Nursing Facility Requirements for Licensure and Medicaid Certification Handbook

Chapter 19  
Subchapter A,  Basis and Scope
§19.1
Basis and Scope
Subchapter B,  Definitions
§19.101
Definitions
Subchapter C,  Nursing Facility Licensure Application Process
§19.201
Criteria for Licensing
§19.202
Building Approval
§19.204
Application Requirements
§19.205
Probationary License
§19.206
Increase in Capacity
§19.208
Renewal Procedures and Qualifications
§19.209
Exclusion from Licensure
§19.210
Change of Ownership License
§19.211
Relocation
§19.212
Time Periods for Processing License Applications
§19.214
Criteria for Denying a License or Renewal of a License
§19.215
Opportunity to Show Compliance
§19.216
License Fees
§19.218
Method of Payment
§19.219
Plan Review Fees
Subchapter D,  Facility Construction
§19.300
General Requirements
§19.301
Applicable Codes and Standards
§19.302
Waivers
§19.303
Emergency Power
§19.304
Space and Equipment
§19.305
Resident Rooms
§19.306
Toilet Facilities
§19.307
Resident Call System
§19.308
Dining and Resident Activities
§19.309
Other Environmental Conditions
§19.310
Site and Grounds
§19.311
Fire Service and Access
§19.312
Means of Egress
§19.313
Interior Finishes - Walls, Ceilings, and Floors
§19.314
Fire Alarms, Detection Systems, and Sprinkler Systems
§19.315
Portable Fire Extinguishers
§19.316
Subdivision of Building Spaces — Smoke Barriers
§19.317
Elevators and Escalators
§19.318
Other Rooms and Areas
§19.319
Provisions for Persons with Disabilities
§19.320
Lighting and Illumination
§19.321
Heating, Ventilating, and Air-conditioning Systems (HVAC)
§19.322
Plumbing
§19.323
Housekeeping Services
§19.324
Pest Control
§19.325
Linen
§19.326
Safety Operations
§19.330
Construction and Initial Survey of Completed Construction
§19.331
Construction Standards for Additions, Remodeling, and New Nursing Facilities
§19.332
Location and Site
§19.333
General Considerations
§19.334
Architectural Space Planning and Utilization
§19.335
Exit Provisions
§19.336
Smoke Compartmentation (Subdivision of Building Spaces)
§19.337
Fire Protection Systems
§19.338
Hazardous Areas
§19.339
Structural Requirements
§19.340
Mechanical Requirements
§19.341
Electrical Requirements
§19.342
Miscellaneous Details
§19.343
Elevators
§19.344
Plans, Approvals, and Construction Procedures
Subchapter E,  Resident Rights
§19.401
Introduction
§19.402
Exercise of Rights
§19.403
Notice of Rights and Services
§19.404
Protection of Resident Funds
§19.405
Additional Requirements for Trust Funds in Medicaid-Certified Facilities
§19.406
Free Choice
§19.407
Privacy and Confidentiality
§19.408
Grievances
§19.409
Examination of Survey Results
§19.410
Refunds in Medicaid-Certified Facilities
§19.411
Work
§19.412
Mail
§19.413
Access and Visitation Rights
§19.414
Telephone
§19.415
Postmortem Procedures
§19.416
Personal Property
§19.417
Married Couples
§19.418
Self-Administration of Drugs
§19.419
Advance Directives
§19.420
Documentation for the Delegation of Long-Term Care Resident's Rights
§19.421
Refusal of Certain Transfers in Medicaid-Certified Facilities
§19.422
Authorized Electronic Monitoring (AEM)
§19.423
Model Drug Testing Policy
Subchapter F,  Admission, Transfer, and Discharge Rights In Medicaid-Certified Facilities
§19.501
Admissions Policy for Medicaid-Certified Facilities
§19.502
Transfer and Discharge in Medicaid-Certified Facilities
§19.503
Notice of Bed-Hold Policy and Readmission in Medicaid-Certified Facilities
§19.504
Equal Access to Quality Care in Medicaid-Certified Facilities
§19.505
Discharge Planning in Medicaid-Certified Facilities
Subchapter G,  Resident Behavior and Facility Practice
§19.601
Resident Behavior and Facility Practice
§19.602
Incidents of Abuse and Neglect Reportable to the Texas Department of Human Services (DHS) and Law Enforcement Agencies by Facilities
§19.604
Complaint Investigation
§19.606
Reporting of Resident Death Information
Subchapter H,  Quality of Life
§19.701
Quality of Life
§19.702
Activities
§19.703
Social Services General Requirements
§19.704
Social Services Process
§19.705
Environment
§19.706
Resident Group and Family Council
Subchapter I,  Resident Assessment
§19.801
Resident Assessment
§19.802
Comprehensive Care Plans
§19.803
Discharge Summary (Discharge Plan of Care)
§19.804
Capacity Assessment for Self Care and Financial Management
§19.805
Permanency Planning for a Resident Under 22 Years of Age
Subchapter J,  Quality of Care
§19.901
Quality of Care
§19.910
Quality Assurance Early Warning System
§19.911
Rapid Response Teams
Subchapter K,  Nursing Services
§19.1001
Nursing Services
§19.1002
Additional Nursing Services Staffing Requirements
§19.1004
Director of Nursing Services
§19.1006
Nursing Facility Restorative Nursing Care
§19.1010
Nursing Practices
§19.1011
Student Nurses
§19.1012
Special Nurses and Sitters
Subchapter L,  Dietary Services
§19.1101
Dietary Service
§19.1102
Staffing
§19.1103
Sufficient Staffing
§19.1104
Dietary Consultant Requirements
§19.1107
Menus and Nutritional Adequacy
§19.1108
Food
§19.1109
Food Intake
§19.1110
Frequency of Meals
§19.1111
Sanitary Conditions
§19.1113
Paid Feeding Assistants
§19.1115
Requirements for Training of Paid Feeding Assistants
Subchapter M,  Physician Services
§19.1201
Physician Services
§19.1202
Physician Visits
§19.1203
Frequency of Physician Visits
§19.1204
Availability of Physician for Emergency Care
§19.1205
Physician Delegation of Tasks
§19.1206
Physician Signatures
§19.1207
Prescription of Psychoactive Medication
§19.1208
Physicians' Reporting Communicable Diseases
§19.1210
Certification and Recertification Requirements in Medicaid-Certified Facilities
Subchapter N,  Rehabilitative Services
§19.1301
Provision of Rehabilitative Services
§19.1302
Qualifications
§19.1303
Specialized Services in Medicaid-Certified Facilities
§19.1304
Rehabilitative Services in Medicaid-Certified Facilities
§19.1306
Payment for Specialized and Rehabilitative Services
Subchapter O,  Dental Services
§19.1401
Dental Services
§19.1402
Medicaid-Certified Nursing Facility Emergency Dental Services
Subchapter P,  Pharmacy Services
§19.1501
Pharmacy Services
§19.1502
Choice of Pharmacy Provider
§19.1503
Additional Supervision and Consultation Requirements
§19.1504
Drug Security
§19.1506
Drug Orders
§19.1507
Drug Release
§19.1508
Drug Administration
§19.1509
Controlled Substances
§19.1510
Emergency Medication Kits
Subchapter Q,  Infection Control
§19.1601
Infection Control
§19.1602
Universal Precautions
Subchapter R,  Physical Plant and Environment
§19.1701
Physical Environment
Subchapter T,  Administration
§19.1901
Administration
§19.1902
Governing Body
§19.1903
Required Training of Nurse Aides
§19.1904
Proficiency of Nurse Aides
§19.1905
Staff Qualifications
§19.1906
Use of Outside Resources
§19.1907
Medical Director
§19.1908
Laboratory Services
§19.1909
Radiology and Other Diagnostic Services
§19.1910
Clinical Records
§19.1911
Contents of the Clinical Record
§19.1912
Additional Clinical Record Service Requirements
§19.1913
Clinical Records Service Supervisor
§19.1914
Disaster and Emergency Preparedness
§19.1915
Transfer Agreement
§19.1916
Respite Care
§19.1917
Quality Assessment and Assurance
§19.1918
Disclosure of Ownership
§19.1919
Right to Possession
§19.1920
Operating Policies and Procedures
§19.1921
General Requirements for a Nursing Facility
§19.1922
Resident Care Policies
§19.1923
Incident or Accident Reporting
§19.1924
Financial Records
§19.1925
Financial Condition
§19.1926
Medicaid Hospice Services
§19.1928
Volunteer Program
§19.1929
Staff Development
§19.1930
Blood and Blood Products
§19.1934
Educational Requirements for Persons under Age 22
Subchapter U,  Inspections, Surveys, and Visits
§19.2002
Procedural Requirements - Licensure Inspections and Surveys
§19.2004
Determinations and Actions Pursuant to Inspections
§19.2006
Reporting Incidents and Complaints
§19.2008
Investigations of Incidents and Complaints
§19.2009
Hearings on Complaints of Resident Neglect and Abuse, and Misappropriation of Resident Property in Medicaid-Certified Facilities
§19.2010
General Provisions
§19.2011
Procedures for Inspection of Public Records
Subchapter V,  Enforcement
Division 1,  Enforcement Generally
§19.2102
Enforcement Generally
Division 2,  Licensing Remedies
§19.2103
Warning Letter
§19.2104
Suspension of a License
§19.2106
Revocation of a License
§19.2108
Emergency Suspension and Closing Order
§19.2110
Referral to the Attorney General
§19.2111
Suspension of Admissions
§19.2112
Administrative Penalties
§19.2114
Right to Correct
§19.2115
Amelioration of Violation
§19.2116
Involuntary Appointment of a Trustee
§19.2118
Appointment of a Trustee by Agreement
§19.2119
Open Hearing
Division 3,  Remedies in Medicaid-Certified Facilities
§19.2120
Definitions Pertaining to Medicaid Remedies
§19.2121
General Provisions
§19.2129
Interest on Civil Money Penalties
§19.2144
Procedures Following Termination of the Provider Agreement
§19.2146
Termination of Provider Agreement on the Basis of the Imposition of Enforcement Actions Three Times Within an Accountability Period
§19.2147
Informal Dispute Resolution
§19.2148
Arbitration
§19.2149
Exclusions
§19.2150
Fraud Referral
§19.2151
Construction
Subchapter W,  Certification of Facilities for Care of Persons with Alzheimer's Disease and Related Disorders
§19.2204
Voluntary Certification of Facilities for Care of Persons with Alzheimer's Disease
§19.2206
General Requirements for a Certified Facility
§19.2208
Standards for Certified Alzheimer's Facilities
Subchapter X,  Requirements Form Medicaid-Certified Facilities
§19.2301
Conditions for Participation as a Medicaid-Certified Facility
§19.2302
Requirements for a Contracted Medicaid Facility
§19.2304
Contract Requirements
§19.2306
Effective Dates of Provider Contracts
§19.2308
Change of Ownership
§19.2310
Nursing Facility Ceases to Participate
§19.2312
Surety Bonds or Letters of Credit
§19.2314
Financial Audits
§19.2316
Collection of Applied Income
§19.2318
Computation of Daily Reimbursement Rate for Recipients with Applied Income
§19.2320
Medical Transportation
§19.2322
Medicaid Bed Allocation Requirements
§19.2324
Selection and Contracting Procedures for Adding Medicaid Beds in High-Occupancy Areas
§19.2326
Medicaid Swing Bed Program for Rural Hospitals
Subchapter Y,  Medical Review and Re-Evaluation
§19.2401
General Qualifications for Medical Necessity Determinations
§19.2403
Medical Necessity Determination
§19.2405
Physicians' Certifications and Recertifications
§19.2407
Denied Medical Necessity
§19.2413
Determination of Payment Rate Based on the MDS Assessment Submission
Subchapter Z,  Preadmission Screening and Resident Review (PASARR)
§19.2500
Preadmission Screening and Resident Review (PASARR)
Subchapter AA,  Vendor Payment
§19.2601
Vendor Payment (Items and Services Included)
§19.2602
Additional Charges (Items and Services Excluded from Vendor Payment)
§19.2603
Therapeutic Home Visits Away from the Facility
§19.2604
Vendor Payment Information
§19.2605
Effective Date of Vendor Coverage
§19.2606
Supplementation of Vendor Payments
§19.2607
Penalties for Supplementation
§19.2608
Limitations on Provider Charges
§19.2609
Payment of Claims
§19.2610
Medicare Part A Skilled Nursing Facility Deductible and Coinsurance Payment
§19.2611
Retroactive Vendor Payment
§19.2612
Quality Incentive Payment
§19.2613
Augmentative Communication Device Systems
§19.2614
Customized Power Wheelchairs
§19.2615
Resident Transaction Notices