reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter D - FACILITY CONSTRUCTION › Division 11 - NEW LARGE TYPE B ASSISTED LIVING FACILITIES › Section 553.244 - Smoke Compartmentation for a New Large Type B Assisted Living Facility

Current through Reg. 49, No. 28; July 12, 2024
(a) A new large
					 Type B assisted living facility must meet the requirements of 18.3.6,
					 Corridors, in NFPA 101, Chapter 18, New Health Care Occupancies.
(b) A new large Type B assisted living
					 facility must meet the requirements of 18.3.7, Subdivision of Building Spaces,
					 in NFPA 101, Chapter 18, New Health Care Occupancies.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter D - FACILITY CONSTRUCTION › Division 11 - NEW LARGE TYPE B ASSISTED LIVING FACILITIES › Section 553.246 - Hazardous Area Requirements for a New Large Type B Assisted Living Facility

Current through Reg. 49, No. 28; July 12, 2024
(a) A new large
					 Type B assisted living facility must meet the requirements of 19.3.2,
					 Protection from Hazards, in NFPA 101, Chapter 19, New Health Care
					 Occupancies.
(b) A new large Type B
					 assisted living facility must ensure flammable or combustible liquids,
					 including gasoline, oil-based paint, charcoal lighter fluid, or similar
					 products are not stored in a building housing residents.
(c) A new large Type B assisted living
					 facility must protect any cooking operation according to the requirements of
					 18.3.2.5, Cooking Facilities, in NFPA 101, Chapter 18, New Health Care
					 Occupancies.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter D - FACILITY CONSTRUCTION › Division 11 - NEW LARGE TYPE B ASSISTED LIVING FACILITIES › Section 553.247 - Mechanical Requirements for a New Large Type B Assisted Living Facility

Current through Reg. 49, No. 28; July 12, 2024
(a) Wastewater and
					 water supply.
(1) Wastewater. A new large
					 Type B assisted living facility must ensure wastewater and sewage are
					 discharged into a sewerage system or an onsite sewerage facility approved by
					 the Water Quality Division of TCEQ, or to a system regulated by an entity
					 responsible for water quality in that jurisdiction as approved by the Water
					 Quality Division of TCEQ.
(2) Water
					 supply. A new large Type B assisted living facility must ensure the water
					 supply is of safe, sanitary quality, suitable for use, adequate in quantity and
					 pressure, and obtained from a public or private water supply system or a
					 private well.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter D - FACILITY CONSTRUCTION › Division 11 - NEW LARGE TYPE B ASSISTED LIVING FACILITIES › Section 553.248 - Electrical Requirements for a New Large Type B Assisted Living Facility

Current through Reg. 49, No. 28; July 12, 2024
(a) Electrical
					 system. A new large Type B assisted living facility must ensure an electrical
					 system meets the requirements of 9.1.2, Electrical Systems, in NFPA 101,
					 Chapter 9, Building Service and Fire Protection Equipment.
(b) Lighting. A new large Type B assisted
					 living facility must provide illumination throughout the building. Minimum
					 lighting levels must not be lower than:
(1) 10
					 footcandles in resident rooms during the day--illumination requirements for
					 these areas apply to lighting throughout the space, as measured at 30 inches
					 above the floor anywhere in the room.
(2) 20 footcandles in each corridor, staff
					 station, dining room, lobby, toilet room, bathroom, bathing facility, laundry
					 room, stairway, and elevator during the day--illumination requirements for
					 these areas apply to lighting throughout the space, as measured at 30 inches
					 above the floor anywhere in the room.
(3) 50 footcandles for each medication
					 preparation or storage area, kitchen, and desk within a staff station.
					 Illumination requirements apply when the area is in use for a task it supports,
					 as measured where the task is being performed.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter D - FACILITY CONSTRUCTION › Division 11 - NEW LARGE TYPE B ASSISTED LIVING FACILITIES › Section 553.249 - Miscellaneous Requirements for a New Large Type B Assisted Living Facility

Current through Reg. 49, No. 28; July 12, 2024
(a) A new large
					 Type B assisted living facility must provide an elevator if:
(1) the building in which the facility is
					 located is three or more stories in height; or
(2) the facility provides services or social
					 activities to residents in spaces located on a floor other than the floor where
					 the entrance to the facility is located.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter E - STANDARDS FOR LICENSURE › Section 553.253 - Employee Qualifications and Training

Current through Reg. 49, No. 28; July 12, 2024
(a) Manager qualifications. Each facility
				  must designate, in writing, a manager to have authority over the operation.
(1) Qualifications. In small facilities, the
				  manager must have proof of graduation from an accredited high school or
				  certification of equivalency of graduation. In large facilities, a manager
				  musthave:
(A) an associate's degree in
				  nursing, health care management, or a related field;
(B) a bachelor's degree; or
(C) proof of graduation from an accredited
				  high school or certification of equivalency of graduation and at least one year
				  of experience working in management or in health care industry
				  management.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter E - STANDARDS FOR LICENSURE › Section 553.255 - All Staff Policy for Residents with Alzheimer's Disease or a Related Disorder

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility
				  must adopt, implement, and enforce a written policy that:
(1) requires a facility employee who provides
				  direct care to a resident with Alzheimer's disease or a related disorder to
				  successfully complete training in the provision of care to residents with
				  Alzheimer's disease and related disorders; and
(2) ensures the care and services provided by
				  a facility employee to a resident with Alzheimer's disease or a related
				  disorder meet the specific identified needs of the resident relating to the
				  diagnosis of Alzheimer's disease or a related disorder.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter E - STANDARDS FOR LICENSURE › Section 553.257 - Human Resources

Current through Reg. 49, No. 28; July 12, 2024
(a) Personnel
				  records. A facility must keep current and complete personnel records on a
				  facility employee for review by HHSC staff including:
(1) documentation that the facility performed
				  a criminal history check;
(2) an
				  annual employee misconduct registry check;
(3) an annual nurse aide registry
				  check;
(4) documentation of initial
				  tuberculosis screenings referenced in § 553.261(f) of this subchapter
				  (relating to Coordination of Care);
(5) documentation of the employee's
				  compliance with or exemption from the facility vaccination policy referenced in
				  § 553.261(f) of this subchapter;
(6) the signed statement from the employee
				  referenced in § 553.273 of this subchapter (relating to Abuse, Neglect, or
				  Exploitation Reportable to HHSC by Facilities), acknowledging that the employee
				  may be criminally liable for the failure to report abuse, neglect, and
				  exploitation; and
(7) a signed
				  disclosure statement, indicating whether the employee:
(A) has been convicted of an offense
				  described in Texas Health and Safety Code §
												250.006;
				  and
(B) has lived in a state other
				  than Texas within the past five years.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter E - STANDARDS FOR LICENSURE › Section 553.261 - Coordination of Care

Current through Reg. 49, No. 28; July 12, 2024
(a) Medications.
(1) Administration. Medications must be
				  administered according to physician's orders.
(A) Residents who choose not to or cannot
				  self-administer their medications must have their medications administered by a
				  person who:
(i) holds a current license under
				  state law that authorizes the licensee to administer medication;
(ii) holds a current medication aide permit
				  and who:
(I) acts under the authority of a
				  person who holds a current nursing license under state law that authorizes the
				  licensee to administer medication; and
(II) functions under the direct supervision
				  of a licensed nurse on duty or on call by the facility; or
(iii) is an employee of the facility to whom
				  medication administration has been delegated by a registered nurse, who has
				  trained the employee to administer medications or verified their training. The
				  delegation of the medication administration is governed by 22 TAC Chapter 225
				  (concerning RN Delegation to Unlicensed Personnel and Tasks Not Requiring
				  Delegation in Independent Living Environments for Clients with Stable and
				  Predictable Conditions), which implements the Nursing Practice Act.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter E - STANDARDS FOR LICENSURE › Section 553.263 - Health maintenance activities

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility may allow personal care staff
				  to perform a health maintenance activity (HMA) for a resident, without being
				  delegated, only if:
(1) the activity is
				  performed for a person with a functional disability as defined in § 553.3
				  of this chapter (relating to Definitions);
(2) a registered nurse (RN) acting on behalf
				  of the facility conducts and documents an assessment in accordance with
				  subsection (b) of this section, and determines, based on the assessment, that
				  the activity qualifies as an HMA not requiring delegation; and
(3) the facility ensures and documents that
				  all the conditions and requirements of subsection (c) of this section are met:
(A) the resident, the resident's legally
				  authorized representative, or other adult chosen by the resident, as
				  applicable, is willing and able to direct personal care staff to perform the
				  task without RN supervision; and
(B) the resident, the resident's legally
				  authorized representative, or other adult chosen by the resident, as
				  applicable, is willing and able and has agreed in writing, to participate in
				  directing the personal care staff's actions in carrying out the HMA;
(4) the activity addresses a
				  condition that is stable and predictable, as defined in § 553.3 of this
				  chapter; and
(5) the activity is
				  performed for a resident who could perform the task on his or her own but for a
				  functional disability that prevents it.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter E - STANDARDS FOR LICENSURE › Section 553.265 - Resident Records and Retention

Current through Reg. 49, No. 28; July 12, 2024
(a) Resident records.
(1) Records that pertain to residents must be
				  treated as confidential and properly safeguarded from unauthorized use, loss,
				  or destruction.
(2) Resident
				  records must contain:
(A) information
				  contained in the facility's standard and customary admission form;
(B) a record of the resident's
				  assessments;
(C) the resident's
				  service plan;
(D) physician's
				  orders, if any;
(E) any advance
				  directives;
(F) documentation of a
				  health examination by a physician performed within 30 days before admission or
				  14 days after admission, unless:
(i) a
				  transferring hospital or facility has a physical examination in the medical
				  record; or
(ii) the resident is a
				  Christian Scientist;
(G)
				  documentation by health care professionals of any services delivered in
				  accordance with the licensing, certification, or other regulatory standards
				  applicable to the health care professional under law; and
(H) a copy of the most recent court order
				  appointing a guardian of a resident or a resident's estate and letters of
				  guardianship that the facility received in response to the request made in
				  accordance with subsection (c) of this section.
(3) Records must be available to residents,
				  their legal representatives, and HHSC staff.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter E - STANDARDS FOR LICENSURE › Section 553.267 - Rights

Current through Reg. 49, No. 28; July 12, 2024
(a) Residents' Bill
				  of Rights.
(1) A facility must:
(A) provide a copy of the Residents' Bill of
				  Rights to each resident; and
(B)
				  post the Residents' Bill of Rights, as provided by HHSC, in a prominent place
				  in the facility and written in the primary language of each resident.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter E - STANDARDS FOR LICENSURE › Section 553.269 - Access to Residents and Records by the State Long-Term Care Ombudsman Program

Current through Reg. 49, No. 28; July 12, 2024
(a) A resident
				  has the right to be visited by the State Ombudsman, a certified ombudsman, or
				  an ombudsman intern.
(b) In
				  accordance with 42 United States Code (U.S. Code) §3058g (b)(1)(A) and
				  45
				  CFR §
											1324.11(e)(2), a
				  facility must allow:
(1) the State Ombudsman,
				  a certified ombudsman, and an ombudsman intern to have:
(A) immediate, private, and unimpeded access
				  to enter the facility at any time during the facility's regular business hours
				  or regular visiting hours;
(B)
				  immediate, private, and unimpeded access to a resident; and
(C) immediate and unimpeded access to the
				  name and contact information of the resident's legally authorized
				  representative, if the State Ombudsman, a certified ombudsman, or an ombudsman
				  intern determines the information is needed to perform a function of the
				  Ombudsman Program; and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter E - STANDARDS FOR LICENSURE › Section 553.271 - Postings

Current through Reg. 49, No. 28; July 12, 2024
An assisted living facility must prominently and
					 conspicuously post for display in a public area of the facility that is readily
					 available to residents, employees, and visitors:
(1) the license issued under this
				  chapter;
(2) a sign prescribed by
				  HHSC that specifies complaint procedures established under these rules and
				  specifies how complaints may be filed with HHSC;
(3) a notice in the form prescribed by HHSC
				  stating that inspection and related reports are available at the facility for
				  public inspection and providing HHSC toll-free telephone number that may be
				  used to obtain information concerning the facility;
(4) a copy of the most recent inspection
				  report relating to the facility;
(5) Residents' Bill of Rights;
(6) Providers' Bill of Rights;
(7) the telephone number of the managing
				  local ombudsman and the toll-free number of the Ombudsman Program,
				  1-800-252-2412;
(8) the facility's
				  normal 24-hour staffing patterns;and
(9) a sign stating: "Cases of Suspected
				  Abuse, Neglect, or Exploitation must be reported to HHSC by calling
				  1-800-458-9858."
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter E - STANDARDS FOR LICENSURE › Section 553.272 - Advertisements, Solicitations, and Promotional Material

Current through Reg. 49, No. 28; July 12, 2024
A facility must use its state-issued facility
					 identification number in all advertisements, solicitations, and promotional
					 materials, including yellow pages, brochures, and business
					 cards.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter E - STANDARDS FOR LICENSURE › Section 553.273 - Abuse, Neglect, or Exploitation Reportable to HHSC by Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) An assisted
				  living facility staff who has cause to believe that the physical or mental
				  health or welfare of a resident has been or may be adversely affected by abuse,
				  neglect, or exploitation or that the resident has died due to abuse or neglect,
				  must report the abuse, neglect, or exploitation to:
(1) HHSC Consumer Rights and Services section
				  at 1-800-458-9858 or via the HHSC website; and
(2) one of the following law enforcement
				  agencies:
(A) a municipal law enforcement
				  agency, if the facility is located within the territorial boundaries of a
				  municipality; or
(B) the sheriff's
				  department of the county in which the facility is located if the facility is
				  not located within the territorial boundaries of a
				  municipality.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter F - ADDITIONAL LICENSING STANDARDS FOR CERTIFIED ALZHEIMER'S ASSISTED LIVING FACILITIES › Section 553.301 - Manager Qualifications and Training

Current through Reg. 49, No. 28; July 12, 2024
(a) The manager of the certified Alzheimer's
				  facility or the supervisor of the certified Alzheimer's unit must be 21 years
				  of age, and have:
(1) an associate's degree
				  in nursing or health care management;
(2) a bachelor's degree in psychology,
				  gerontology, nursing, or a related field; or
(3) proof of graduation from an accredited
				  high school or certification of equivalency of graduation and at least one year
				  of experience working with persons with dementia.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter F - ADDITIONAL LICENSING STANDARDS FOR CERTIFIED ALZHEIMER'S ASSISTED LIVING FACILITIES › Section 553.303 - Staff Training

Current through Reg. 49, No. 28; July 12, 2024
(a) In addition
				  to the staff training requirements under § 553.253 of this chapter
				  (relating to Employee Qualifications and Training), all staff members must
				  receive four hours of dementia-specific orientation prior to assuming any job
				  responsibilities. Training must cover, at a minimum, the following topics:
(1) basic information about the causes,
				  progression, and management of Alzheimer's disease;
(2) managing dysfunctional behavior;
				  and
(3) identifying and alleviating
				  safety risks to residents with Alzheimer's disease.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter F - ADDITIONAL LICENSING STANDARDS FOR CERTIFIED ALZHEIMER'S ASSISTED LIVING FACILITIES › Section 553.305 - Staffing

Current through Reg. 49, No. 28; July 12, 2024
A facility must employ sufficient staff to provide services
					 for and meet the needs of its Alzheimer's residents. In large facilities or
					 units with 17 or more residents, two staff members must be immediately
					 available when residents are present.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter F - ADDITIONAL LICENSING STANDARDS FOR CERTIFIED ALZHEIMER'S ASSISTED LIVING FACILITIES › Section 553.307 - Admission Procedures, Assessment, and Service Plan

Current through Reg. 49, No. 28; July 12, 2024
(a) Alzheimer's Assisted Living Disclosure
				  Statement form. A facility must use the Alzheimer's Assisted Living Disclosure
				  Statement form and amend the form if changes in the operation of the facility
				  affect the information in the form.
(b) Pre-admission. The facility must
				  establish procedures, such as an application process, interviews, and home
				  visits, to ensure that the placement of prospective residents is appropriate
				  and that their needs can be met.
(1) Prior to
				  admitting a resident, facility staff must discuss and explain the Alzheimer's
				  Assisted Living Disclosure Statement form with the family or responsible
				  party.
(2) The facility must give
				  the Alzheimer's Assisted Living Disclosure Statement form to any individual
				  seeking information about the facility's care or treatment of residents with
				  Alzheimer's disease and related disorders.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter F - ADDITIONAL LICENSING STANDARDS FOR CERTIFIED ALZHEIMER'S ASSISTED LIVING FACILITIES › Section 553.309 - Activities Program

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility must
				  encourage socialization, cognitive awareness, self-expression, and physical
				  activity in a planned and structured activities program. Activities must be
				  individualized, based upon the resident assessment, and appropriate for each
				  resident's abilities.
(b) The
				  activity program must contain a balanced mixture of activities addressing
				  cognitive, recreational, and activity of daily living (ADL) needs.
(1) Cognitive activities include arts,
				  crafts, storytelling, poetry readings, writing, music, reading, discussion,
				  reminiscences, and reviews of current events.
(2) Recreational activities include all
				  socially interactive activities, such as board games and cards, and physical
				  exercise. Care of pets is encouraged.
(3) Self-care ADLs include grooming, bathing,
				  dressing, oral care, and eating. Occupational ADLs include cleaning, dusting,
				  cooking, gardening, and yard work. Residents must be allowed to perform
				  self-care ADLs as long as they are able, to promote independence and
				  self-worth.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter F - ADDITIONAL LICENSING STANDARDS FOR CERTIFIED ALZHEIMER'S ASSISTED LIVING FACILITIES › Section 553.311 - Physical Plant Requirements for Alzheimer's Units

Current through Reg. 49, No. 28; July 12, 2024
Alzheimer's units, if segregated from other parts of the
					 Type B facility with approved security devices, must meet the following
					 requirements within the Alzheimer's unit:
(1) Resident living areas must be in
				  compliance with applicable requirements in Subchapter D of this chapter
				  (relating to Facility Construction).
(2) Resident dining areas must be in
				  compliance with applicable requirements in Subchapter D of this chapter for
				  resident dining areas.
(3) Resident
				  toilet and bathing facilities must be in compliance with applicable
				  requirements in Subchapter D of this chapter for resident toilet and bathing
				  facilities.
(4) A monitoring
				  station must be provided within the Alzheimer's unit with a writing surface
				  such as a desk or counter, chair, task illumination, telephone or intercom, and
				  lockable storage for resident records.
(5) Access to at least two approved exits
				  remote from each other must be provided in order to meet the NFPA 101
				  requirements.
(6) In large
				  facilities, cross corridor control doors, if used for the security of the
				  residents, must be similar to smoke doors, which are each 34 inches in width
				  and swing in opposite directions. A latch or other fastening device on a door
				  must be provided with a knob, handle, panic bar, or other simple type of
				  releasing device.
(7) An outdoor
				  area of at least 800 square feet must be provided in at least one contiguous
				  space. This area must be connected to, be a part of, be controlled by, and be
				  directly accessible from the facility.
(A)
				  Such areas must have walls or fencing that do not allow climbing or present a
				  hazard and meet the following requirements. These minimum dimensions do not
				  apply to additional fencing erected along property lines or building setback
				  lines for privacy or to meet requirements of local building authorities.
(i) Minimum distance of the enclosure fence
				  from the building is 8 feet if the fence is parallel to the building and there
				  are no window openings.
(ii)
				  Minimum distance of the enclosure fence (parallel with building walls) from
				  bedroom windows is 20 feet if the fencing is solid and 15 feet from bedroom
				  windows if the fencing is open.
(iii) For unusual or unique site conditions,
				  areas of enclosure may have alternate configurations with HHSC
				  approval.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter G - INSPECTIONS, INVESTIGATIONS, AND INFORMAL DISPUTE RESOLUTION › Section 553.327 - Inspections, Investigations, and Other Visits

Current through Reg. 49, No. 28; July 12, 2024
(a) HHSC inspection and survey personnel
				  perform inspections and surveys, follow-up visits, complaint investigations,
				  investigations of abuse or neglect, and other contact visits from time to time
				  as they deem appropriate, or as required for carrying out the responsibilities
				  of licensing.
(b) In addition to
				  the inspections required under Subchapter B of this chapter (relating to
				  Licensing), HHSC inspects a facility at least once every two years after the
				  initial inspection.
(c) An
				  inspection may be conducted by an individual surveyor or by a team, depending
				  on the purpose of the inspection or survey, size of facility, and service
				  provided by the facility, and other factors.
(d) To determine standard compliance which
				  cannot be verified during regular working hours, HHSC, with the least possible
				  interference to staff and residents, may conduct night or weekend inspections
				  to cover specific aspects of a facility's operation.
(e) Generally, HHSC conducts routine and
				  nonroutine inspections, surveys, complaint investigations and other visits made
				  for the purpose of determining the appropriateness of resident care and
				  day-to-day operations of a facility on an unannounced basis, unless there is
				  justification for an exception.
(f)
				  Certain visits may be announced, including, but not limited to, conditions when
				  certain emergencies arise, such as fire, windstorm, or malfunctioning or
				  nonfunctioning of electrical or mechanical systems.
(g) When HHSC conducts a complaint
				  investigation, HHSC notifies the facility of the complaint received and a
				  summary of the complaint, without identifying the source of the complaint. A
				  complaint is an allegation received by HHSC regarding:
(1) abuse, neglect, or exploitation of a
				  resident; or
(2) a violation of
				  state standards.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter G - INSPECTIONS, INVESTIGATIONS, AND INFORMAL DISPUTE RESOLUTION › Section 553.329 - HHSC Investigation of Allegations of Abuse, Neglect or Exploitation

Current through Reg. 49, No. 28; July 12, 2024
(a) In accordance
				  with the memorandum of understanding (relating to Memorandum of Understanding
				  Concerning Protective Services for the Elderly), between HHSC and the Texas
				  Department of Family and Protective Services (DFPS), HHSC receives and
				  investigates reports of abuse, neglect, and exploitation of elderly and
				  disabled persons or other residents living in facilities licensed under this
				  chapter.
(b) HHSC only investigates
				  complaints of abuse, neglect, or exploitation when the act occurs in the
				  facility, when the licensed facility is responsible for the supervision of the
				  resident at the time the act occurs, or when the alleged perpetrator is
				  affiliated with the facility. Other complaints of abuse, neglect, or
				  exploitation not meeting these criteria must be referred to DFPS.
(c) Complaint investigations include a visit
				  to the resident's facility and consultation with persons thought to have
				  knowledge of the circumstances. If the facility fails to admit HHSC staff for a
				  complaint investigation, HHSC seeks a probate or county court order for
				  admission. Investigators may request of the court that a peace officer
				  accompany them.
(d) In cases
				  concluded to be physical abuse, HHSC submits the written report of the HHSC
				  investigation to the appropriate law enforcement agency.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter G - INSPECTIONS, INVESTIGATIONS, AND INFORMAL DISPUTE RESOLUTION › Section 553.331 - Determinations and Actions (Investigation Findings)

Current through Reg. 49, No. 28; July 12, 2024
(a) HHSC determines if a facility meets HHSC
				  licensing rules, including physical plant and facility operation requirements,
				  by conducting inspections, surveys, investigations, and on-site
				  visits.
(b) HHSC lists violations
				  of licensing rules on a report of contact. The report of contact includes a
				  specific reference to a licensing rule that has been violated.
(c) At the conclusion of an inspection,
				  survey, investigation, or on-site visit, an HHSC surveyor conducts an exit
				  conference to advise the facility of the findings resulting from the
				  inspection, survey, investigation, or on-site visit.
(d) At the exit conference, the surveyor
				  provides a copy of the report of contact described in subsection (b) of this
				  section to the facility.
(e) If,
				  after the initial exit conference, an HHSC surveyor cites an additional
				  licensing rule violation, the surveyor conducts another exit conference
				  regarding the newly identified violations and updates the report of contact
				  with a specific reference to the licensing rule that has been
				  violated.
(f) HHSC provides to the
				  facility a written statement of violations from an inspection, survey,
				  investigation, or on-site visit on HHSC Form 3724 within 10 days after the
				  final exit conference. The statement of violations includes a clear and concise
				  summary in nontechnical language of each licensing rule violation. The
				  statement of violations does not include names of residents or staff,
				  statements that identify a resident, or other prohibited information.
(g) A facility must submit an acceptable plan
				  of correction to the HHSC regional director for the HHSC surveyor within 10
				  working days after receiving the statement of violations described in
				  subsection (f) of this section. An acceptable plan of correction must address:
(1) how corrective action will be
				  accomplished for a resident affected by a violation of a licensing
				  rule;
(2) how the facility will
				  identify other residents who may be affected by the violation of the licensing
				  rule;
(3) how the corrective action
				  the facility implements will ensure the violation does not reoccur;
(4) how the facility will monitor its
				  corrective action to ensure the violation is being corrected and will not
				  reoccur; and
(5) dates when
				  corrective action will be completed.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter G - INSPECTIONS, INVESTIGATIONS, AND INFORMAL DISPUTE RESOLUTION › Section 553.333 - Informal Disputev Resolution

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  If a facility disputes a violation of a licensing rule, which HHSC cites on a
				  statement of violations in accordance with § 553.331(f) of this subchapter
				  (relating to Determinations and Actions (Investigation Findings)), the facility
				  may request informal dispute resolution conducted in accordance with Texas
				  Government Code §
										531.058
				  and Texas Health and Safety Code §
										247.051,
				  and, to the extent consistent with those statutes, 1 TAC §
										393.2(relating
				  to Informal Dispute Resolution for Assisted Living Facilities).
(b) To request informal dispute resolution, a
				  facility must follow the informal dispute resolution process provided on the
				  HHSC website and submit a completed Informal Dispute Resolution Request Form to
				  HHSC in accordance with the form's instructions no later than 10 calendar days
				  after the facility receives the statement of violations. The request form must
				  summarize each violation that the facility disputes.
(c) If a facility requests informal dispute
				  resolution in accordance with subsection (b) of this section, HHSC sends to the
				  facility a copy of all documents referenced in the disputed statement of
				  violations or on which a cited licensure violation is based in connection with
				  the survey, inspection, investigation, or other regulatory visit, including any
				  notes taken by, or emails or messages sent by, an HHSC employee involved with
				  the survey, inspection, investigation, or other regulatory visit, no later than
				  20 working days after HHSC receives the facility's request for informal dispute
				  resolution. HHSC redacts or excludes the following information from the
				  documents it sends to the facility:
(1) the
				  name of any complainant, witness, or informant;
(2) information that would reasonably lead to
				  the identification of a complainant, witness, or informant;
(3) information obtained from or contained in
				  the records of the facility;
(4)
				  information that is publicly available; and
(5) information that is confidential by
				  law.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter G - INSPECTIONS, INVESTIGATIONS, AND INFORMAL DISPUTE RESOLUTION › Section 553.335 - Confidentiality and Release of Information

Current through Reg. 49, No. 28; July 12, 2024
(a) Confidentiality. All reports, records,
				  and working papers used or developed by HHSC in an investigation are
				  confidential and may be released only as provided in this subsection.
(1) Completed written investigation reports
				  on cases concluded to be abuse or neglect must be furnished to the district
				  attorney and appropriate law enforcement agency. HHSC also may release these
				  reports to any other public agency HHSC deems appropriate to the
				  investigation.
(2) Completed
				  written investigation reports are open to the public, provided the report is
				  deidentified. The process of deidentification means removing all names and
				  other personally identifiable data, including any information from witnesses
				  and others furnished to HHSC as part of the investigation.
(3) HHSC notifies the reporter and the
				  facility of the results of the HHSC investigation of a reported case of abuse
				  or neglect, whether HHSC concludes that abuse or neglect occurred or did not
				  occur.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter G - INSPECTIONS, INVESTIGATIONS, AND INFORMAL DISPUTE RESOLUTION › Section 553.337 - Retaliation

Current through Reg. 49, No. 28; July 12, 2024
An HHSC employee must not retaliate against an assisted
					 living facility, an employee of an assisted living facility, or a person in
					 control of an assisted living facility for:
(1) complaining about the conduct of an HHSC
				  employee;
(2) disagreeing with an
				  HHSC employee about the existence of a violation of this chapter or a rule
				  adopted under this chapter; or
(3)
				  asserting a right under state or federal law.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 1 - GENERAL INFORMATION › Section 553.351 - When may HHSC take an enforcement action?

Current through Reg. 49, No. 28; July 12, 2024
HHSC may take enforcement action when a facility is in
						violation of:
(1) the sections of this
					 chapter;
(2) the Texas Health and
					 Safety Code, Chapter 247;
(3) an
					 order adopted under Texas Health and Safety Code, Chapter 247; or
(4) a license issued under Texas Health and
					 Safety Code, Chapter 247.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 1 - GENERAL INFORMATION › Section 553.353 - What enforcement actions may HHSC take?

Current through Reg. 49, No. 28; July 12, 2024
HHSC may:
(1)
					 suspend a license;
(2) order
					 immediate closing of all or part of the facility;
(3) revoke a license;
(4) refer the violation to the Office of the
					 Attorney General for involuntary appointment of a trustee, injunction, or for
					 the assessment of civil penalties; or
(5) assess administrative
					 penalties.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.401 - When may HHSC suspend a facility's license?

Current through Reg. 49, No. 28; July 12, 2024
HHSC may suspend a facility's license when the applicant,
						license holder, or a controlling person violates:
(1) the Texas Health and Safety Code, Chapter
					 247; a section, standard or order adopted under Texas Health and Safety Code,
					 Chapter 247; or a license issued under Chapter 247 in a repeated or substantial
					 manner; or
(2)
											§553.751(a)(2)
					 - (9) of this subchapter (relating to Administrative Penalties).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.403 - Does HHSC provide notice of a license suspension and the opportunity for a hearing to the applicant, license holder, or a controlling person?

Current through Reg. 49, No. 28; July 12, 2024
Yes.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.405 - May HHSC suspend a license at the same time another enforcement action is occurring?

Current through Reg. 49, No. 28; July 12, 2024
Yes.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.407 - How does HHSC notify a license holder of a proposed suspension?

Current through Reg. 49, No. 28; July 12, 2024
HHSC notifies a license holder by certified
						mail.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.409 - What information does HHSC provide the license holder concerning a proposed suspension?

Current through Reg. 49, No. 28; July 12, 2024
HHSC provides the license holder with the facts or
						conduct alleged to warrant the suspension.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.411 - Does the license holder have an opportunity to show compliance with all requirements for keeping the license before HHSC begins proceedings to suspend a license?

Current through Reg. 49, No. 28; July 12, 2024
Yes.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.413 - How does a license holder request an opportunity to show compliance?

Current through Reg. 49, No. 28; July 12, 2024
A license holder must send a written request for an
						opportunity to show compliance to the Associate Commissioner of Long-term Care
						Regulation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.415 - How much time does a license holder have to request an opportunity to show compliance?

Current through Reg. 49, No. 28; July 12, 2024
A request for an opportunity to show compliance must be
						postmarked within 10 calendar days of the date of HHSC notice and must be
						received in the office of the Associate Commissioner of Long-term Care
						Regulation within 10 calendar days after the postmark.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.417 - What must the request for an opportunity to show compliance contain?

Current through Reg. 49, No. 28; July 12, 2024
The request must contain specific documentation showing
						how the facts or conduct that support the proposed suspension are incorrect.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.419 - How does HHSC conduct the opportunity to show compliance?

Current through Reg. 49, No. 28; July 12, 2024
HHSC review is limited to documentation submitted by the
						license holder and information used by HHSC as the basis for its proposed
						action. The review is not conducted as an adversary hearing.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.421 - Does HHSC give the license holder a written affirmation or reversal of the proposed action?

Current through Reg. 49, No. 28; July 12, 2024
Yes.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.423 - How does HHSC notify a license holder of its final decision to suspend a license?

Current through Reg. 49, No. 28; July 12, 2024
HHSC notifies the facility by certified
						mail.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.425 - May the facility request a formal hearing?

Current through Reg. 49, No. 28; July 12, 2024
Yes.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.427 - How long does a license holder have to request a formal hearing?

Current through Reg. 49, No. 28; July 12, 2024
The license holder has 15 calendar days from receipt of
						the certified mail notice to request a hearing.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.429 - If a license holder does not appeal, when does the suspension take effect?

Current through Reg. 49, No. 28; July 12, 2024
The suspension takes effect after the deadline for an
						appeal passes.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.431 - If a license holder appeals, when does the suspension take effect?

Current through Reg. 49, No. 28; July 12, 2024
The status of the license remains in effect until after
						the appeal is complete.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 553 - LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES › Subchapter H - ENFORCEMENT › Division 2 - ACTIONS AGAINST A LICENSE: SUSPENSION › Section 553.433 - May a facility operate during a suspension?

Current through Reg. 49, No. 28; July 12, 2024
A facility may continue to operate as long as the
						suspension is under appeal.