26 Tex. Admin. Code § 554.503 - Notice of Bed-Hold Policy and Return to Medicaid-Certified Facilities
(a) Notice before transfer. Before a nursing
facility transfers a resident to a hospital or a resident goes on therapeutic
leave, the nursing facility must provide written information to the resident or
resident representative that specifies:
(1)
the duration of the bed-hold policy under the Medicaid State Plan, if any,
during which the resident is permitted to return and resume residence in the
facility;
(2) the reserved bed
payment policy, in the State plan;
(3) the facility's policies regarding
bed-hold periods, which must be consistent with subsection (c) of this section,
permitting a resident to return; and
(4) the information specified in §
554.502 of this subchapter
(relating to Transfer and Discharge in Medicaid-certifiedFacilities).
(b) Bed-hold notice upon transfer.
At the time of transfer of a resident to a hospital or for therapeutic leave, a
nursing facility must provide to the resident and resident representative,
written notice which specifies the duration of the bed-hold policy described in
subsection (a) of this section.
(c)
Permitting resident to return to facility. A nursing facility must establish
and follow a written policy on permitting residents to return to the facility
after they are hospitalized or placed on therapeutic leave.
(1) The policy must provide that a resident
whose hospitalization or therapeutic leave exceeds the bed-hold period under
the State Plan returns to the facility and to the resident's previous room if
available or returns to the facility immediately upon the first availability of
a bed in a semi-private room if the resident:
(A) requires the services provided by the
facility; and
(B) is eligible for
Medicare skilled nursing facility services or Medicaid nursing facility
services.
(2) If the
facility that determines that a resident who was transferred with an
expectation of returning to the facility cannot return to the facility, the
facility must comply with the requirements of §
554.502 of this
subchapter.
(d)
Readmission to a composite distinct part. When the facility to which a resident
returns is a composite distinct part, as defined by
42
CFR §
483.5, the resident must be
permitted to return to an available bed in the particular location of the
composite distinct part in which the resident resided previously. If the bed is
not available in that location at the time of readmission, the resident must be
given the option to return to that location upon the first availability of a
bed.
(e) Bed-hold charges. The
facility may enter into a written agreement with the resident or resident
representative to reserve a bed.
(1) The
facility may charge the recipient an amount not to exceed the HHSC daily vendor
rate according to the recipient's classification at the time the resident
leaves the facility.
(2) The
facility must document all bed-hold charges in the recipient's financial record
at the time the bed-hold reservation services were provided.
(3) The facility may not charge a bed-hold
fee if HHSC is paying for the same period of time, as in a three-day
therapeutic home visit.
Notes
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No prior version found.