Bed Allocation Rules and Policies

The purpose of the bed allocation rules and policies is to improve the quality of resident care by selecting and limiting the allocation of Medicaid beds, to promote competition and to control the number of Medicaid beds for which DADS contracts. The number of Medicaid beds in a facility can be increased only through waivers and exemptions.

Types of Waivers

The following can be found in the Texas Administrative Code, Title 40, Part 1, Chapter 19, Subchapter X, Rule 19.2322

  • Community needs — see 40 TAC 19.2322(h)(1)
  • Criminal justice — see 40 TAC 19.2322(h)(2)
  • Under-served minority — see 40 TAC 19.2322(h)(3)
  • Alzheimer's — see 40 TAC 19.2322(h)(4)
  • Teaching — see 40 TAC 19.2322(h)(5)
  • Rural county — see 40 TAC 19.2322(h)(6)
  • State veterans homes — see 40 TAC 19.2322(h)(7)

List of waiver applications submitted

Types of Exemptions

The following can be found in the Texas Administrative Code, Title 40, Part 1, Chapter 19, Subchapter X, Rule 19.2322

  • Replacement — see 40 TAC 19.2322(f)(1)
  • Transfer — see 40 TAC 19.2322(f)(2)
  • High occupancy (10 percent) — see 40 TAC 19.2322(f)(3)
  • Non-certified nursing facilities (Licensed-only) — see 40 TAC 19.2322(f)(4)
  • Low capacity facilities (Up to 60) — see 40 TAC 19.2322(f)(5)
  • Spend-down Medicaid beds — see 40 TAC 19.2322(f)(6)

Medicaid Bed Allocation Requirements

Click here for information on rules and regulations pertaining to Medicaid beds.

Bed Change Procedures

A change in bed count constitutes an increase or decrease in the facility's Medicare and/or Medicaid bed count.

Loss of Medicaid Beds Based on Low Occupancy (Annual Decertification Project)

DADS may review Medicaid bed occupancy rates annually for the purpose of de-allocating and decertifying unused Medicaid beds. Medicaid beds will be de-allocated and decertified in facilities that have an average occupancy rate below 70 percent. See 40 TAC 19.2322(l).

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Updated: September 15, 2014