Nebraska Administrative Code Topic - HEALTH AND HUMAN SERVICES SYSTEM
1. Overview of Nebraska Administrative Code – Health and Human Services (HHS)
The Nebraska Administrative Code for HHS sets rules for:
Licensing and regulation of healthcare facilities – Hospitals, clinics, nursing homes, and assisted living facilities.
Professional licensing and conduct – Nurses, social workers, and other healthcare professionals.
Public health and safety regulations – Infection control, medication management, and sanitation.
Medicaid and assistance programs – Eligibility, benefits, and administrative procedures.
Contested case procedures – How complaints, violations, and disputes are formally handled.
The NAC ensures public health and safety while providing due process for licensees and facilities.
2. Contested Case Procedures in HHS
HHS follows a structured process when rules are violated:
Complaint/Notice of Violation – A complaint is filed when a facility or professional violates HHS rules.
Response – The licensee may respond in writing, providing evidence or explanations.
Investigation and Hearing – HHS conducts an investigation and may hold a contested case hearing.
Decision and Sanctions – HHS issues a decision, which can include fines, suspension, revocation, or corrective actions.
Appeal – Licensees can appeal the decision according to administrative law procedures.
3. Detailed Case Examples
Here are five illustrative cases based on common types of HHS violations:
Case 1: Nursing Home Medication Error
Rule Violated: Medication administration must follow established procedures, including double-checking dosages and documenting administration.
Scenario:
A nursing home nurse accidentally gave a resident twice the prescribed dose of a blood pressure medication. The incident was reported to HHS.
Outcome:
HHS conducted an investigation and found insufficient staff training and supervision.
The facility was required to provide retraining for all nursing staff.
A fine was issued, and the facility’s license was placed on probation for 12 months.
This case emphasizes the importance of proper training and documentation in resident care.
Case 2: Hospital Sanitation Violation
Rule Violated: Hospitals must maintain sanitary conditions in all patient care areas.
Scenario:
During a routine inspection, HHS found mold in a hospital’s storage room and improper cleaning of surgical instruments.
Outcome:
The hospital received a notice of violation and was required to submit a corrective action plan.
A follow-up inspection confirmed compliance.
No suspension was issued, but HHS retained authority to re-inspect.
This illustrates HHS’s role in maintaining infection control standards.
Case 3: Assisted Living Facility Abuse Allegation
Rule Violated: Facilities must prevent abuse and neglect of residents.
Scenario:
A family reported that a caregiver at an assisted living facility was verbally and physically abusive toward a resident.
Outcome:
HHS conducted interviews and reviewed surveillance footage.
The caregiver was terminated, and the facility was fined for failing to monitor staff adequately.
Mandatory staff retraining on resident rights and abuse prevention was required.
This shows HHS enforcement protects vulnerable populations in residential care.
Case 4: Social Worker Licensing Violation
Rule Violated: Licensed social workers must adhere to professional conduct and ethical guidelines.
Scenario:
A social worker was found to have disclosed confidential client information without consent.
Outcome:
HHS conducted a contested case hearing.
The social worker received a license suspension for six months and had to complete ethics training before reinstatement.
This highlights HHS oversight of professional conduct and confidentiality in human services.
Case 5: Medicaid Fraud Investigation
Rule Violated: Providers must submit accurate billing for Medicaid services.
Scenario:
A home health agency submitted claims for services that were not provided.
Outcome:
HHS investigated and found repeated false claims.
The agency was required to repay the overbilled amount, was fined, and had its Medicaid provider status suspended.
The case demonstrates HHS enforcement of financial and program integrity standards.
4. Key Takeaways from HHS NAC Enforcement
Public Safety First – Inspections, training, and compliance ensure the safety of residents and patients.
Due Process for Licensees – Contested case hearings allow for defense and evidence presentation.
Broad Authority – HHS can sanction facilities, individual professionals, or agencies depending on the severity of violations.
Corrective Measures – Many cases involve training, policy changes, and ongoing monitoring.
Protection of Vulnerable Populations – NAC rules specifically safeguard residents in nursing homes, assisted living, and other care facilities.
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