If the state determines that the program provider is not in compliance at the end of

the follow-up review to vendor hold, it denies certification of the program provider

and recommends termination of its waiver program provider agreement.

The state can deny certification of a program provider’s contract if there is a hazard

to the health, safety, or welfare of residents and the hazard is not eliminated before

the end of any review, or based on a program provider’s serious or pervasive

noncompliance with one or more of the program principles.

Home and Community-based Services Actions by Contract Area for FY

2018

Type of Remedy 01 02 03 04 05 06 07 08 09 Totals

Vendor hold 0 0 0 1 0 0 0 0 0 1

Denial of certification 0 0 0 0 0 0 0 0 0 0

H-2

Texas Home Living Actions by Contract Area for FY 2018

Type of Remedy 01 02 03 04 05 06 07 08 09 Totals

Vendor hold 0 0 0 0 0 0 0 0 0 0

Denial of certification 0 0 0 0 0 0 0 0 0 0

Home and Community-based Services Vendor Holds for FY 2018

Waiver

Contract

Area

Waiver

Contract City

Contract

Number Contract

Visit Exit

Date

4 Willis 1021680 Nayobi Health Services, LLC 06/13/2018

1 Total Home and Community-based Services vendor holds.

Texas Home Living Vendor Holds for FY 2018

HHSC did not recommend vendor hold for any Texas Home Living in FY 2018.

Home and Community-based Services Denials of Certification for FY

2018

HHSC did not recommend denial of certification for any Home and Community-

based Services in FY 2018.

Texas Home Living Denial of Certifications for FY 2018

HHSC did not recommend denial of certification for any Texas Home Living in FY

2018.

H-3

Home and Community-based Services and Texas

Home Living Complaints and Referrals

Complaints

Complaints are received by the regulatory complaint and incident intake unit. If it

determines regulatory action is required, the complaint is referred to regulatory

staff, which reviews the complaint to determine follow-up actions.

The actions are determined by:

● The severity of the complaint

● The number and severity of other complaints received about that program

provider

● The pattern and trends of any reported abuse, neglect, or exploitation

associated with the program provider

● The performance of the program provider on certification reviews

Desk Review

The state regulatory agency completes a desk review of the complaint if it is

determined that there is low risk to those served by that program provider. The

determination of low risk is made if the complaint did not involve issues that relate

to the health or safety of those served and if contact with the program provider

indicates the situation has been satisfactorily resolved.

On-Site Visit

The state conducts an on-site visit if there is significant risk to the clients involved

in the complaint. If the program provider is found to be out of compliance with one

or more program principles, the results are recorded in a certification review.

H-4

Home and Community-based Services and Texas Home Living

Complaints for FY 2018

Waiver Program Intakes

Received

Referred to

Waiver

Program

On-site

Review

Conducted

Home and Community-based Services 5,557 107 99

Texas Home Living 52 5 3

Total 5,609 112 102

Documents

HHSC Long-term Care Regulatory Annual Report for Fiscal