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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 554NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER BBNURSING FACILITY RESPONSIBILITIES RELATED TO PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR)
DIVISION 3NURSING FACILITY SPECIALIZED SERVICES FOR DESIGNATED RESIDENTS
RULE §554.2751Requesting Authorization to Provide Therapy Services

(a) Before requesting authorization to provide a therapy service to a designated resident, a nursing facility must ensure that:

  (1) the therapy service is required by the designated resident's comprehensive care plan;

  (2) the designated resident has a diagnosis relevant to the need for the therapy service;

  (3) the therapy service is ordered by the designated resident's attending physician; and

  (4) a therapy provider who meets the qualifications in §19.2752 of this division (relating to Qualifications of a Provider of Therapy Services) completes an assessment within 30 days before the nursing facility request for authorization to provide the therapy service.

(b) After a nursing facility submits a request for authorization to provide a therapy service to a designated resident:

  (1) the nursing facility receives a written approval or denial of its request through the LTC Online Portal; and

  (2) HHSC notifies the designated resident or the designated resident's LAR that the request has been approved or denied.

(c) If HHSC denies a request for authorization to provide therapy services to a designated resident, the designated resident may request a fair hearing in accordance with 1 TAC Chapter 357, Subchapter A (relating to Uniform Fair Hearing Rules), to appeal the denial.


Source Note: The provisions of this §554.2751 adopted to be effective September 10, 2017, 42 TexReg 4468; transferred effective January 15, 2021, as published in the Texas Register December 11, 2020, 45 TexReg 8871

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