<<Prev Rule

Texas Administrative Code

Next Rule>>
TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 3LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
SUBCHAPTER YSTANDARDS FOR LONG-TERM CARE INSURANCE, NON-PARTNERSHIP AND PARTNERSHIP LONG-TERM CARE INSURANCE COVERAGE UNDER INDIVIDUAL AND GROUP POLICIES AND ANNUITY CONTRACTS, AND LIFE INSURANCE POLICIES THAT PROVIDE LONG-TERM CARE BENEFITS WITHIN THE POLICY
DIVISION 2NON-PARTNERSHIP AND PARTNERSHIP LONG-TERM CARE INSURANCE
RULE §3.3812Policy Standards for Provider

(a) A provider of services, including, but not limited to, assisted living facility, skilled nursing facility, extended care facility, intermediate care facility, convalescent nursing home, maintenance or personal care facility, and home health care agency, shall be defined in relation to the services and facilities required to be available and the licensure or degree status of those providing or supervising the services. Such definitions may not be more restrictive than definitions for the same or similar facilities contained in the Insurance Code or otherwise in legislative enactments for the State of Texas.

(b) The terms, "assisted living facility," "convalescent nursing home," "extended care facility," "intermediate care facility," or "skilled nursing facility," shall be defined in relation to status, facilities, and available services.

  (1) A definition of such home or facility may not be more restrictive than one requiring that it be operated pursuant to state and federal law.

  (2) The definition of such home or facility may exclude:

    (A) any home, facility, or part thereof used primarily for rest;

    (B) a home or facility for the aged or for the care of drug addicts or alcoholics; or

    (C) a home or facility primarily used for the care and treatment of mental diseases or disorders, or custodial or educational care.


Source Note: The provisions of this §3.3812 adopted to be effective February 15, 1990, 15 TexReg 544; amended to be effective July 20, 1992, 17 TexReg 4769; amended to be effective May 8, 1997, 22 TexReg 3786

Link to Texas Secretary of State Home Page | link to Texas Register home page | link to Texas Administrative Code home page | link to Open Meetings home page