(DD) Waiver Service Standards - New Mexico Department of Health

(a) There is any failure to comply with a state regulation or Provider
Agency agreement or contract requirement where that failure poses an
immediate threat of death to an individual;
(b) There is any failure to comply with applicable regulation where that
failure to comply poses a substantial probability of serious mental or
physical harm to an individual or individuals;
(c) The occurrence of a repeated deficiency that poses a substantial risk to
the health or safety to individual or individuals; and
(d) The occurrence of a repeated deficiency that infringes on an
individual’s rights.
(5) Assessment of Penalties: If the DOH assesses financial penalties, an
assessment of penalties will be issued. The assessment shall describe each
violation committed by the Provider Agency, the regulation, contract or
agreement that has been violated, and the duration of the violation. If the
Provider Agency does not contest the imposition or amount of the penalty,
the Provider Agency shall pay within thirty (30) calendar days of receipt of
the assessment of the penalty. If the Provider Agency disagrees with the
imposition or amount of the penalty, the Provider Agency shall notify the
DOH within ten (10) calendar days of receipt of the assessment of
penalties. The DOH will schedule an informal conference to resolve the
dispute, and a written decision based on this conference will be provided. If
the Provider Agency is still dissatisfied with the written decision, a DOH
administrative hearing may be requested.
(6) Other sanctions for failure to comply may include:
(a) DOH may refuse to issue or renew agreement and/or contract to
operate;
(b) DOH may termination of the Provider Agency’s DD Waiver
Agreement and /or contract;
(c) When upon investigation, conditions are found which, in the opinion of
the DOH, immediately endanger the health or safety of the individuals
living in or attending the Provider Agency’s services, the DOH may
request that court suspend the agreement and/or contract on an
emergency basis;
(d) Mandated DDSD Regional Office Intervention (review of other DDSD
services, directed technical assistance, required training);
(e) Review by DHI;
(f) Withholding of payment;
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