[TX providers only] Change in CHOW instructions for nursing facilities

Melina HalikiasSecure News, SimpleCFS, Texas MedicaidLeave a Comment

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Texas Health and Human Services has confirmed that nursing facilities going through a CHOW must follow the steps below to maintain compliance with federal and state PASRR regulations.  This only applies to CHOWS where the facility receives a new contract/provider number.

The NF must:

  1. maintain a list of all newly admitted residents after the CHOW was initiated;
  2. enter a PL1 for every resident in the NF once TMHP LTC portal access is reinstated; and
  3. enter a PL1 for every resident in the facility within 90 calendar days, regardless of payor source.
  4. NFs may use the PEs from the old contract number (completed before the CHOW) to complete the new PL1 to determine ID/DD/MI status and ensure individuals that were previously PASRR positive remain positive.  NFs can run a query from the LTC portal that will identify all the individuals in the NF who are PASRR positive.  For example: If the facility had 10 individuals under the old contract number who are positive for PASRR based on the last PE, there should be 10 positive PL1s entered.
  5. Individuals with prior negative PL1s (without a positive PE attached) and who have not had any changes to their diagnosis that would indicate a need to evaluate for ID, DD and/or MI again, should enter negative PL1s.
  6. Individuals with negative PEs completed prior to the CHOW who have not had any changes to their diagnosis that would indicate a need to evaluate for ID, DD and/or MI again, can have a negative PL1 submitted after the CHOW.
  7. NFs should not indicate positive PL1s for everyone in their facility without supporting evidence of MI, ID or DD in their records.
  8. HHSC PASRR staff may provide guidance on completing the post-CHOW PL1s.

NFs can print reports showing all the individuals in the facility that are positive for PASRR.  These reports will help them during the CHOW process to complete the new PL1s.  CHOW PEs may take longer to complete than non-CHOW PEs.  The NF can contact the LA and ask if extensions have been granted by HHSC to better determine when all the PEs will be completed.

Questions? Please contact Texas Health and Human Services at (855) 435-7180 or PASRR.Support@hhsc.state.tx.us.

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