Current through Reg. 49, No. 38; September 20, 2024
(a) If an individual seeks admission to a
nursing facility, the nursing facility:
(1)
must coordinate with the referring entity to ensure the referring entity
conducts a PL 1; and
(2) may
provide assistance in completing the PL 1, if the referring entity is a family
member, LAR, other personal representative selected by the individual, or a
representative from an emergency placement source and requests assistance in
completing the PL 1.
(b)
A nursing facility must not admit an individual who has not had a PL 1
conducted before the individual is admitted to the facility.
(c) If an individual's PL 1 indicates the
individual is not suspected of having MI, ID, or DD, a nursing facility must
enter the PL 1 from the referring entity into the LTC Online Portal. The
nursing facility may admit the individual into the facility through the routine
admission process.
(d) For an
individual whose PL 1 indicates the individual is suspected of having MI, ID,
or DD, a nursing facility:
(1) must enter the
PL 1 into the LTC Online Portal if the individual's admission category is:
(A) expedited admission; or
(B) exempted hospital discharge;
and
(2) must not enter
the PL 1 into the LTC Online Portal if the individual's admission category is
pre-admission.
(e)
Except as provided by subsection (f) of this section, a nursing facility must
not admit an individual whose PL 1 indicates a suspicion of MI, ID, or DD
without a complete PE and PASRR determination.
(f) A nursing facility may admit an
individual whose PL 1 indicates a suspicion of MI, ID, or DD without a complete
PE and PASRR determination only if the individual:
(1) is admitted as an expedited
admission;
(2) is admitted as an
exempted hospital discharge; or
(3)
has not had an interruption in continuous nursing facility residence other than
for acute care lasting fewer than 30 days and is returning to the same nursing
facility.
(g) A nursing
facility must check the LTC Online Portal daily for messages related to
admissions and directives related to the PASRR process.
(h) Within seven calendar days after the
LIDDA or LMHA has entered a PE or resident review into the LTC Online Portal
for an individual or resident who has MI, ID, or DD, a nursing facility must:
(1) review the recommended list of nursing
facility specialized services, LIDDA specialized services, and LMHA specialized
services; and
(2) certify in the
LTC Online Portal whether the individual's or resident's needs can be met in
the nursing facility.
(i) After an individual or resident who is
determined to have MI, ID, or DD from a PE or resident review has been admitted
to a nursing facility, the facility must:
(1)
contact the LIDDA or LMHA within two calendar days after the individual's
admission or, for a resident, within two calendar days after the LTC Online
Portal generated an automated notification to the LIDDA or LMHA, to schedule an
IDT meeting to discuss nursing facility specialized services, LIDDA specialized
services, and LMHA specialized services;
(2) convene the IDT meeting within 14
calendar days after admission or, for a resident review, within 14 calendar
days after the LTC Online Portal generated an automated notification to the
LIDDA or LMHA;
(3) participate in
the IDT meeting to:
(A) identify which of the
nursing facility specialized services, LIDDA specialized services, and LMHA
specialized services recommended for the resident that the resident, or LAR on
the resident's behalf, wants to receive; and
(B) determine whether the resident is best
served in a facility or community setting.
(4) provide staff from the LIDDA and LMHA
access to the resident and the resident's clinical facility records upon
request from the LIDDA or LMHA;
(5)
enter into the LTC Online Portal within 3 business days after the IDT meeting
for a resident:
(A) the date of the IDT
meeting;
(B) the name of the
persons who participated in the IDT meeting;
(C) the nursing facility specialized
services, LIDDA specialized services, and LMHA specialized services that were
agreed to in the IDT meeting; and
(D) the determination of whether the resident
is best served in a facility or community setting;
(6) include in the comprehensive care plan:
(A) the nursing facility specialized services
agreed to by the resident or LAR; and
(B) the nursing facility PASRR support
activities;
(7) submit a
complete and accurate request for nursing facility specialized services in the
LTC Online Portal within 20 business days after the date of the IDT
meeting;
(8) start providing a
therapy service within three business days after receiving approval from HHSC
in the LTC Online Portal;
(9) order
DME or CMWC in accordance with § 554.2754(e) of this subchapter (relating
to Requesting Authorization to Provide Durable Medical Equipment and Customized
Manual Wheelchairs);
(10) provide
on-going therapy services as approved by HHSC;
(11) for a designated resident, annually
document in the LTC Online Portal all nursing facility specialized services,
LIDDA specialized services, and LMHA specialized services being provided to the
designated resident; and
(12)
promptly report a significant change in the mental or physical condition of a
resident by submitting a MDS Significant Change in Status Assessment Form in
the LTC Online Portal.
