THCA

Volume XXXI, Number 8
August 2016

Changes to Nursing Facility Requirements for Licensure and Medicaid Certification and Licensing Standards for Assisted Living Facilities

The Texas Department of Aging and Disability Services (DADS) issued Provider Letter No. 16-25 that added new rules and amended existing rules in 40 TAC Chapters 19 and 92 regarding procedures that require a facility to request guardianship orders for a resident, and to disclose whether a facility is certified to provide services and treatment to Alzheimer’s residents. The new rules became effective on July 21, 2016; however, surveyors will begin enforcing rules for Chapters 19 and 92 as of September 1, 2016.

New rules at §19.1936 and §92.42 requires a NF or an ALF to request a copy of a court order appointing a guardian and the letters of guardianship for the resident or a resident’s estate from a resident’s nearest relative or person responsible for the resident’s support upon admission or when the facility becomes aware a guardian is appointed. The new rules indicate the number of follow-up attempts that are to be made when documents are not received and when to request updated guardianship documentation. DADS also amended §19.1911 and §92.41 to require a NF and an ALF to maintain a copy of the court order and letters of guardianship in the clinical records or resident’s records, as appropriate. These new rules and amendments implement Texas Health and Safety Code (HSC) §242.019 and §247.070, as added by House Bill (H.B.) 1337 of the 84th Legislature, Regular Session, 2015.

DADS amended §19.204 and §92.53 to require a NF and an ALF to include in the Alzheimer’s disclosure statement whether the facility is certified under HSC §242.040 or §247.029 to provide specialized services and treatment to residents with Alzheimer’s disease. DADS will revise forms as appropriate. DADS amended §19.1921 to clarify which NF residents must receive an Alzheimer’s disclosure statement and to establish a 30-day time frame for the NF to notify a resident before updating the disclosure statement. These amendments implement changes to HSC §242.202 and §247.026, as added by H.B. 2588 of the 84th Legislature, Regular Session, 2015.

Finally, DADS amended §19.101 and §92.2 to include a definition of “Alzheimer’s disease and related disorders” in the NF and ALF rules. These amendments implement changes to HSC §242.040 and §247.029, as added by H.B. 2588.