Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
Subchapter X - REQUIREMENTS FOR MEDICAID-CERTIFIED FACILITIES
Section 554.2310 - Nursing Facility Ceases to Participate
Universal Citation: 26 TX Admin Code ยง 554.2310
Current through Reg. 49, No. 38; September 20, 2024
A nursing facility may voluntarily terminate or be involuntarily terminated from Medicaid participation. A facility must have policies and procedures in place to ensure that the administrator's duties and responsibilities include providing the appropriate notices in the event of a Medicaid termination.
(1) If a facility voluntarily closes and ceases providing nursing facility services, the facility must comply with this paragraph.
(A)
The facility must close on the first day of a month.
(B) At least 75 days before closure, the
administrator must submit to the HHSC regional director a plan for relocation
of all residents. The plan must:
(i) provide
for the transfer and adequate relocation of the residents;
(ii) include assurances that residents are
Transferred to the most appropriate facility or other setting in terms of
quality, services, and location, taking into consideration the needs, choice,
and best interests of each resident; and
(iii) be revised as necessary to obtain HHSC
approval.
(C) At least
60 days before closure, the administrator must submit written notice of the
closure that includes the approved closure plan and the closure date to:
(i) the secretary or the secretary's
designee;
(ii) HHSC Regulatory
Services;
(iii) the State
Ombudsman;
(iv) each resident;
and
(v) each resident's legal
representative or responsible party.
(D) The notice to each resident and the
resident's legal representative or responsible party must include the
information required by § 554.502(f) of this chapter (relating to Transfer
and Discharge in Medicaid-certified Facilities).
(E) The facility must not admit any new
residents on or after the date the written notice is submitted.
(F) The facility must have the resources to
operate through the closure date.
(2) If HHSC or CMS terminates a facility's Medicaid provider agreement, the facility must comply with this paragraph.
(A) At least 15 days before the notice date
set by HHSC or CMS, the administrator must submit to the HHSC regional director
a plan for relocation of all residents. The plan must:
(i) provide for the transfer and adequate
relocation of the residents;
(ii)
include assurances that residents are Transferred to the most appropriate
facility or other setting in terms of quality, services, and location, taking
into consideration the needs, choice, and best interests of each resident;
and
(iii) be revised as necessary
to obtain HHSC approval.
(B) By the date set by HHSC or CMS, the
administrator must submit written notice of the closure that includes the
approved plan and the closure date to:
(i)
the secretary or secretary's designee;
(ii) HHSC Regulatory Services;
(iii) the State Ombudsman;
(iv) each resident; and
(v) each resident's legal representative or
responsible party.
(C)
The notice to each resident and the resident's legal representative or
responsible party must include the information required by § 554.502(f) of
this chapter.
(D) The facility must
not admit any new residents on or after the date the notice is
submitted.
(3) If a facility voluntarily withdraws from Medicaid but continues to provide nursing facility services, the facility must comply with this paragraph.
(A) The facility may not use the withdrawal
as a reason to transfer or discharge a resident who was residing in the
facility on the day before the effective withdrawal date.
(B) The facility is deemed to have a provider
agreement with regard to any resident who was residing in the facility on the
day before the effective withdrawal date and who is eligible for Medicaid or
who later becomes eligible for Medicaid.
(C) The facility must:
(i) provide oral and written notice to an
individual who is admitted after withdrawal from Medicaid that:
(I) the facility is not participating in the
Medicaid program with respect to new residents; and
(II) the facility may transfer or discharge a
resident if the resident does not pay the facility charges even though the
resident may have become eligible for Medicaid nursing facility
services;
(ii) provide
the written notice in a prominent manner on a separate page of the admission
agreement when the resident is admitted; and
(iii) have the resident sign a written
receipt, separate from other signed documents, that the resident received the
information in the written notice.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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