1. CMS and State Enforcement
Mary T. Henderson, Assistant Commissioner, Regulatory Services, Texas Department of Aging and Disability Services
Derek Jakovich, Enforcement Director, Regulatory Services, Texas Department of Aging and Disability Services

2. CMS Perspective
Ginger Odle, CMS Region 6 Enforcement Branch Manager

3. State Attorney General’s Perspective
William Carpenter, Texas Assistant Attorney General

4. When a case is referred to the Office of the Attorney General (OAG)
LAWSUIT!
DUTY TO PRESERVE EVIDENCE
COLLECTING EVIDENCE
IDENTIFYING THE DEFENDANTS

5. When a case is referred to the OAG
DUTY TO PRESERVE EVIDENCE
There is a legal duty to preserve evidence that is relevant to a lawsuit regarding a violation.
Examples: Database Records, Documents, Reports, Letters, s.
Document retention policies

6. When a case is referred to the OAG
COLLECTING EVIDENCE
A lawsuit requires solid evidence that defendants violated the law.
Need evidence for each element to the cause of action
Look to the statute for elements
What is good evidence for a lawsuit?

7. When a case is referred to the OAG
IDENTIFYING THE DEFENDANTS
A lawsuit requires evidence that identifies the defendants and connects the defendants to the facility
References in survey documents: facility and owner(s)
Review documents filed with agency. Verify the information.
Sources to verify

8. CMS and State Enforcement – State Enforcement
Organization – Enforcement Staff in State Office; Enforcement Coordinators in Regional Offices across the state
The enabling statute and administrative rules govern all state enforcement actions
Texas Administrative Procedures Act (APA)

9. CMS and State Enforcement
Communication and coordination between staff is the key to success
Regional Staff
Enforcement Staff
Office of General Counsel – Regional Enforcement Attorneys
CMS Enforcement Branch

10. CMS and State Enforcement
Process
It all starts with a survey or an investigation
Deficiencies or violations found
Issuance of a federal 2567 or a State Form
Regional Enforcement Review
Is there a Right To Correct?
Evidence

11. CMS and State Enforcement
Due Process
Notice
Informal Settlement Conferences
Administrative Hearings
PFDs – ALJs proposed decisions
Commissioner’s Final Decisions
Appeals
Enforcement Action Taken