The Texas Department of Human Services (DHS) proposes new §19.805, concerning permanency planning for pediatric residents; and to amend §19.801, concerning resident assessment, §19.1911, concerning contents of the clinical record, and §19.1912, concerning additional clinical record service requirements, in its Nursing Facility Requirements for Licensure and Medicaid Certification chapter. The purpose of the amendments is to include permanency planning components in response to Senate Bill 368. Section 19.805 is added to specifically address nursing facility responsibilities regarding permanency planning.

James R. Hine, Commissioner, has determined that for the first five-year period the proposed sections will be in effect, there will be fiscal implications for state government as a result of enforcing or administering the sections.

The effect on state government for the first five-year period the sections will be in effect is an estimated additional cost of $150,000 in fiscal year (FY) 2002; $75,000 in FY 2003; $0 in FY 2004; $0 in FY 2005; and $0 in FY 2006.

Mr. Hine also has determined that for each year of the first five years the sections are in effect, the public benefit anticipated as a result of adoption of the proposed sections will be to aid in matching children in nursing facilities with community resources to achieve the goal of assisting families to keep their disabled children at home with community support. There will be a negligible effect on small or micro businesses as a result of enforcing or administering the sections because the only additional responsibilities for facilities will be additional telephone calls to the pediatric nurse specialist and the community resource coordination group in the county where the parent or guardian resides. This occurs only when a child is admitted to a facility. There is no anticipated economic cost to persons who are required to comply with the proposed sections. There will be no anticipated effect on local employment in geographic areas affected by these sections.

Subchapter I. RESIDENT ASSESSMENT

40 TAC §19.801, §19.805

The amendment and new section are proposed under the Health and Safety Code, Chapter 242, which authorizes DHS to license and regulate convalescent and nursing homes and related institutions.

The amendment and new section implement the Health and Safety Code, §§242.001- 242.268.

§19.801.Resident Assessment.

The facility must conduct initially and periodically a comprehensive, accurate, standardized, reproducible assessment of each resident's functional capacity. In Medicaid-certified and dually certified nursing facilities, admission, annual, quarterly, and significant change assessments must be transmitted electronically to the Texas Department of Human Services (DHS).

(1)-(2) (No change.)

(3) Quarterly review assessment. A facility must assess a resident using the quarterly review instrument specified by DHS and approved by the Centers for Medicare & Medicaid Services (CMS) [ ~~Health Care Financing Administration (HCFA)~~ ] not less frequently than once every three months.

(4)-(5) (No change.)

(6) Automated data processing requirement for Medicaid-certified and dually certified facilities only.

(A) (No change.)

(B) Transmitting data. Within seven days after a facility completes a resident's assessment, a facility must be capable of transmitting to DHS information for each resident contained in the MDS in a format that conforms to standard record layouts and data dictionaries, and that passes standardized edits defined by CMS [ ~~HCFA~~ ] and DHS.