SECTION 554.503. Notice of Bed-Hold Policy and Return To Medicaid-certified Facilities

(a) Notice before transfer. Before a nursing facility transfers a resident to a hospital or a resident goes on therapeutic leave, the nursing facility must provide written information to the resident or resident representative that specifies:

(1) the duration of the bed-hold policy under the Medicaid State Plan, if any, during which the resident is permitted to return and resume residence in the facility;

(2) the reserved bed payment policy, in the State plan;

(3) the facility's policies regarding bed-hold periods, which must be consistent with subsection (c) of this section, permitting a resident to return; and

(4) the information specified in §19.502 of this subchapter (relating to Transfer and Discharge in Medicaid-certified Facilities).

(b) Bed-hold notice upon transfer. At the time of transfer of a resident to a hospital or for therapeutic leave, a nursing facility must provide to the resident and resident representative, written notice which specifies the duration of the bed-hold policy described in subsection (a) of this section.

(c) Permitting resident to return to facility. A nursing facility must establish and follow a written policy on permitting residents to return to the facility after they are hospitalized or placed on therapeutic leave.

(1) The policy must provide that a resident whose hospitalization or therapeutic leave exceeds the bed-hold period under the State Plan returns to the facility and to the resident's previous room if available or returns to the facility immediately upon the first availability of a bed in a semi-private room if the resident:

(A) requires the services provided by the facility; and

(B) is eligible for Medicare skilled nursing facility services or Medicaid nursing facility services.

(2) If the facility that determines that a resident who was transferred with an expectation of returning to the facility cannot return to the facility, the facility must comply with the requirements of §19.502 of this subchapter.

(d) Readmission to a composite distinct part. When the facility to which a resident returns is a composite distinct part, as defined by 42 CFR §483.5, the resident must be permitted to return to an available bed in the particular location of the composite distinct part in which the resident resided previously. If the bed is not available in that location at the time of readmission, the resident must be given the option to return to that location upon the first availability of a bed.

(e) Bed-hold charges. The facility may enter into a written agreement with the resident or resident representative to reserve a bed.

(1) The facility may charge the recipient an amount not to exceed the HHSC daily vendor rate according to the recipient's classification at the time the resident leaves the facility.

(2) The facility must document all bed-hold charges in the recipient's financial record at the time the bed-hold reservation services were provided.

(3) The facility may not charge a bed-hold fee if HHSC is paying for the same period of time, as in a three-day therapeutic home visit.

Source Note: The provisions of this §554.503 adopted to be effective May 1, 1995, 20 TexReg 2393; amended to be effective March 1, 1998, 23 TexReg 1314; 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