(a) An individual may elect to receive hospice care
in a facility if the individual is eligible for such care in accordance
with 40 TAC §30.10 (relating to Eligibility Requirements). An
individual's LAR or surrogate decision-maker, appointed in accordance
with §405.237 of this title (relating to Appointment and Qualifications
of a Surrogate Decision-Maker), may elect hospice care for the individual.
(b) If hospice care is elected for an individual in
accordance with 40 TAC §30.16 (relating to Election of Hospice
Care), the program provider for the individual must contract with
the designated hospice or discharge the individual in accordance with §419.227
of this title (relating to Discharge from a Facility).
(c) Before hospice care is provided to an individual
at a facility:
(1) the program provider and the hospice must execute
a contract, as described in subsection (d) of this section;
(2) the program provider and the hospice must review
the individual's MR/RC Assessment to determine if a revision to the
individual's LON is needed in accordance with §419.246 of this
subchapter (relating to Renewal and Revision of Level of Need);
(3) the program provider must provide a signed copy
of the completed MR/RC Assessment to the hospice; and
(4) the program provider must notify the TDMHMR Help
Desk at (888) 952-4357 that the individual has elected to receive
hospice care.
(d) A contract between a program provider and a hospice
must establish the amount the hospice will pay the program provider
for the individual's room and board and must require the hospice and
the program provider to develop a plan of care for the individual.
In this section, "room and board" includes performance of personal
care services, including assistance with activities of daily living,
administration of medication, maintaining the cleanliness of an individual's
room, and supervision and assistance with durable medical equipment
and prescribed therapies.
(e) A program provider must continue to provide services
in accordance with this subchapter to an individual receiving hospice
care in a facility. If the individual, or the LAR on the individual's
behalf, chooses continued participation in active treatment and
such treatment, in the opinion of the individual's physician, is not
contraindicated by the individual's condition, it must be provided
in accordance with the individual's ability to participate in it.
(f) A program provider must pay the quality assurance
fee described in 1 TAC Chapter 352 (relating to Quality Assurance
Fee for Long-Term Care Facilities) for an individual receiving hospice
care in a facility of the program provider.
(g) Hospice staff will not be considered facility staff
to establish or maintain a staff-to-client ratio.
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Source Note: The provisions of this §261.274 adopted to be effective January 5, 2003, 27 TexReg 12251; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective October 1, 2020, as published in the Texas Register August 28, 2020, 45 TexReg 6127 |