Section 261.241 - Level of Need Criteria(a) The department will assign one of five LONs as follows: (1) An intermittent LON (LON 1) will be assigned if the person's ICAP service level score equals 7, 8, or 9;(2) A limited LON (LON 5) will be assigned if the person's ICAP service level score equals 4, 5, or 6, or an LON 1 is increased in accordance with subsection (b) or (d) of this section;(3) An extensive LON (LON 8) will be assigned if the person's ICAP service level score equals 2 or 3, or an LON 5 is increased in accordance with subsection (b) or (d) of this section;(4) A pervasive LON (LON 6) will be assigned if the person's ICAP service level score equals 1, or an LON 8 is increased in accordance with subsection (b) or (d) of this section; and(5) Regardless of a person's ICAP service level score, a pervasive plus LON (LON 9) will be assigned if the person meets the criteria set forth in subsection (c) of this section.(b) An LON 1, LON 5, or LON 8 will be increased to the next LON by the department, due to a person's dangerous behavior, if the supporting documentation described in § 261.242 (1) of this chapter (relating to Supporting Documentation for Level of Need) is submitted to the department proving that: (1) the person exhibits dangerous behavior that could cause serious physical injury to the person or others;(2) a written behavior intervention plan has been implemented for the person;(3) more staff members are needed and available than would be needed if the person did not exhibit dangerous behavior;(4) management of the individual's behavior requires that staff members are constantly prepared to physically prevent the dangerous behavior or intervene when the behavior occurs; and(5) the person's MR/RC Assessment is correctly scored with a "1" in the "Behavior" section.(c) An LON 9 will be assigned by the department, due to the person's extremely dangerous behavior, if the supporting documentation described in § 261.242(2) of this chapter (relating to Supporting Documentation for Level of Need) is submitted to the department proving that: (1) the person exhibits extremely dangerous behavior that is life threatening to the person or to others such that specified staff must be at arm's length during waking hours;(2) a written behavior intervention plan has been implemented for the person;(3) management of the person's behavior requires a staff member to exclusively and constantly supervise the person during the person's waking hours, which must be at least 16 hours per day;(4) the staff member assigned to supervise the person has no other duties during such assignment; and(5) the person's MR/RC Assessment is correctly scored with a "2" in the "Behavior" section.(d) An LON 1, LON 5, or LON 8 will be increased to the next LON by the department, due to a person's extraordinary medical needs, if the supporting documentation described in § 261.242(3) of this chapter (relating to Supporting Documentation for Level of Need) is submitted to the department proving that: (1) the person's extraordinary medical needs require direct nursing treatment in excess of 180 minutes per week;(2) the provision of nursing treatment is documented by a nurse in the person's medical record to include the amount of time spent for treatment; and(3) the person's MR/RC Assessment is correctly scored with a "6" in the "Nursing" section.26 Tex. Admin. Code § 261.241
Adopted to be effective September 1, 2001, 26 TexReg 5384; Transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; Transferred from Title 40, § 9.241 by Texas Register, Volume 45, Number 35, August 28, 2020, TexReg 6127, eff. 10/1/2020