(a) The Texas Health and Human Services Commission (HHSC) gives a licensee a formal hearing notice if:(1) HHSC proposes a sanction; or(2) HHSC upholds or modifies a proposed sanction after an informal review, in accordance with §555.52 of this subchapter (relating to Informal Reviews).(b) The formal hearing notice to the licensee includes:(1) a description of the alleged rule violations warranting the proposed sanction;(2) HHSC decision to uphold or modify the sanction if the notice is issued after an informal review; and(3) the option for the licensee to:(A) accept the sanction; or(B) request a formal hearing no later than 20 days after receiving the formal hearing notice from HHSC.(c) If the licensee does not accept a modified sanction resulting from an informal review, the hearing notice may be for the original sanction HHSC proposed before the informal review.(d) HHSC imposes a sanction against a licensee if:(1) the licensee accepts the decision from HHSC to impose the sanction;(2) the administrative law judge upholds the proposed sanction from HHSC after the formal hearing; or(3) the licensee does not request a hearing within 20 days after receiving the formal hearing notice from HHSC.(e) A hearing is governed by Texas Administrative Code,