Bed Allocation Rules and Policies

Bed allocation rules and policies improve the quality of resident care by selecting and limiting the allocation of Medicaid beds thereby prompting competition and to controlling 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

  • High occupancy waiver — 40 TAC 19.2322(h)(1)
  • Community needs waiver — 40 TAC 19.2322(h)(2)
  • Criminal justice waiver — 40 TAC 19.2322(h)(3)
  • Economically disadvantaged waiver — 40 TAC 19.2322(h)(4)
  • Alzheimer's waiver — 40 TAC 19.2322(h)(5)
  • Teaching nursing facility waiver — 40 TAC 19.2322(h)(6)
  • Rural County waiver — 40 TAC 19.2322(h)(7)
  • State veterans waiver — 40 TAC 19.2322(h)(8)
  • Small house waiver — 40 TAC 19.2322(h)(9)

List of nursing facility 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 — 40 TAC 19.2322(f)(1)
  • Transfer — 40 TAC 19.2322(f)(2)
  • High occupancy (10 percent) — 40 TAC 19.2322(f)(3)
  • Non-certified nursing facilities (Licensed-only) — 40 TAC 19.2322(f)(4)
  • Low capacity facilities (Up to 60) — 40 TAC 19.2322(f)(5)
  • Spend-down Medicaid beds — 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 to de-allocate and decertify 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: January 25, 2016