If the agency's revised plan of correction is still not acceptable, HHSC can pursue enforcement actions.

• For certified HCSSAs, HHSC sends the agency a letter proposing termination of certification. CMS will then send the agency a letter terminating certification.
• For licensed HCSSAs, HHSC may recommend enforcement action.

It is in the agency's interest to ensure that its plans of correction meet the criteria outlined in this course, in the document "How to Write an Acceptable Plan of Correction" (which is given to the agency at exit), and in S&CC Letter 07-13, Unacceptable Plan of Correction (PoC) Procedures.