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.
Fiscal Year 2015 Updates
Medicaid Bed Allocation Policies and Procedures effective Sept. 1, 2014.
- Form 3709: Medicaid Bed Waiver Application for Nursing Facilities
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- Attachment A: Qualifying Requirements (PDF)
- Attachment B: Ownership and Controlling Person Information According to Business Entity Type(PDF)
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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.
- Provider Letter 01-39 defines the rules and processes for obtaining a change in bed classification or location.
- Request for Bed Changes and Bed Relocation Form (PDF)
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).