SECTION 554.1. Basis and Scope

(a) Basis in legislation. The Nursing Facility Requirements for Licensure and Medicaid Certification implement the requirements of federal and state laws and regulations governing licensed nursing facilities and nursing facilities participating in the Medicaid program administered by HHSC in cooperation with other federal and state agencies. If there is a conflict between material in these requirements and the laws or regulations governing the Medicaid program, the Medicaid laws and regulations are controlling. It is the intent of the Texas Legislature that rules adopted under Chapter 242 of the Texas Health and Safety Code may be more stringent than the standards imposed by federal law for certification for participation in the state Medicaid program. The rules and standards may not be less stringent than the Medicaid certification standards imposed under the Omnibus Budget Reconciliation Act of 1987.

(b) Scope. The Nursing Facility Requirements for Licensure and Medicaid Certification contain the requirements that an institution must meet in order to be licensed as a nursing facility and also to qualify to participate in the Medicaid program. The requirements serve as a basis for survey activities for licensure and certification.

(1) Certain requirements are specific to Medicaid-certified facilities and are so designated. The Medicaid-specific requirements apply to all residents, including private pay, Medicaid applicants and recipients, U.S. Department of Veteran's Affairs patients, and Medicare recipients, who are admitted to and reside in a Medicaid-certified facility or a Medicaid-certified distinct part of a facility.

(2) Additional requirements for facilities or distinct parts of facilities that are certified for Medicare-only participation are in 42 CFR §§483.5-483.95.

(3) These requirements do not apply to skilled nursing facilities licensed under the Texas Health and Safety Code, Chapter 241, participating only in the Medicare program.

Source Note: The provisions of this §554.1 adopted to be effective May 1, 1995, 20 TexReg 2393; amended to be effective March 1, 1998, 23 TexReg 1314; amended to be effective August 1, 2000, 25 TexReg 6779; amended to be effective March 24, 2020, 45 TexReg 2025; transferred effective January 15, 2021, as published in the Texas Register December 11, 2020, 45 TexReg 8871