26 Tex. Admin. Code § 368.505 - Transfer between Nursing Facilities in Different Contract Areas and Local Service Areas
(a) When a
designated resident moves from a NF in one local service area to a NF in a
different contract area and a different local service area without an
intervening hospital stay, the transferring LIDDA must:
(1) within three business days of learning
that the designated resident will move or has moved:
(A) notify the service provider agency and
determine whether the service provider agency has a contract in the new local
service area;
(B) determine whether
the designated resident wants to select a new service provider agency or
continue receiving IHSS from the current service provider agency, if the
service provider agency has a contract in the new local service area;
and
(C) notify the receiving LIDDA
of the move date and whether the designated resident must select a new service
provider agency;
(2) send
the receiving LIDDA:
(A) all assessments,
including the PE;
(B) the HSP and
individual profile form;
(C) the
current plan of care; and
(D) any
other information requested by the receiving LIDDA;
(3) terminate the current plan of care
effective on the move date, if the designated resident must select a new
service provider agency; and
(4)
terminate the habilitation coordination service authorization in accordance
with the Habilitation Coordination Billing Guidelines.
(b) When the designated resident moves to the
NF in a new local service area, the receiving LIDDA must:
(1) comply with Chapter 303 of this title
(relating to Preadmission Screening and Resident Review (PASRR)) and follow
processes described in the IDD PASRR Handbook;
(2) if the designated resident must choose a
new service provider agency, ensure the designated resident or LAR selects a
new service provider agency in accordance with §
368.203 of this chapter (relating
to Process for Provider Selection); and
(3) initiate IHSS at the NF in accordance
with §
368.204 of this chapter (relating
to Process for Service Initiation).
(c) If the service provider agency has a
contract in the new local service area and the designated resident or LAR
elects to receive IHSS from the same service provider agency, the service
provider agency may continue to deliver IHSS in accordance with §
368.502(b) of
this subchapter (relating to Transfer between Nursing Facilities in the Same
Contract Area and Local Service Area).
(d) If the designated resident selects a new
service provider agency:
(1) the new service
provider agency must ensure IHSS are not delivered until HHSC has authorized
the IHSS on the plan of care; and
(2) the previous service provider agency must
respond to the transferring or receiving LIDDA's requests for information or
documentation related to the designated resident's IHSS within three business
days of the request.
Notes
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