| (a) Notice before transfer. Before a nursing facility
transfers a resident to a hospital or a resident goes on therapeutic
leave, the nursing facility must provide written information to the
resident or resident representative that specifies:
(1) the duration of the bed-hold policy under the Medicaid
State Plan, if any, during which the resident is permitted to return
and resume residence in the facility;
(2) the reserved bed payment policy, in the State plan;
(3) the facility's policies regarding bed-hold periods,
which must be consistent with subsection (c) of this section, permitting
a resident to return; and
(4) the information specified in §19.502 of this
subchapter (relating to Transfer and Discharge in Medicaid-certified
Facilities).
(b) Bed-hold notice upon transfer. At the time of transfer
of a resident to a hospital or for therapeutic leave, a nursing facility
must provide to the resident and resident representative, written
notice which specifies the duration of the bed-hold policy described
in subsection (a) of this section.
(c) Permitting resident to return to facility. A nursing
facility must establish and follow a written policy on permitting
residents to return to the facility after they are hospitalized or
placed on therapeutic leave.
(1) The policy must provide that a resident whose hospitalization
or therapeutic leave exceeds the bed-hold period under the State
Plan returns to the facility and to the resident's previous room if
available or returns to the facility immediately upon the first availability
of a bed in a semi-private room if the resident:
(A) requires the services provided by the facility;
and
(B) is eligible for Medicare skilled nursing facility
services or Medicaid nursing facility services.
(2) If the facility that determines that a resident
who was transferred with an expectation of returning to the facility
cannot return to the facility, the facility must comply with the requirements
of §19.502 of this subchapter.
(d) Readmission to a composite distinct part. When
the facility to which a resident returns is a composite distinct
part, as defined by 42 CFR §483.5, the resident must be permitted
to return to an available bed in the particular location of the composite
distinct part in which the resident resided previously. If the bed
is not available in that location at the time of readmission, the
resident must be given the option to return to that location upon
the first availability of a bed.
(e) Bed-hold charges. The facility may enter into a
written agreement with the resident or resident representative to
reserve a bed.
(1) The facility may charge the recipient an amount
not to exceed the HHSC daily vendor rate according to the recipient's
classification at the time the resident leaves the facility.
(2) The facility must document all bed-hold charges
in the recipient's financial record at the time the bed-hold reservation
services were provided.
(3) The facility may not charge a bed-hold fee if HHSC
is paying for the same period of time, as in a three-day therapeutic
home visit.
|
| Source Note: The provisions of this §554.503 adopted to be effective May 1, 1995, 20 TexReg 2393; amended to be effective March 1, 1998, 23 TexReg 1314; amended to be effective March 24, 2020, 45 TexReg 2025; transferred effective January 15, 2021, as published in the Texas Register December 11, 2020, 45 TexReg 8871 |
