R510-200-10. De-Designation of Service Providers

  (1) Criteria for De-designation.

  (a) the SLTCO may de-designate an entity, including an AAA, as a Provider Agency for one or more of the following reasons:

  (i) failure to continue to meet the criteria for designation;

  (ii) existence of a conflict of interest with the LTCOP as outlined in section R510-200-14, Conflicts of Interest;

  (iii) failure to disclose any conflict of interest;

  (iv) violation of SLTCO confidentiality requirements as outlined in section R510-200-24, Confidentiality;

  (v) failure to provide adequate LTCO services;

  (vi) failure to fill a vacant ombudsman position;

  (vii) failure to use funds designated for the LTCOP for LTCO services or as directed by the SLTCO as outlined in section R510-200-4, Program Administration;

  (viii) failure to adhere to the terms of the contract for the provision of ombudsman services; or

  (iv) failure to adhere to applicable Federal and State laws and regulations.

  (2) Process for De-designation of a Provider Agency.

  (a) when an AAA serves as a Provider Agency, the process to de-designate the Provider Agency shall be as follows:

  (i) the SLTCO shall send notice of the intent to de-designate to the AAA. Notice shall include the reason for de-designation;

  (ii) the Provider Agency shall respond in writing to the notice within ten business days, outlining its plan to reach compliance; and

  (iii) after ten business days have passed, and at its sole discretion, SLTCO may amend or terminate the contract between the AAA and the Division.

  (b) when an AAA contracts with a Provider Agency, the process to de-designate the Provider Agency shall be as follows:

  (i) the SLTCO shall send notice of the intent to de-designate to the AAA and the Provider Agency. Notice shall include the reason for de-designation;

  (ii) the AAA and SLTCO shall provide for the continuation of ombudsman services by ensuring that either the SLTCO or the AAA are providing services to that specific area;

  (iii) the Provider Agency shall respond within ten business days, outlining its plan to reach compliance; and

  (iv) after ten business days have passed, and at the discretion of the AAA and the SLTCO, an AAA may terminate its contract for LTCO services with the Provider Agency.

  (c) when a Provider Agency contracts directly with the Division, the process to de-designate the Provider Agency shall be as follows:

  (i) the SLTCO shall send notice of the intent to de-designate to the Provider Agency. Notice shall include the reason for de-designation;

  (ii) the SLTCO shall ensure the provision of continued ombudsman services;

  (iii) the Provider Agency shall respond in writing to the notice within ten business days, outlining its plan to come into compliance;

  (iv) after ten business days have passed, and at its sole discretion, the SLTCO may terminate the contract with the Provider Agency; and

  (v) when immediate de-designation is deemed necessary, the Provider Agency shall respond in writing to the notice of immediate de-designation within five business days, outlining its plan to come into compliance.

  (3) Voluntary Withdrawal of a Provider Agency.

  (a) a Provider Agency may voluntarily relinquish its designation by:

  (i) providing written notice 90 days in advance of the date of relinquishment of designation to the SLTCO and AAA; and

  (ii) maintaining and performing program activities during the 90 days.

  (4) Continuation of Ombudsman Services.

  (a) when a Provider Agency is in the process of appealing its de-designation or has relinquished its designation:

  (i) the SLTCO or the AAA, if applicable, may arrange for the provision of ombudsman services until a new Provider Agency is designated;

  (ii) the Provider Agency shall, at the sole discretion of the SLTCO, surrender any equipment and supplies purchased with State or Federal funds designated for LTCO services; and

  (iii) the Provider Agency shall surrender the balance of any advanced State or Federal monies to the AAA, or to the SLTCO where the AAA serves as the Provider Agency.

  (5) Appeal Procedures of De-Designation.

  (a) the Provider Agency may file an appeal with the Director of the Division to have complaints heard regarding any de-designation activities by:

  (i) contacting the Director in writing within ten business days of the SLTCO final decision for de-designation; and

  (ii) address directly:

  (A) the stated reason for de-designation;

  (B) how the Provider Agency has made corrections and come into compliance;

  (C) how said corrections qualify the Provider Agency for re-designation; and

  (D) sub-contracted agencies must use this process to appeal directly to the AAA.

  (b) where the Director of the Division denies the appeal for re-designation, final appeal may be made to the State of Utah Department of Human Services Deputy Director by:

  (i) contacting the Deputy Director in writing within ten business days of the Division Director's denial; and

  (ii) address directly:

  (A) the stated reason for de-designation;

  (B) the stated reason for denial of appeal for re-designation;

  (C) how the Provider Agency has made corrections and come into compliance; and

  (D) how said corrections qualify the Provider Agency for re-designation.