(a) The facility must notify the Department of Aging and Disability Services (DADS) when one of the following happens:      
        (1) significant changes in the client's health and/or condition;       
        (2) the client temporarily enters an institution;       
        (3) serious occurrences or emergencies involving the client or facility staff;       
        (4) the client or the client's representative requests that services end;       
        (5) the client refuses to comply with the service plan;       
        (6) the client engages in discrimination in violation of applicable law;       
        (7) the client or the client's representative fails to pay copayment;       
        (8) the client uses ten personal leave days in the current calendar year;       
        (9) the client or the client's representative requests to move to another facility; or       
        (10) the facility believes that a client's functional needs have changed such that it will impact the client's level of care, if the facility provides assisted living services under the Community Based Alternatives (CBA) Assisted Living/Residential Care (AL/RC) Program and participates in the attendant compensation rate option.       
      (b) The facility must notify the client's DADS case manager orally or by facsimile about the change no later than one DADS working day after the change happens. If the facility's first notification is oral, the facility must send written notification to the case manager within five working days of the initial notification.     
     Source Note:        The provisions of this §46.45 adopted to be effective September 1, 2003, 28 TexReg 6941; amended to be effective September 1, 2008, 33 TexReg 7285