Texas Register


The Texas Health and Human Services Commission (HHSC) adopts amendments to §556.2, concerning Definitions; §556.3, concerning Nurse Aide Training and Competency Evaluation Program (NATCEP) Requirements; §556.6, concerning Competency Evaluation Requirements; and §556.9, concerning Nurse Aide Registry and Renewal; in Title 26, Part 1, Chapter 556, Nurse Aides.  A NATCEP is a program approved by HHSC to train and evaluate an individual’s ability to work as a nurse aide in a nursing facility. Currently, all NATCEP training is provided in a classroom and clinical setting. The purpose of the adopted rules is to allow a NATCEP provider to offer certain components of required training online.  The rules respond to a critical shortage in trained nurse aides in nursing homes. External stakeholders, such as Texas Health Care Association and Leading Age, requested that HHSC allow NATCEP providers to offer online training opportunities for portions of the NATCEP classroom curriculum. This option is intended to increase the number of nurse aides qualified for employment in a nursing facility.  Due to the challenges presented by the COVID-19 pandemic and the need for greater awareness and emphasis on infection control, the adopted rules increase the number of hours of infection control training a NATCEP must provide and require all nurse aides to complete a course in infection control each year.  The rules implement legislative amendments to Texas Administrative Code §556.3(e)(3) to provide that HHSC does not approve a NATCEP offered by or in a facility if, within the previous two years, the facility has been assessed a civil money penalty of not less than $5,000, as adjusted annually for inflation under 45 Code of Federal Regulations (CFR), Part 102, for deficiencies in nursing facility standards. This change was made to link the dollar amount referenced in the rule to the amount specified by the Centers for Medicare and Medicaid Services, as adjusted annually for inflation.  For more information, go to:  https://www.sos.state.tx.us/texreg/archive/July302021/Adopted%20Rules/26.HEALTH%20AND%20HUMAN%20SERVICES.html#126.



Federal News and Information

Fiscal Year 2022 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice Quality Reporting Program Requirements, and Home Health Quality Reporting Program Final Rule CMS-1754-F

On July 29, 2021 the Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1754-F) that provided updates to and finalized proposals for fiscal year (FY) 2022 Hospice Quality Reporting Program (HQRP). This rule includes finalizations for changes to the Home Health Quality Reporting Program beginning with January 2022 to address exceptions related to the COVID-19 public health emergency. We included Home Health in this rule because we will resume public reporting for the HH QRP with the January 2022 refresh of Care Compare. In order to accommodate the exception of 2020 Q1 and Q2 data, we finalized the resumption of public reporting using 3 out of 4 quarters of data for the January 2022 refresh. In order to complete this proposal in time to release the required preview report related to the refresh, which we release 3 months prior to any given refresh (Oct. 2021), we needed the rule containing this proposal to finalize by October 2021.


The final rule went on display at the Federal Register’s Public Inspection Desk and will be available under “Special Filings,” at https://www.federalregister.gov/public-inspection.

For further information, visit http://www.cms.gov/Center/Provider-Type/Hospice-Center.htm.


New Mexico News and Information


Governor to implement vaccination policy for state government employees

Under the order, state employees who are not fully vaccinated against COVID-19 shall be required to demonstrate a negative COVID-19 test at least once every two weeks.  State employees who are not fully vaccinated, under the order, must wear a facemask when indoors during the course and scope of their employment — with minor exceptions for eating and drinking. (Pursuant to updated guidance from the Centers for Disease Control and Prevention, it is recommended vaccinated individuals resume wearing facemasks indoors as well.)  To review the policy, go to:  https://www.governor.state.nm.us/wp-content/uploads/2021/07/Executive-Order-2021-045.pdf .



Texas News and Information


Texas Medicaid Healthcare Partnership (TMHP)

The TMHP August 2021 bulletin was released.  Topics include :MESAV,  COVID updates, 2021 Quality Long Term Care Conference,  claims identified for potential recoupment and webinars.  To view the most current edition online, go to:



Health and Human Services Commission (HHSC)

COVID-19 Cases Rise – Plan for Emergencies, Staffing Shortages Related to Infectious Diseases

COVID-19 cases are increasing across Texas. Long-term care providers must ensure their emergency plan is up-to-date. Staff must be aware of what to do in the event of any sort of emergency, including an outbreak of flu or COVID-19.

LTC providers are always required to provide services to residents or clients before, during and after an emergency. The emergency plan must include:

  • Planning for staff shortages.
  • A back-up plan to ensure operations and care of resident or clients continue.

See program specific rules related to staffing, emergency preparedness and infection control. Rules for the above provider base can be accessed at:


A checklist is available to assist you with creating a plan for dealing with an outbreak of flu or COVID-19.  Go to:  https://www.phe.gov/Preparedness/COVID19/Documents/COVID-19%20Healthcare%20Planning%20Checklist.pdf.


Hurricane and Flooding Readiness Webinars for LTC Providers

These Emergency Preparedness webinar recordings cover requirements for the development of emergency preparedness plans. There are separate webinars for each program. The focus is on hurricanes and flooding. Topics include:

  • Risk assessment
  • Phases of emergency preparedness
  • The eight core functions required for an emergency plan

Access provider specific trainings at:  https://www.gotostage.com/channel/emergencypreparedness

Email Joint Training for questions to:  [email protected]


HHSC Ends Suspension of Certain LTCR Requirements Related to the COVID-19 Outbreak

At the start of the COVID-19 outbreak the Office of the Governor granted HHSC’s request to suspend certain rules and statutes during the disaster. HHSC is now ending the suspension of these rules and statues as of the dates provided on the attached document.  Read HHSC Suspension End Dates: