reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 1 - OPERATIONS AND SAFETY PROVISIONS › Section 550.206 - Person-Centered Direction and Guidance

Current through Reg. 49, No. 28; July 12, 2024
(a) A center must adopt and enforce written
					 policies and procedures for the use of person-centered direction and guidance
					 by individuals providing services to minors at the center. The policy must
					 include:
(1) the implementation of a
					 system-wide, person-centered direction and guidance program for minors that
					 includes:
(A) the teaching of successful
					 behavior and coping skills;
(B)
					 proactive strategies to identify and manage a minor's behaviors before they
					 escalate; and
(C) the monitoring
					 and evaluation of the effectiveness of direction and guidance used with a minor
					 by a committee as described in this section;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 1 - OPERATIONS AND SAFETY PROVISIONS › Section 550.207 - Protective Devices and Restraints

Current through Reg. 49, No. 28; July 12, 2024
(a) Protective Devices. A center must ensure
					 that a protective device is used only as ordered by a minor's physician, as
					 agreed to by an adult minor or a minor's parent, and in accordance with the
					 minor's plan of care.
(1) A center may use a
					 protective device only in the following circumstances:
(A) as part of a therapeutic regimen of basic
					 services for a minor's physical health and development;
(B) during medical, nursing, diagnostic, and
					 dental procedures as prescribed by a physician's order and to protect the
					 health and safety of a minor; or
(C) in a medical emergency to protect the
					 health and safety of a minor.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 1 - OPERATIONS AND SAFETY PROVISIONS › Section 550.208 - Equipment, Devices, and Supplies

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 center, with input from the medical director, must determine the quantity and
					 types including age and developmentally appropriate equipment, devices, and
					 supplies that the center must keep on the premises to meet the needs of minors
					 and for emergency purposes.
(b) The
					 center must coordinate with a minor, a minor's parent, and a minor's
					 prescribing physician and other basic service providers, as applicable, to
					 ensure that equipment, devices, and supplies used by a minor are available to a
					 minor at the center.
(c) The center
					 must ensure the provision of necessary consumable supplies and resources,
					 including diapers, if the center determines, after the minor's arrival at the
					 center, that the minor's parent failed to provide an adequate amount of
					 necessary consumable supplies and resources for the minor.
(d) The center must adopt and enforce written
					 preventive maintenance policies and procedures to ensure the center's
					 equipment, devices, and supplies are inspected for safety purposes and
					 maintained at least annually or more frequently if recommended by the
					 manufacturer. Equipment, devices, and supplies must be maintained free of
					 defects that could pose a potential hazard to a minor or an individual at the
					 center. The staff may perform preventive maintenance if the staff are trained
					 and experienced in maintaining the specific equipment.
(e) The center must adopt and enforce written
					 policies and procedures to ensure equipment used by a minor is cleaned and
					 sanitized after each use.
(f) A
					 center must have clean storage areas for equipment, devices, and
					 supplies.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 1 - OPERATIONS AND SAFETY PROVISIONS › Section 550.209 - Emergency Preparedness Planning and Implementation

Current through Reg. 49, No. 28; July 12, 2024
(a) A center must have a written emergency
					 preparedness and response plan that comprehensively describes its approach to
					 an emergency situation, including a public health disaster that could affect
					 the need for its services or its ability to provide those services.
(b) Administration. A center must:
(1) develop and implement a written plan as
					 described in subsection (c) of this section;
(2) maintain a current written copy of the
					 plan in a central location that is accessible to all staff at all times and at
					 a work station of each staff who has responsibilities under the plan;
(3) evaluate the plan to determine if
					 information in the plan must change:
(A) no
					 later than 30 days after an emergency situation;
(B) as soon as possible after the remodeling
					 or construction of an addition to the center; and
(C) at least annually;
(4) revise the plan no later than 30 days
					 after information in the plan changes; and
(5) maintain documentation of compliance with
					 this section.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 1 - OPERATIONS AND SAFETY PROVISIONS › Section 550.210 - Sanitation, Housekeeping, and Linens

Current through Reg. 49, No. 28; July 12, 2024
(a) A center must ensure a sanitary
					 environment by following accepted standards of practice and maintain a safe
					 physical environment free of hazards for minors, staff, and visitors.
(b) A center must ensure that the following
					 conditions are met.
(1) Wastewater and sewage
					 must be discharged into a state-approved municipal sewage system. An on-site
					 sewage facility must be approved by the Texas Commission on Environmental
					 Quality (TCEQ) or authorized agent.
(2) The water supply must be from a system
					 approved by the Public Drinking Water Section of the TCEQ, or from a system
					 regulated by an entity responsible for water quality in the jurisdiction where
					 the center is located as approved by the Public Drinking Water Section of the
					 TCEQ.
(3) Waste, trash, and garbage
					 must be disposed of from the premises at regular intervals in accordance with
					 state and local practices. Excessive accumulations are not permitted. Outside
					 containers must have tight-fitting lids left in closed position. Containers
					 must be maintained in a clean and serviceable condition.
(4) Center grounds must be well kept and the
					 exterior of the building, including sidewalks, steps, porches, ramps, and
					 fences, must be in good repair.
(5)
					 The interior of the center's buildings including walls, ceilings, floors,
					 windows, window coverings, doors, plumbing and electrical fixtures must be in
					 good repair.
(6) Pest control must
					 be provided by a licensed structural pest control applicator with a license
					 category for pests. The center must maintain documented evidence of routine
					 efforts to remove rodents and insects.
(7) The center must be kept free of offensive
					 odors, accumulations of dirt, rubbish, dust, and hazards. Storage areas,
					 attics, and cellars must be free of refuse and extraneous materials.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 1 - OPERATIONS AND SAFETY PROVISIONS › Section 550.211 - Infection Prevention and Control Program and Vaccinations Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) A center must
					 establish and maintain an infection prevention and control program (IPCP)
					 designed to provide a safe, sanitary, and comfortable environment by preventing
					 the development and transmission of disease and infection. Under the IPCP, the
					 center must:
(1) investigate, prevent, and
					 control infections at the center;
(2) decide what procedures, such as
					 isolation, should be applied to an individual minor;
(3) address vaccine preventable diseases in
					 accordance with THSC, Chapter 224;
(4) address hepatitis B vaccinations in
					 accordance with Occupational Safety and Health Administration;
(5) address tuberculosis requirements;
					 and
(6) maintain a record of
					 incidents and corrective actions relating to infections.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 2 - ADMINISTRATION AND MANAGEMENT › Section 550.301 - License Holder's Responsibilities

Current through Reg. 49, No. 28; July 12, 2024
(a) The license holder is responsible for the
					 conduct of the center and for the adoption, implementation, and enforcement of
					 the written policies required throughout this chapter. The license holder is
					 also responsible for ensuring that these policies comply with THSC Chapter 248A
					 and the applicable provisions of this chapter and are administered to provide
					 safe, professional, and quality health care.
(b) The persons described in §
					 550.101(f) of this chapter (relating to Criteria and Eligibility for a License)
					 must not have been convicted of an offense described in § 99.2 of Title 40
					 (relating to Convictions Barring Licensure), during the time frames described
					 in that chapter.
(c) The license
					 holder must ensure that all documents submitted to DADS or maintained by the
					 center as required by this chapter are accurate and do not misrepresent or
					 conceal a material fact.
(d) The
					 license holder must comply with an order of the DADS commissioner or other
					 enforcement orders that may be imposed on the center in accordance with THSC
					 Chapter 248A and this chapter.
(e)
					 The license holder of the center must have full legal authority and
					 responsibility for the operation of the center.
(f) A license holder must designate in
					 writing an individual who meets the qualifications and conditions set out in
					 § 550.303 of this subchapter (relating to Administrator and Alternate
					 Administrator Qualifications and Conditions) to serve as the administrator of
					 the center.
(g) A license holder
					 must designate in writing an alternate administrator who meets the
					 qualifications and conditions of an administrator set out in § 550.303 of
					 this subchapter to act in the absence of the administrator or when the
					 administrator is unavailable to the staff during the center's operating
					 hours.
(h) A license holder must
					 ensure the position and designation of an administrator or alternate
					 administrator is filled with a qualified staff.
(i) A license holder must ensure maintenance
					 of documentation of efforts to ensure a vacancy in the position of an
					 administrator or alternate administrator does not last more than 30
					 days.
(j) A license holder must
					 ensure all written notices to DADS required by this chapter, unless specified,
					 are submitted as described in the instructions provided on the DADS
					 website.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 2 - ADMINISTRATION AND MANAGEMENT › Section 550.302 - Organizational Structure and Lines of Authority

Current through Reg. 49, No. 28; July 12, 2024
(a) A center must prepare and maintain a
					 current written description of the center's organizational structure. The
					 document may be either in the form of a chart or a narrative.
(b) The description must include:
(1) all services provided by the
					 center;
(2) if applicable to the
					 center's organization structure and lines of authority, the governing body,
					 board of directors, the administrator, alternate administrator, the medical
					 director, the nursing director, the alternate nursing director, advisory
					 committee, IDT, and staff, as appropriate, based on services provided by the
					 center; and
(3) the lines of
					 authority and the delegation of responsibility down to and including the direct
					 care level.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 2 - ADMINISTRATION AND MANAGEMENT › Section 550.303 - Administrator and Alternate Administrator Qualifications and Conditions

Current through Reg. 49, No. 28; July 12, 2024
(a) The
					 administrator and alternate administrator of a center must have two years of
					 experience in supervision and management in a pediatric health care setting and
					 meet one of the following criteria:
(1) be a
					 physician licensed in Texas to practice medicine in accordance with Texas
					 Occupations Code, Chapter 155;
(2)
					 be an RN with a master's or baccalaureate degree in nursing and be licensed
					 under the Nursing Practice Act, Texas Occupations Code, Chapter 301, with no
					 disciplinary actions;
(3) be a
					 college graduate with a bachelor's degree with one additional year of
					 supervision or management experience in a health care setting;
(4) have an associate's degree in health care
					 or administration with two additional years of supervision or management
					 experience in a health care setting; or
(5) have an associate's degree in nursing and
					 currently licensed under the Nursing Practice Act, Texas Occupations Code,
					 Chapter 301, with no disciplinary action with two additional years of
					 supervision or management experience in a health care setting.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 2 - ADMINISTRATION AND MANAGEMENT › Section 550.304 - Administrator Responsibilities

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 An administrator of a center must be responsible for implementing and
					 supervising the administrative policies and operations of the center and for
					 administratively supervising the provision of all services to minors on a
					 day-to-day basis.
(b) A center's
					 administrator must:
(1) ensure that the
					 center complies with applicable federal, state, and local laws, rules, and
					 regulations;
(2) manage the daily
					 operations of the center;
(3)
					 organize and direct the center's ongoing functions;
(4) ensure the availability of qualified
					 staff and ancillary services to ensure the health, safety, and proper care of
					 each minor;
(5) ensure criminal
					 history checks, employee misconduct, and nurse aide registry checks are
					 conducted for required staff before employment;
(6) ensure the implementation of the center's
					 training program policies and procedures;
(7) familiarize staff with regulatory issues,
					 as well as the center's policies and procedures;
(8) ensure that the documentation of services
					 provided is accurate and timely;
(9) manage census records, including daily,
					 actual, and total, in accordance with § 550.803 of this chapter (relating
					 to Census);
(10) ensure that the
					 center immediately notifies a minor's parent of any and all accidents or
					 unusual incidents involving their minor or that had the potential to cause
					 injury or harm to a minor;
(11)
					 ensure that the center provides written notice to the parent of accidents or
					 unusual incidents involving their minor on the day of occurrence;
(12) maintain a record of accidents or
					 unusual incidents involving a minor or staff member that caused, or had the
					 potential to cause, injury or harm to a person or property at the
					 center;
(13) maintain a copy of
					 current contractor agreements with third party providers contracted by the
					 center;
(14) maintain a copy of
					 current written agreements with each contractor;
(15) ensure adequate staff education and
					 evaluations according to requirements in § 550.415 of this subchapter
					 (relating to Staffing Policies for Orientation, Development, and
					 Training);
(16) maintain documented
					 development programs for all staff;
(17) ensure the accuracy of public
					 information materials and activities made available and presented on behalf of
					 the center;
(18) ensure
					 implementation of an effective budgeting and accounting system consistent with
					 good business practice that promotes the health and safety of the center's
					 minors; and
(19) supervise the
					 annual distribution and evaluation of the responses to the parent-satisfaction
					 surveys on all minors served.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 2 - ADMINISTRATION AND MANAGEMENT › Section 550.305 - Initial Training in Administration

Current through Reg. 49, No. 28; July 12, 2024
(a) This section applies to an administrator
					 and alternate administrator designated as an administrator or alternate
					 administrator of a center.
(b)
					 Before designation, an administrator or alternate administrator must complete
					 the DADS pre-licensing program training titled Overview of Prescribed Pediatric
					 Extended Care Center Licensing Standards in Texas.
(c) An administrator and alternate
					 administrator of a center must complete a total of 12 clock hours of training
					 in the administration of a center before the end of the first 12 months after
					 designation to the position.
(d)
					 The initial 12 clock hours of training must address:
(1) information on state and federal laws
					 applicable to a center, including:
(A) the
					 Americans with Disabilities Act
(B)
					 the Civil Rights Act of 1991;
(C)
					 the Rehabilitation Act of 1973;
(D)
					 the Family and Medical Leave Act of 1993;
(E)
													Public Law
					 111-148 Patient Protection and Affordable Care
					 Act; and
(F) Occupational Safety
					 and Health Administration requirements.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 2 - ADMINISTRATION AND MANAGEMENT › Section 550.306 - Continuing Training in Administration

Current through Reg. 49, No. 28; July 12, 2024
(a) An administrator and alternate
					 administrator must complete 12 clock hours of continuing training within each
					 subsequent 12-month period beginning with the date of designation. The 12 clock
					 hours of continuing training must include at least two of the following topics
					 and may include other topics relating to the duties of an administrator:
(1) any one of the training topics listed in
					 § 550.305(d) of this division (relating to Initial Training in
					 Administration);
(2) development
					 and interpretation of the center policies;
(3) basic principles of management in a
					 licensed health care setting;
(4)
					 ethics;
(5) quality
					 improvement;
(6) risk assessment
					 and management;
(7) financial
					 management;
(8) skills for working
					 with minors, a minor's parent, and other professional service
					 providers;
(9) community
					 resources;
(10) communicable
					 disease reporting; or
(11)
					 marketing.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 2 - ADMINISTRATION AND MANAGEMENT › Section 550.307 - Medical Director Qualifications and Conditions

Current through Reg. 49, No. 28; July 12, 2024
(a) A center must designate a medical
					 director who:
(1) has a valid, unrestricted
					 license to practice medicine or osteopathy in Texas in accordance with Texas
					 Occupations Code Chapter 155; and
(2) is board-certified in a pediatric
					 specialty recognized by the American Board of Medical Specialties or the
					 American Osteopathic Association.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 2 - ADMINISTRATION AND MANAGEMENT › Section 550.308 - Medical Director Responsibilities

Current through Reg. 49, No. 28; July 12, 2024
The medical director must:
(1) review the services provided at the
					 center to ensure a high quality of services;
(2) maintain a liaison role with the medical
					 community in the location of the center's place of business;
(3) participate in the development and
					 implementation of appropriate performance improvement and safety initiatives as
					 directed by the Quality Assessment and Performance Improvement (QAPI)
					 program;
(4) participate in the
					 development of new programs and modifications of existing programs at the
					 center;
(5) designate a physician
					 as defined in § 550.5 of this chapter (relating to Definitions) to provide
					 medical consultation in the event the medical director is unavailable to the
					 center's staff;
(6) serve on
					 committees as defined and required by this chapter and the center's
					 polices;
(7) consult with the
					 center's administrator and nursing director on the health status of the
					 center's staff as it relates to the center's IPCP and on a minor's health and
					 safety or as threats to infection control arise;
(8) review reports of accidents and unusual
					 incidents occurring at the center and identify to the center's administrator
					 hazards to health and safety as directed by the QAPI program;
(9) participate in the development and
					 implementation of policies and procedures for the delivery of emergency
					 services for minors;
(10)
					 participate in the development and implementation of policies and procedures
					 for the use of restraints; and
(11)
					 participate in the development and implementation of policies and procedures
					 for the delivery of physician's services when a minor's prescribing physician
					 or designated alternate is not available.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 2 - ADMINISTRATION AND MANAGEMENT › Section 550.309 - Nursing Director and Alternate Nursing Director Qualifications and Conditions

Current through Reg. 49, No. 28; July 12, 2024
(a) A center
					 must designate a nursing director and alternate nursing director who meet the
					 qualifications and conditions set out in this section and who have completed
					 the Texas Health and Human Services Commission (HHSC) pre-licensing program
					 training titled "Overview of Prescribed Pediatric Extended Care Center
					 Licensing Standards in Texas."
(b)
					 The nursing director and alternate nursing director must have the following
					 qualifications:
(1) a valid RN license under
					 Texas Occupations Code, Chapter 301, with no disciplinary action;
(2) a valid certification in Cardio Pulmonary
					 Resuscitation or Basic Cardiac Life Support; and
(3) a minimum of two years of supervision and
					 management in employment in a pediatric setting caring for a medically or
					 technologically dependent minor or at least two years of supervision in one of
					 the following specialty settings:
(A)
					 pediatric intensive care;
(B)
					 neonatal intensive care;
(C)
					 pediatric emergency care;
(D)
					 center;
(E) home health or hospice
					 agency specializing in pediatric care;
(F) ambulatory surgical center specializing
					 in pediatric care; or
(G) have
					 comparable pediatric unit experience in a hospital for two consecutive years
					 before the person applies for the position of nursing director.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 2 - ADMINISTRATION AND MANAGEMENT › Section 550.310 - Nursing Director Responsibilities and Supervision Responsibilities

Current through Reg. 49, No. 28; July 12, 2024
The center's nursing director's responsibilities must
						include, but are not limited to:
(1)
					 supervising all aspects of a minor's plan of care to ensure the minor's plan of
					 care is implemented as ordered;
(2)
					 supervising all activities of the center's professional nursing staff and
					 direct care staff to ensure compliance with current standards of accepted
					 nursing practice;
(3) ensuring
					 compliance with all federal and state laws, rules, and regulations in this
					 chapter;
(4) supervising the daily
					 clinical operations of the center;
(5) ensuring the documentation of the
					 center's actual, daily, and total census in accordance with § 550.803 of
					 this subchapter (relating to Census) and § 550.410 of this subchapter
					 (relating to Nursing Services Staffing Ratio);
(6) ensuring the documentation of the
					 center's staffing ratios in accordance with § 550.410 of this
					 subchapter;
(7) supervising the
					 implementation of staffing policies to ensure that only qualified staff are
					 hired by the center, including verification of licensure and certification
					 before employment and annually thereafter;
(8) ensuring the maintenance of records to
					 support competency of the center's nursing and direct care staff;
(9) ensuring the implementation of the
					 center's policies and procedures that establish and support quality care to a
					 minor;
(10) providing orientation
					 and in-service training to employees and providers of basic services to promote
					 effective basic services and safety to a minor;
(11) performing timely annual performance
					 evaluations for the center's nursing and direct care staff;
(12) ensuring participation in regularly
					 scheduled continuing training for the center's nursing and direct care staff;
					 and
(13) ensuring that the care at
					 the center promotes effective services and the safety of a minor.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 2 - ADMINISTRATION AND MANAGEMENT › Section 550.311 - Prohibition of Solicitation

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 center must adopt and enforce a written policy to ensure compliance of the
					 center and its employees, volunteers and contractors with Texas Occupations
					 Code, Chapter 102.
(b) DADS may
					 take enforcement action against a center in accordance with Subchapter G of
					 this chapter (relating to Enforcement) if the center violates Texas Occupations
					 Code, § 102.001 or § 102.006.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.401 - Nursing Staff

Current through Reg. 49, No. 28; July 12, 2024
If nursing services are provided at a center, the center
						must ensure there are sufficient RNs and LVNs to ensure that the services
						provided to each minor are in accordance with the minor's plan of
						care.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.402 - Registered Nurse Qualifications

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 RN providing services on behalf of a center must have at least the following
					 qualifications and experience:
(1) a valid RN
					 license under Texas Occupations Code, Chapter 301, with no disciplinary
					 action;
(2) valid certifications in
					 Cardio Pulmonary Resuscitation and Basic First Aid; and
(3) one of the following:
(A) one year of pediatric specialty
					 experience with emphasis on medically and technologically dependent minors,
					 obtained within the previous five years; or
(B) sufficient skills to meet the competency
					 and training requirements described in subsection (b) of this
					 section.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.403 - Registered Nurse Responsibilities

Current through Reg. 49, No. 28; July 12, 2024
An RN providing services on behalf of a center must be
						responsible for the following:
(1)
					 maintaining compliance with the standards of nursing practice and
					 delegation;
(2) developing a
					 minor's plan of care;
(3) providing
					 nursing interventions that includes parental training, information, and
					 education to increase a parent's confidence and competence in caring for a
					 minor;
(4) coordinating services
					 with other service providers;
(5)
					 monitoring the ongoing physical and developmental growth of a minor;
(6) having knowledge of access to available
					 community resources;
(7)
					 participating on the IDT and in the IDT meetings regarding a minor's plan of
					 care and progress;
(8)
					 administering medication, intravenous infusions, parenteral feeding, and other
					 specialized treatments; monitoring and documenting the effect of medications,
					 therapies, and progress in accordance with accepted standards of professional
					 practice;
(9) communicating
					 findings to a minor's prescribing physician and the center's nursing director;
					 and
(10) supervising the center's
					 direct care staff.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.404 - Licensed Vocational Nurse Qualifications

Current through Reg. 49, No. 28; July 12, 2024
(a) An LVN providing services on behalf of a
					 center must have at least the following qualifications and experience:
(1) a valid LVN licensed under Texas
					 Occupations Code, Chapter 301, with no disciplinary action;
(2) valid certifications in Cardio Pulmonary
					 Resuscitation and Basic First Aid; and
(3) one of the following:
(A) one year of pediatric specialty
					 experience with emphasis on medically and technologically dependent minors
					 obtained within the last consecutive five years; or
(B) sufficient skills to meet the competency
					 and training requirements described in subsection (b) of this
					 section;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.405 - Licensed Vocational Nurse Responsibilities

Current through Reg. 49, No. 28; July 12, 2024
(a) An LVN providing services on behalf of a
					 center must work under the supervision of an RN and is responsible to provide,
					 within the LVN's level of competence and scope of practice, nursing care to the
					 center's minors as ordered in the plan of care.
(b) An LVN must be responsible for the
					 following:
(1) maintaining compliance with
					 the standards of nursing practice;
(2) providing nursing interventions that
					 includes parental training, information, and education to increase a parent's
					 confidence and competence in caring for a minor;
(3) having knowledge of the availability of
					 community resources;
(4)
					 participating on the IDT and in the IDT meetings regarding a minor's plan of
					 care and progress;
(5)
					 communicating findings to a minor's prescribing physician and an RN;
					 and
(6) administering medication,
					 intravenous infusions, parenteral feeding, and other specialized treatments;
					 monitoring and documenting the effect of medications, therapies, and progress
					 in accordance with accepted standards of professional practice.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.406 - Student Nurses

Current through Reg. 49, No. 28; July 12, 2024
(a) If a center has
					 an agreement with an accredited school of nursing to use the center for a
					 portion of a student nurse's clinical experience, the student nurse may provide
					 care under the following conditions:
(1) the
					 agreement ensures that criminal history checks are conducted for a student
					 nurse in accordance with § 550.418 of this division (relating to Criminal
					 History Checks, Nurse Aide Registry (NAR), and Employee Misconduct Registry
					 (EMR) Requirements) before a student nurse provides direct care;
(2) a student nurse is not counted in the
					 staffing ratio required in this chapter; and
(3) one of the following:
(A) an instructor from the school is onsite,
					 provides class supervision, and assumes responsibility for all student nursing
					 activities at the center; or
(B)
					 the center:
(i) assumes responsibility for
					 supervision of all student nurses and for all student nursing activities at the
					 center; and
(ii) meets the
					 requirements described in subsection (b) of this section.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.407 - Nursing Education, Licensure, and Practice

Current through Reg. 49, No. 28; July 12, 2024
A center must adopt and enforce a written policy to
						ensure compliance with the rules of the Texas Board of Nursing adopted at 22
						TAC Chapters 211, 213 - 217, and 219 - 226.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.408 - Delegation of Nursing Tasks by Registered Professional Nurses to Unlicensed Personnel and Tasks Not Requiring Delegation

Current through Reg. 49, No. 28; July 12, 2024
A center must adopt and enforce a written policy to
						ensure compliance with rules adopted by the Texas Board of Nursing as specified
						in 22 TAC Chapter 224 (relating to Delegation of Nursing Tasks by Registered
						Professional Nurses to Unlicensed Personnel for Clients with Acute Conditions
						or in Acute Care Environments).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.409 - Direct Care Staff Qualifications

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Direct care staff providing services on behalf of a center, must have the
					 following qualifications:
(1) be 18 years of
					 age or older;
(2) a high school
					 diploma or a general equivalency degree;
(3) one of the following:
(A) one year of experience employed in a
					 health care setting providing direct care to minors who are medically or
					 technologically dependent;
(B) two
					 years of experience employed in a health care, childcare, or school setting
					 providing direct care to minors who are medically or technologically
					 dependent;
(C) two years of
					 experience employed in a health care setting providing direct care to adults;
					 or
(D) sufficient skills to meet
					 the competency and training requirements described in subsection (b) of this
					 section; and
(4) maintain
					 current certification in Pediatric Cardio Pulmonary Resuscitation and basic
					 First Aid.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.410 - Nursing Services Staffing Ratio

Current through Reg. 49, No. 28; July 12, 2024
(a) A center's total staffing for nursing
					 services must be maintained, at a minimum, in the following ratios but at no
					 time must there be less than one staff member on duty per three minors
					 receiving nursing services from a center. If only one staff member is on duty,
					 that member must be an RN.
(b) The
					 staffing ratio is based on the number of minors on the center's actual census
					 that are receiving nursing services from the center.
(c) A center must not include direct care
					 staff who qualify under subsection (b) of § 550.409 of this division
					 (relating to Direct Care Staff Qualifications) in the staffing ratio until the
					 staff complete the training program and demonstrate competency as described in
					 subsection (b)(3) of § 550.409 of this division.
(d) A center must maintain documentation to
					 support compliance with this section and § 550.803 of this chapter
					 (relating to Census). Documentation must include:
(1) each change in the number of minors on
					 the center's actual census that are receiving nursing services from the center;
					 and
(2) the increase or decrease in
					 the number of RNs, LVNs, and direct care staff in accordance with this section
					 as changes in the number of minors on the center's actual census that are
					 receiving nursing services from the center occurs.
Attached
						Graphic
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.411 - Rehabilitative and Ancillary Professional Staff and Qualifications

Current through Reg. 49, No. 28; July 12, 2024
(a) If the
					 following staff will be providing services on behalf of a center or supervising
					 services at a center, the staff must have one year of experience of pediatric
					 care in a health care setting. The staff may be:
(1) an audiologist with a valid license under
					 Texas Occupations Code, Chapter 401;
(2) an occupational therapist with a valid
					 license under Texas Occupations Code, Chapter 454;
(3) an occupational therapist assistant with
					 a valid license under Texas Occupations Code, Chapter 454;
(4) a physical therapist with a valid license
					 under Texas Occupations Code, Chapter 453;
(5) a physical therapist assistant with a
					 valid license under Texas Occupations Code, Chapter 453;
(6) a respiratory therapist with a valid
					 license under Texas Occupations Code, Chapter 604;
(7) a speech-language pathologist with a
					 valid license under Texas Occupations Code, Chapter 401;
(8) a licensed assistant in speech-language
					 pathology with a valid license under Texas Occupations Code, Chapter 401;
					 or
(9) a social worker with a valid
					 license under Texas Occupation Code, Chapter 505.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.412 - Peer Review

Current through Reg. 49, No. 28; July 12, 2024
A center must adopt and enforce written policies and
						procedures to ensure that all professional disciplines providing services on
						behalf of the center comply with their respective professional practice acts or
						title acts relating to reporting and peer review.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.413 - Contractors

Current through Reg. 49, No. 28; July 12, 2024
(a) If a center
					 uses contractors, the center must enter into a contract with each contractor.
					 The contract must be enforced by the center and clearly designate:
(1) that minors are accepted for care only by
					 the center;
(2) the services to be
					 provided by the contractor and how they will be provided, including per visit
					 or per hour;
(3) the necessity of
					 the contractor to conform to all applicable center policies, including staff
					 qualifications;
(4) the
					 contractor's responsibility for participating in developing the plan of
					 care;
(5) the manner in which
					 services will be coordinated and evaluated by the center in accordance with
					 § 550.802 of this subchapter (relating to Coordination of Services);
					 and
(6) the procedures for:
(A) submitting information and documentation
					 by the contractor in accordance with the center's record policies;
(B) scheduling of visits by the contractor or
					 the center; and
(C) periodic
					 evaluation of the minor by the contractor.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.414 - Volunteers

Current through Reg. 49, No. 28; July 12, 2024
(a) If a center
					 uses volunteers, the center must use volunteers in defined roles under the
					 supervision of a designated center staff.
(b) A volunteer must meet the same
					 qualifications, requirements and standards in this chapter that apply to center
					 staff performing the same activities on behalf of the center.
(c) A center must not include the volunteer
					 in the center's staffing ratios.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.416 - Staff Development Program

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 center's staff development programs must:
(1)
					 facilitate the ability of the staff to function as a member of an IDT that
					 includes health professionals, an adult minor, and a minor's parent;
(2) improve communication skills to:
(A) facilitate a collaborative relationship
					 between an adult minor, a minor's parent, and the staff;
(B) focus on person-centered
					 thinking;
(C) facilitate positive
					 behavior support; and
(D)
					 incorporate person-first language;
(3) increase the understanding of childhood
					 illness and the effects it has on a minor's development, a minor's parent, and
					 a minor's family;
(4) provide
					 mechanisms and skills for coping with the effects of childhood
					 illness;
(5) develop case
					 management skills to assist an adult minor and a minor's parent in setting
					 priorities, planning, and implementing a minor's care at home;
(6) facilitate staff implementation of
					 life-sustaining and assistive technology, provided by the center or by durable
					 medical equipment contractors, used in the care of a minor;
(7) facilitate the ability of staff to
					 develop an individualized comprehensive plan of care; and
(8) prepare staff for the response to and
					 management of emergency medical situations in a center.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 550 - LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS › Subchapter C - GENERAL PROVISIONS › Division 3 - NURSING AND STAFFING REQUIREMENTS › Section 550.417 - Personnel Records

Current through Reg. 49, No. 28; July 12, 2024
(a) A center must
					 maintain a personnel record for an employee and volunteer. A personnel record
					 may be maintained electronically if it meets the same requirements as a paper
					 record. All information must be kept current. A personnel record must include
					 the following:
(1) a signed job description
					 and qualifications for each position accepted or a signed statement that the
					 person read the job description and qualifications for each position
					 accepted;
(2) an application for
					 employment or volunteer agreement;
(3) a record of the immunizations
					 requirements and evaluation of the tuberculosis results;
(4) verification of references, job
					 experience, and educational requirements as conducted by the center to verify
					 qualifications for each position accepted;
(5) verification of licenses, permits, and
					 certifications before employment and annually;
(6) annual performance evaluations and
					 disciplinary actions;
(7) the
					 signed statement about compliance with center policies required by §
					 550.415 of this division (relating to Staffing Policies for Staff Orientation,
					 Development, and Training); and
(8)
					 for an employee and volunteer:
(A) a printed
					 copy of the results of the initial and annual searches of the nurse aide
					 registry and employee misconduct registry obtained from the DADS Internet
					 website; and
(B) documentation that
					 the employee, volunteer, or contractor in accordance with § 550.418 of
					 this division (relating to Criminal History Checks, Nurse Aide Registry (NAR)
					 and Employee Misconduct Registry (EMR) Requirements) received written
					 information about the EMR.