W. Va. Code R. § 64-14-11

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 64-14-11 - Licensure Denials, Revocations, and Suspensions

11.1. An assisted living provider licensed by the Department of Health and Human Resources adversely affected by an order or citation of a deficient practice may request an informal dispute resolution process. A licensee may contest a cited deficiency as contrary to rule, regulation, or law or unwarranted by the facts, or any combination thereof.

11.2. The informal dispute resolution process is not a formal evidentiary proceeding and utilization of the informal dispute resolution does not waive the right of the licensee to request a formal hearing with the Secretary.

11.3. The informal dispute resolution process shall consist of the following:

11.3.1. The Secretary shall transmit to the licensee a statement of deficiencies attributed to the licensee and request that the licensee submit a plan of correction addressing the cited deficiencies no later than 10 working days following the last day of the survey or inspection, or no later than 10 working days following the last day of a complaint investigation. Notification of the availability of the informal dispute resolution process and an explanation of the process shall be included in the transmittal.

11.3.2. When the licensee returns its plan of correction to the Secretary, the licensee may request, in writing, to participate in the informal dispute resolution process to protest or refute all or part of the cited deficiencies within 10 working days. The Secretary may not release the final report until the informal dispute process is final.

11.3.3. The informal dispute resolution must be held, unless additional time is requested by either the licensee or the Secretary, within 10 working days of receipt of the written request for the informal dispute resolution process by a licensee. The licensee or the Secretary may submit additional information before the informal dispute resolution conference.

11.3.4. Neither the Secretary nor the licensee may be accompanied by counsel during the informal dispute resolution conference. The manner in which the informal dispute resolution conference is held is at the discretion of the licensee, but is limited to:

11.3.4.a. A review of written information submitted by the licensee;

11.3.4.b. A telephonic conference; or

11.3.4.c A face-to-face conference held at a mutually agreed upon location.

11.3.5. If the informal dispute resolution determines the need for additional information, clarification, or discussion at the conclusion of the informal dispute resolution conference, the Secretary and the licensee shall present the requested information.

11.3.6. The informal dispute resolution committee, consisting of qualified individuals who have no involvement in the investigation or survey being reviewed, shall make a determination within 10 working days of receipt of any additional information as provided or the conclusion of the informal dispute resolution conference, based upon the facts and findings presented, and shall transmit a written decision containing the rationale for its determination to the Secretary.

11.3.7. If the Secretary disagrees with the determination, the Secretary may reject the determination made by the informal dispute resolution process and shall issue an order setting forth the rationale for the reversal of the informal dispute resolution's decision to the licensee within 10 working days of receiving the independent review provider's determination.

11.3.8. If the Secretary accepts the determination, the Secretary shall issue an order affirming the informal dispute review's determination within 10 working days of receiving the review determination.

11.3.9. If the review determines that the original statement of deficiencies should be changed as a result of the informal dispute resolution process and the Secretary accepts the determination, the Secretary shall transmit a revised statement of deficiencies to the licensee within 10 working days of the review determination.

11.3.10. The licensee shall submit a revised plan to correct any remaining deficiencies to the Secretary within 10 working days of receipt of the Secretary's order and the revised statement of deficiencies.

11.4. Establishment of the informal dispute resolution process does not preclude licensees from utilizing other processes provided by statute or rule in lieu of the informal dispute resolution process.

11.5. Administrative and judicial review of a decision rendered through the informal dispute resolution process may be made in accordance with provisions of this rule.

11.6. Any decision issued by the Secretary as a result of the informal dispute resolution process shall be made effective from the date of issuance.

11.7. The pendency of administrative or judicial review does not prevent the Secretary or a licensee from obtaining injunctive relief as provided by statute or rule.

11.8. Grounds for Denial, Revocation, or Suspension.

11.8.1. The Secretary may deny, revoke, or suspend a license issued pursuant to this rule if any provisions of subdivision 11.8.2. are violated. The Secretary may revoke a license based upon the findings and results of an annual, periodic, complaint, or other inspection and evaluation. The period of suspension for the license of an assisted living residence shall be prescribed by the Secretary but may not exceed one year.

11.8.2. The Secretary may deny, revoke, or suspend an assisted living residence license for one or more of the following reasons:

11.8.2.a. The Secretary makes a determination that fraud or other illegal action has been committed by any owner of the assisted living residence;

11.8.2.b. The assisted living residence has violated federal, state, or local law relating to licensure, building, health, fire protection, safety, sanitation, or zoning;

11.8.2.c. The assisted living residence engages in practices that jeopardize the health, safety, welfare, or clinical treatment of a resident;

11.8.2.d. The assisted living residence has failed or refused to submit reports or make records available as requested by the Secretary;

11.8.2.e. An assisted living residence has refused to provide access to its location or records as requested by the Secretary;

11.8.2.f. An assisted living residence's administrator or owner has knowingly, and intentionally misrepresented actions taken to correct a violation;

11.8.2.g. An administrator or owner of an assisted living residence concurrently operates an unlicensed assisted living residence;

11.8.2.h. An administrator or any owner knowingly operates, owns, or manages an unlicensed assisted living residence that is required to be registered;

11.8.2.i. The owners of an assisted living residence fail to apply for a new license for the residence upon a change of ownership and operate the residence under the new ownership;

11.8.2.j. An administrator or any owner acquires or attempts to acquire a license for an assisted living residence through misrepresentation or fraud or procures or attempts to procure a license for an assisted living residence for any other person by making or causing to be made any false representation; or

11.8.2.k. The assisted living residence fails to have an administrator at the residence location as required by this rule.

11.9. Effect of Denial, Revocation, or Suspension.

11.9.1. If a license for an assisted living residence has been revoked, the Secretary may stay the effective date of the revocation if the owner or owners or administrator of the assisted living residence can show that the stay is necessary to ensure appropriate referral and placement of residents.

11.9.2. If the license of an assisted living residence is denied, revoked, or suspended, no person, firm, association, or corporation may operate the residence as an assisted living residence as of the effective date of the denial, revocation, or suspension. The owners of the assisted living residence are responsible for removing all signs and symbols identifying the premises as an assisted living residence within 30 days from the date of the denial, revocation, or suspension.

11.9.3. If a license for an assisted living residence has been denied, revoked, or suspended the residence must supply, at a minimum, a copy of the following information to the Secretary;

11.9.3.a. A closure notice to be provided to all residents;

11.9.3.b. The date the closure notice will be provided to all residents;

11.9.3.c. The number of residents to receive the closure notice;

11.9.3.d. A Class II legal advertisement that complies with the requirements of W. Va. Code §§ 59-3-1, et seq., regarding the residence closure, including the dates the notice will appear and the name of the newspaper; and

11.9.3.e. Contact information the assisted living residence has supplied to residents who may need help locating a new assisted living residence.

11.9.4. Upon the effective date of the denial, revocation, or suspension the administrator or owner of the assisted living residence shall advise the Secretary and the West Virginia Board of Pharmacy of the disposition of all drugs located at the premises. The disposition is subject to the supervision and approval of the Secretary and the Drug Enforcement Agency. Drugs that are purchased or held by an unlicensed assisted living residence may be deemed adulterated.

11.9.5. If the license of an assisted living residence is revoked or suspended, no persons owning or operating the assisted living residence, may apply to own, license, or operate another assisted living residence for five years after the date of revocation or suspension, either individually or as part of a group, firm, association, or corporation.

11.9.6. If an assisted living residence license is denied or revoked, a new application for licensure shall be considered by the Secretary, if, when, and after the conditions upon which denial or revocation were based have been corrected and evidence of this fact has been furnished. A new license may then be granted after proper inspection has been made and the Secretary makes a written finding that all provisions of this rule have been satisfied.

W. Va. Code R. § 64-14-11