26 Tex. Admin. Code § 368.505

Current through Reg. 49, No. 49; December 6, 2024
Section 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.

26 Tex. Admin. Code § 368.505

Adopted by Texas Register, Volume 46, Number 28, July 9, 2021, TexReg 4162, eff. 9/1/2021