A facility contracted to provide Medicaid-reimbursed home- and community-based services (HCBS) is required to comply with the federal home-based and community-based setting final rule, published in the Federal Register at 79 FR 2947 (January 16, 2014).

1. (1) Medicaid-reimbursed individuals receiving HCBS services shall be afforded the rights referenced in 42 C.F.R. 441.301(c)(4) of the HCBS Settings Rule.
2. (2) The service recipients of an agency contracted to provide Medicaid-reimbursed HCBS residential services have the right to associate and communicate privately with persons of their choice including receiving visitors at any time.

3. (3) The rights of persons supported in a facility receiving HCBS services may only be modified or limited as provided in the federal home-based and community-based setting final rule, published in the Federal Register at 79 FR 2947 (January 16, 2014).

   1. (a) Any modifications or limitations must be documented in the service recipient’s record or service plan and must:

      1. 1. Identify a specific and individualized assessed need;
      2. 2. Document the positive interventions and supports used prior to any modifications to the person-centered service plan; AND FACILITIES
      3. 3. Document less intrusive methods of meeting the need that have been tried but did not work;
      4. 4. Include a clear description of the condition that is directly proportionate to the specific assessed need;
      5. 5. Include regular collection and review of data to measure the ongoing effectiveness of the modification;
      6. 6. Include established time limits for periodic reviews to determine if the modification is still necessary or can be terminated;
      7. 7. Include the informed consent of the service recipient or legal representative; and,
      8. 8. Include an assurance that interventions and supports will cause no harm to the service recipient.

Authority: T.C.A. §§ 4-4-103, 33-1-302, 33-1-305, 33-1-309, and 33-2-404. Administrative History: Original rule filed May 28, 2010; to have been effective August 26, 2010. Stay of amendment filed by the Tennessee Department of Mental Health and Substance Abuse Services on July 21, 2010; new effective date November 9, 2010. Withdrawal of amendment filed August 2, 2010. Amendment filed August 30, 2010; to have been effective January 29, 2011. Stay of amendment filed by the Tennessee Department of Mental Health and Substance Abuse Services on January 29, 2011; new effective date March 7, 2011. Withdrawal of amendment filed by the Tennessee Department of Mental Health and Substance Abuse Services on February 25, 2011. Repeal and new rules filed November 30, 2016; effective February 28, 2017. Administrative corrections made to agency names in December 2022 pursuant to Public Chapter 575 of 2012. Amendments filed February 24, 2026; effective May 25, 2026.