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Nursing Facility (NF)

Overview

The Nursing Facility program provides institutional care to Medicaid recipients whose medical condition regularly requires the skills of licensed nurses. The nursing facility must provide for the total medical, social and psychological needs of each client, including room and board, social services, over-the-counter drugs, medical supplies and equipment, and personal needs items.

Reporting Information

Cost and Accountability Reports

View Cost and Accountability Reporting Information

Liability Insurance Coverage Rate Add-Ons

View Liability Insurance Coverage Rate Add-ons

Methodology / Rules

The Texas Medicaid Nursing Facility (program-specific) Cost-Finding Methodology is located at Title 1 of the Texas Administrative Code, Part 15, Chapter 355, Subchapter C, Rules 304, 306, 307, 308, 401-403. These rules explain in detail how the daily RUG payment rates are calculated.

Cost Determination Process Rules applicable to the Texas Medicaid Nursing Facility Program are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 355, Subchapter A, Rules 101-110.

Rules pertaining to the maintenance of contractor records for the Texas Medicaid Nursing Facility Program are located at Title 40 of the Texas Administrative Code, Part 1, Chapter 49, Subchapter C, Rule §49.305 and Rule §49.307.

Rules pertaining to the Direct Care Staff Compensation Rate Enhancement are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 355, Subchapter C, Rule 308.

Rules pertaining to Direct Care Staff Spending Requirement on or after September 1, 2023, are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 255, Subchapter C, Rule 304.

Payment Rate Information

For temporary COVID-19 rate increases, please visit the Main PFD-LTSS webpage here

Effective September 1, 2023 (.pdf)
Effective June 10, 2023-August 31, 2023 (.pdf)
Effective September 1, 2014 (.pdf)
Effective September 1, 2013 (.pdf)
Effective February 1, 2011 (.pdf)
Effective September 1, 2010 (.pdf)
Effective September 1, 2009 (.pdf)
Effective September 1, 2008 (.pdf)
Effective September 1, 2007 (.pdf)
Effective September 1, 2006 (.pdf)
Effective January 1, 2006 (.pdf)
Effective September 1, 2005 (.pdf)
Effective September 1, 2004 (.pdf)
Effective September 1, 2003 (.pdf)
Effective September 1, 2002 (.pdf)
Effective September 1, 2001 (.pdf)
Effective September 1, 2000 (.pdf)

Nursing Aid Training Rates

View Nursing Aid Training Rates (.pdf) (Effective September 1, 2023)
View Nursing Aid Training Rates (.pdf) (Effective prior to September 1, 2023)

Rate Enhancement - Direct Care Staff Compensation

View 2025 Rate Enhancement - Attendant Compensation Information
View 2024 Rate Enhancement - Attendant Compensation Information
View 2023 Rate Enhancement - Attendant Compensation Information

Training Information

View Cost Report Training Information

Nursing Facility Supplemental Payment Programs

View Nursing Facility Upper Payment Limit (UPL) Supplemental Payment Program
View Nursing Facility Minimum Payment Amount
View Quality Incentive Payment Program (QIPP)

Special Reimbursement Class

View Pediatric Care Facility Special Reimbursement Class