N.M. Admin. Code § 7.20.11.14

Current through Register Vol. 35, No. 23, December 10, 2024

Section 7.20.11.14 - PROGRAM SURVEYS, INVESTIGATIONS, AND REPORTS

A. Application for certification, whether initial or renewal, constitutes permission for entry into, and surveys of a program by the authorized LCA representatives at reasonable times while the application is pending.

B. LCA surveyors may enter the premises of an agency at any time and review any and all records of medicaid recipients, CYFD custody clients and agency staff; the LCA may conduct interviews with staff and/or clients in programs that are certified or required to be certified, whether or not an application for certification has been made, for the purpose of determining compliance with these certification requirements.

C. The LCA may conduct a survey(s) to assess/monitor progress with correction of violations found on previous surveys; or to investigate complaints or allegations of abuse, neglect or exploitation. The LCA may also conduct inquiry into matters of potential health and/or safety risk to clients as identified in serious incident reports or other information received by the LCA.

D. Findings made by the LCA during on-site surveys or investigations described in these certification requirements may result in changes of certification status, sanction(s), suspension, revocation, non-renewal, or denial of certification in accordance with all of the guidelines governing such actions as defined in these certification requirements.

E. When certification on-site surveys are conducted concurrently with licensing on-site surveys and there are violations found of both licensing and certification requirements that do not directly overlap, the LCA may issue a single report citing deficiencies with reference to both licensing and certification requirements.

F. When, during a certification survey, the LCA finds a violation(s) of these certification requirements that also constitute(s) a violation(s) of the licensing regulations of the department, the LCA may issue a single report addressing the violation(s) with reference to certification requirements only.

G. REPORTS:

(1) The LCA issues a written report of the findings for all required certification surveys within 30 business days of completion of the survey.

(2) When a survey is conducted for purposes of investigation, the LCA issues a report in instances of partial or fully substantiated complaint(s)/allegation(s) within 30 business days of the completion of the investigation.

(3) When a survey is conducted for purposes of investigation and the complaint(s)/allegation(s) are unsubstantiated, the LCA issues a letter indicating that the complaint was not substantiated, but does not issue a report.

(4) When a survey is conducted for the purposes of inquiry into questions of compliance arising from incident reports or other reports, the LCA may issue a report of any findings of noncompliance. If such a report is issued, it will be issued within 30 calendar days after completion of the survey.

(5) When a survey is conducted for purposes of following-up a monitoring plan, the LCA issues a follow up letter, but does not issue a report unless information obtained during such a visit indicates the need for a full program review and/or additional investigation(s).

(6) When a survey is conducted for purposes of technical assistance, the LCA does not issue a report.

(7) A report of a survey or investigation may be combined with a notice of contemplated action or notice of emergency sanction.

N.M. Admin. Code § 7.20.11.14

7.20.11.14 NMAC - Rp 7 NMAC 20.11.14, 03/29/02