(a) The department will assign one of five LONs as follows:
  (1) An intermittent LON (LON 1) will be assigned if the person's ICAP service level score equals 7, 8, or 9;
  (2) A limited LON (LON 5) will be assigned if the person's ICAP service level score equals 4, 5, or 6, or an LON 1 is increased in accordance with subsection (b) or (d) of this section;
  (3) An extensive LON (LON 8) will be assigned if the person's ICAP service level score equals 2 or 3, or an LON 5 is increased in accordance with subsection (b) or (d) of this section;
  (4) A pervasive LON (LON 6) will be assigned if the person's ICAP service level score equals 1, or an LON 8 is increased in accordance with subsection (b) or (d) of this section; and
  (5) Regardless of a person's ICAP service level score, a pervasive plus LON (LON 9) will be assigned if the person meets the criteria set forth in subsection (c) of this section.
(b) An LON 1, LON 5, or LON 8 will be increased to the next LON by the department, due to a person's dangerous behavior, if the supporting documentation described in §419.242 (1) (relating to Supporting Documentation for Level of Need) is submitted to the department proving that:
  (1) the person exhibits dangerous behavior that could cause serious physical injury to the person or others;
  (2) a written behavior intervention plan has been implemented for the person;
  (3) more staff members are needed and available than would be needed if the person did not exhibit dangerous behavior;
  (4) management of the individual's behavior requires that staff members are constantly prepared to physically prevent the dangerous behavior or intervene when the behavior occurs; and
  (5) the person's MR/RC Assessment is correctly scored with a "1" in the "Behavior" section.
(c) An LON 9 will be assigned by the department, due to the person's extremely dangerous behavior, if the supporting documentation described in §419.242(2) (relating to Supporting Documentation for Level of Need) is submitted to the department proving that:
  (1) the person exhibits extremely dangerous behavior that is life threatening to the person or to others such that specified staff must be at arm's length during waking hours;
  (2) a written behavior intervention plan has been implemented for the person;
  (3) management of the person's behavior requires a staff member to exclusively and constantly supervise the person during the person's waking hours, which must be at least 16 hours per day;
  (4) the staff member assigned to supervise the person has no other duties during such assignment; and
  (5) the person's MR/RC Assessment is correctly scored with a "2" in the "Behavior" section.
(d) An LON 1, LON 5, or LON 8 will be increased to the next LON by the department, due to a person's extraordinary medical needs, if the supporting documentation described in §419.242(3) (relating to Supporting Documentation for Level of Need) is submitted to the department proving that:
  (1) the person's extraordinary medical needs require direct nursing treatment in excess of 180 minutes per week;
  (2) the provision of nursing treatment is documented by a nurse in the person's medical record to include the amount of time spent for treatment; and
  (3) the person's MR/RC Assessment is correctly scored with a "6" in the "Nursing" section.

Source Note: The provisions of this §261.241 adopted to be effective September 1, 2001, 26 TexReg 5384; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective October 1, 2020, as published in the Texas Register August 28, 2020, 45 TexReg 6127