reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter Q - INFECTION CONTROL › Section 554.1601 - Infection Control

Current through Reg. 49, No. 28; July 12, 2024
(a) General. The
				  facility must establish and maintain an infection prevention and control
				  program designed to provide a safe, sanitary, and comfortable environment and
				  to help prevent the development and transmission of communicable diseases and
				  infections.
(b) Infection
				  prevention and control program (IPCP). The facility must establish an IPCP and
				  conduct an annual review, effective November 28, 2019, of the IPCP and update
				  the program, as necessary. The Quality Assessment and Assurance Committee, as
				  described in § 554.1917 of this chapter (relating to Quality Assessment
				  and Assurance) monitors the IPCP. The IPCP must include:
(1) a system for preventing, identifying,
				  reporting, investigating, and controlling infections and communicable diseases
				  for all residents, staff, volunteers, visitors, and other individuals providing
				  services under a contractual arrangement based upon the facility assessment
				  conducted according to § 554.1931 of this chapter (relating to Facility
				  Assessment), and following accepted national standards;
(2) written standards, policies, and
				  procedures for the program, which must include:
(A) a system of surveillance designed to
				  identify possible communicable diseases or infections, including
				  multidrug-resistant organisms, before they can spread to other persons in the
				  facility;
(B) when and to whom
				  possible incidents of communicable diseases or infections should be
				  reported;
(C) standard and
				  transmission-based precautions to be followed to prevent spread of
				  infections;
(D) when and how
				  isolation should be used for a resident; including:
(i) the type and duration of the isolation,
				  depending upon the infectious agent or organism involved; and
(ii) a requirement that the isolation should
				  be the least restrictive possible for the resident under the
				  circumstances;
(E) the
				  circumstances under which the facility must prohibit employees with a
				  communicable disease or infected skin lesions from direct contact with a
				  resident or a resident's food, if direct contact will transmit the disease;
				  and
(F) the hand hygiene procedures
				  to be followed by staff involved in direct resident contact;
(3) an antibiotic stewardship
				  program that includes antibiotic use protocols and a system to monitor
				  antibiotic use;
(4) procedures for
				  making rapid influenza diagnostic tests available to facility
				  residents;
(5) a system for
				  recording incidents identified under the facility's IPCP and the corrective
				  actions taken by the facility; and
(6) acceptable accommodations for a resident
				  with a communicable disease according to current practices and policies for
				  infection control.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter Q - INFECTION CONTROL › Section 554.1602 - Universal Precautions

Current through Reg. 49, No. 28; July 12, 2024
Universal precautions must be used in the care of all
					 residents. Facilities are responsible for complying with Occupational Safety
					 Hazards Administration (OSHA) regulations found at 29 Code of Federal
					 Regulations §1910.1030 (relating to Bloodborne
					 Pathogens).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter R - PHYSICAL PLANT AND ENVIRONMENT › Section 554.1701 - Physical Environment

Current through Reg. 49, No. 28; July 12, 2024
The facility must be designed, constructed, equipped, and
					 maintained to protect the health and ensure the safety of residents, personnel,
					 and the public.
(1) Life safety from
				  fire.
(A) The facility must meet the
				  applicable provisions of NFPA 101 as designated by the federal law and
				  regulations.
(B) After
				  consideration of the findings of HHSC, CMS may waive specific provisions of
				  NFPA 101 which, if rigidly applied, would result in unreasonable hardship on
				  the facility, but only if the waiver does not adversely affect the health and
				  safety of residents or personnel.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1901 - Administration

Current through Reg. 49, No. 28; July 12, 2024
A nursing facility must be administered in a manner that
					 enables it to use its resources effectively and efficiently to attain or
					 maintain the highest practicable physical, mental, and psychosocial well-being
					 of each resident.
(1) Licensure. A
				  nursing facility (NF) must be licensed by HHSC as described in § 554.201
				  of this chapter (relating to Criteria for Licensing).
(2) Compliance with federal, state, and local
				  laws and professional standards. The facility must operate and provide services
				  in compliance with all applicable federal, state, and local laws, regulations,
				  and codes, and with accepted professional standards and principles that apply
				  to professionals providing services in such a facility.
(3) Medicaid-certified facilities'
				  relationship to other Health and Human Services regulations.
(A) In addition to compliance with the
				  regulations set forth in this chapter, as Medicaid providers, facilities are
				  obliged to meet the applicable provisions of other federal regulations,
				  including those pertaining to:
(i)
				  nondiscrimination on the basis of race, color, or national origin (45 CFR, Part
				  80);
(ii) nondiscrimination on the
				  basis of disability (45 CFR, Part 84);
(iii) nondiscrimination on the basis of age
				  (45 CFR, Part 91);
(iv)
				  nondiscrimination on the basis of race, color, national origin, sex, age, or
				  disability (45 CFR, Part 92);
(v)
				  protection of human subjects of research (45 CFR, Part 46);
(vi) protection from fraud and abuse (42 CFR
				  , Part 455); and
(vii) protection
				  of individually identifiable health information (45 CFR, Parts 160 and
				  164).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1902 - Governing Body

Current through Reg. 49, No. 28; July 12, 2024
(a) The facility
				  must have a governing body, or designated persons functioning as a governing
				  body that is legally responsible for establishing and implementing policies
				  regarding the management and operation of the facility. The governing body must
				  have periodically updated written policies and procedures that are formally
				  adopted and dated, specifying and governing all services. The policies and
				  procedures must be available to all of the facility's governing body's members,
				  staff, residents, family or resident representatives, and the public. The
				  governing body must:
(1) designate a person
				  to exercise the administrator's authority when the facility does not have an
				  administrator. The facility must secure a licensed nursing home administrator
				  within 30 days; and
(2) ensure that
				  a person designated as being in authority notifies HHSC immediately when the
				  facility does not have an administrator.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1905 - Staff Qualifications

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  The facility must employ on a full-time, part-time, or consultant basis those
				  professionals necessary to carry out the provisions of these requirements of
				  participation.
(b) Professional
				  staff must be licensed, certified or registered in accordance with applicable
				  state laws.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1906 - Use of Outside Resources

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  If the facility does not employ a qualified professional to furnish a specific
				  service to be provided by the facility, the facility must have that service
				  furnished to residents by a person or agency outside the facility under an
				  agreement described in subsection (b) of this section.
(b) Agreements pertaining to services
				  furnished by outside resources must specify in writing that the facility
				  assumes responsibility for:
(1) obtaining
				  services that meet professional standards and principles; and
(2) the timeliness of the services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1907 - Medical Director

Current through Reg. 49, No. 28; July 12, 2024
(a) The nursing
				  facility must designate a physician to serve as medical director.
(b) The medical director is responsible for:
(1) implementation of resident care policies
				  (see § 554.1922 of Title 40 (relating to Resident Care Policies));
				  and
(2) the coordination of medical
				  care in the facility.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1908 - Laboratory Services

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  facility must provide or obtain clinical laboratory services to meet the needs
				  of its residents. The facility is responsible for the quality and timeliness of
				  the services.
(1) If the facility provides
				  its own laboratory services, the services must meet the applicable requirements
				  for laboratories specified in 42 CFR, Part 493.
(2) If the facility provides blood bank and
				  transfusion services, it must meet the applicable requirements for laboratories
				  specified in 42 CFR, Part 493.
(3)
				  If the laboratory chooses to refer specimens for testing to another laboratory,
				  the referral laboratory must be certified in the appropriate specialties or
				  subspecialties of services in accordance with 42 CFR, Part 493.
(4) If the facility does not provide
				  laboratory services on site, it must have an agreement to obtain these services
				  only from a laboratory that meets the applicable requirements of 42 CFR, Part
				  493, or from a physician's office.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1909 - Radiology and Other Diagnostic Services

Current through Reg. 49, No. 28; July 12, 2024
(a) The nursing facility must provide or
				  obtain radiology and other diagnostic services to meet the needs of its
				  residents. The facility is responsible for the quality and timeliness of the
				  services.
(1) If the facility provides its own
				  diagnostic services, the services must meet the applicable conditions of
				  participation for hospitals contained in
				  42 CFR, §
												482.26.
(2) If the facility does not provide its own
				  diagnostic services, it must have an agreement to obtain these services from a
				  provider or supplier that is approved to provide these services under
				  Medicare.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1910 - Clinical Records

Current through Reg. 49, No. 28; July 12, 2024
(a) The facility
				  must maintain clinical records on each resident, in accordance with accepted
				  professional health information management standards and practices, that are:
(1) complete;
(2) accurately documented;
(3) readily accessible;
(4) systematically organized; and
(5) protected from unauthorized
				  release.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1912 - Additional Clinical Record Service Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) Index of admissions and discharges. The
				  facility must maintain a permanent, master index of all residents admitted to
				  and discharged from the facility. This index must contain at least the
				  following information concerning each resident:
(1) name of resident (first, middle, and
				  last);
(2) date of birth;
(3) date of admission;
(4) date of discharge; and
(5) social security, Medicare, or Medicaid
				  number.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1914 - Emergency Preparedness and Response

Current through Reg. 49, No. 28; July 12, 2024
(a) Definitions. In this section:
(1) "emergency situation" means an impending
				  or actual situation that:
(A) interferes with
				  normal activities of a facility and its residents;
(B) may:
(i)
				  cause injury or death to a resident or staff member of the facility;
				  or
(ii) cause damage to facility
				  property;
(C) requires
				  the facility to respond immediately to mitigate or avoid the injury, death,
				  damage or interference; and
(D)
				  does not include a situation that arises from the medical condition of a
				  resident, such as cardiac arrest, obstructed airway, or cerebrovascular
				  accident;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1915 - Transfer Agreement

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  facility must have in effect a written transfer agreement with one or more
				  hospitals that reasonably assures that:
(1)
				  Residents will be transferred from the facility to the hospital and ensured of
				  timely admission to the hospital when transfer is medically appropriate as
				  determined by the attending physician or, in an emergency situation, another
				  practitioner in accordance with written facility policy.
(2) Providers will exchange medical and other
				  information, including information required under § 554.502(b)(4) of this
				  chapter (relating to Transfer and Discharge in Medicaid-certified Facilities),
				  needed for care and treatment of residents, and when the transferring facility
				  deems it appropriate, for determining whether such residents can receive
				  appropriate services, receive services in a less restrictive setting than
				  either the facility or the hospital, or reintegrate into the community
				  .
(3) For Medicaid-certified
				  facilities, the hospitals must be approved for participation under the Medicare
				  and Medicaid programs.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1916 - Respite Care

Current through Reg. 49, No. 28; July 12, 2024
Facilities offering respite care must meet the requirements
					 of this chapter, except as provided in paragraph (4) of this section.
(1) Definitions. The following words and
				  terms, when used in this subchapter, shall have the following meanings, unless
				  the context clearly indicates otherwise.
(A)
				  Plan of care--A written description of the medical care or the supervision and
				  nonmedical care needed by an individual during respite care.
(B) Respite care--The provision by a facility
				  to an individual, for not more than two weeks for each stay in the facility, of
				  room, board, and care at the level ordinarily provided for permanent
				  residents.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1917 - Quality Assessment and Assurance

Current through Reg. 49, No. 28; July 12, 2024
(a) The facility must maintain a Quality
				  Assessment and Assurance Committee consisting of:
(1) the director of nursing
				  services;
(2) the medical director
				  or designee;
(3) at least three
				  other members of the facility's staff, at least one of whom must be the
				  administrator, a board member or other individual in a leadership role;
				  and
(4) effective November 28,
				  2019, the infection preventionist.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1918 - Disclosure of Ownership

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  facility must comply with the disclosure requirements of 42 Code of Federal
				  Regulations, §420.206 and §455.104.
(b) The facility must provide written notice
				  to Facility Enrollment, Long-Term Care-Regulatory, Texas Department of Human
				  Services (DHS) at the time of change if a change occurs in:
(1) persons with an ownership or control
				  interest, as defined in 42 Code of Federal Regulations, §420.201 and
				  §455.101;
(2) the officers,
				  directors, agents or managing employees;
(3) the corporation, association, or other
				  company responsible for the management of the facility;
(4) the facility's administrator or director
				  of nursing; or
(5) the controlling
				  person.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1919 - Right to Possession

Current through Reg. 49, No. 28; July 12, 2024
(a) As a
				  condition of continued licensure, a license holder must maintain the right to
				  possession of the facility as described in § 554.204(b)(1) of Title 40
				  (relating to Application Requirements).
(b) The license holder must notify DADS in
				  writing within 72 hours after the license holder becomes aware of or should
				  have become aware of the loss and imminent loss of the right to possession of
				  the facility, such as notice of eviction, foreclosure, termination of lease, or
				  similar proposed action. The notification must:
(1) include a description of the specific
				  situation that resulted in loss of possession of the facility;
(2) be faxed to (512) 438-2730 or (512)
				  438-2728; and
(3) be kept on file
				  with a copy of the fax confirmation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1920 - Operating Policies and Procedures

Current through Reg. 49, No. 28; July 12, 2024
(a) The facility must have an administrative
				  policy and procedure manual that outlines the general operating policies and
				  procedures of the facility. The manual must include policies and procedures
				  related to admission and admission agreements, resident care services, refunds,
				  transfers and discharges, termination from Medicaid or Medicare participation
				  in accordance with § 554.2121 of this chapter (relating to General
				  Provisions), receiving and responding to complaints and recommendations, and
				  protection of a resident's personal property and civil rights. A copy of this
				  manual must be made available for review upon request to each physician, staff
				  member, resident, and resident's next of kin or guardian and to the
				  public.
(b) The facility must have
				  written personnel policies and procedures that are explained to employees
				  during initial orientation and are readily available to them after that
				  time.
(c) The facility must ensure
				  that personnel records are correct and contain sufficient information to
				  support placement in the assigned position (including a resume of training and
				  experience). When appropriate, a current copy of the person's license or permit
				  must be in the file.
(d) Upon
				  request of HHSC, the facility must make available financial records to
				  demonstrate the facility's compliance with applicable state laws and standards
				  relating to licensing.
(e) A
				  facility must develop, 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 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1921 - General Requirements for a Nursing Facility

Current through Reg. 49, No. 28; July 12, 2024
(a) The facility
				  must admit and retain only residents whose needs can be met through service
				  from the facility staff, or in cooperation with community resources or other
				  providers under contract.
(b)
				  Individuals who have met the requirements of Chapter 17 of this title (relating
				  to Preadmission Screening and Resident Review (PASRR) and have mental or
				  physical diseases, or both, that endanger other residents may be admitted or
				  retained if adequate rooms and care are provided to protect the other
				  residents.
(c) The term "hospital"
				  may not be used as part of the name of a nursing facility unless it has been
				  classified and duly licensed as a hospital by the appropriate state
				  agency.
(d) A facility that ceases
				  operation, temporarily or permanently, voluntarily or involuntarily, must
				  provide notice to the residents and residents' relatives or responsible parties
				  of closure. See § 554.2310 of this chapter (relating to Nursing Facility
				  Ceases to Participate) for additional notice requirements that apply to a
				  Medicaid or Medicare certified facility.
(1)
				  If the closure is voluntary, within one week after the date on which the
				  decision to close is made, the facility must send written notice to residents'
				  relatives or responsible parties stating that the closure will occur no earlier
				  than 60 days after receipt of the notice.
(2) If the closure is involuntary, the
				  facility must make the notification, whether orally or in writing, immediately
				  on receiving notice of the closure.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1922 - Resident Care Policies

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  facility must have written policies to govern the nursing care and related
				  medical or other services provided. The written policies must include plans for
				  promoting self-care and independence. If children are admitted to the facility,
				  written policies must address the care of children, consistent with currently
				  acceptable pediatric practice and should address the ongoing assessment of the
				  potential for community reintegration.
(b) Resident care policies are developed by
				  the medical director and by professional personnel, including one or more
				  physicians, licensed or registered nurses, a registered pharmacist, and the
				  licensed nursing home administrator. The advisory group must review the
				  policies at least annually and update them as necessary.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1923 - Incident or Accident Reporting

Current through Reg. 49, No. 28; July 12, 2024
(a) The facility must detail in the medical
				  record every accident or incident, including allegations of mistreatment of
				  residents by facility staff, medication errors, and drug reactions.
(b) Accidents, whether or not resulting in
				  injury, and any unusual incidents or abnormal events including allegations of
				  mistreatment of residents by staff or personnel or visitors, must be described
				  in a separate administrative record and reported by the facility in accordance
				  with the licensure Act and this section.
(1)
				  If the incident appears to be of a serious nature, it must be investigated by
				  or under the direction of the director of nurses, the facility administrator,
				  or a committee charged with this responsibility.
(2) If the incident involves a resident and
				  is serious or requires special reporting to HHSC , the resident's responsible
				  party and attending physician must be immediately notified.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1924 - Financial Records

Current through Reg. 49, No. 28; July 12, 2024
Nursing facility staff must maintain current financial
					 records in accordance with recognized fiscal and accounting procedures. The
					 facility must ensure that records clearly identify each charge and payment made
					 on behalf of each resident residing in the facility. The facility must clearly
					 state in its records to whom charges were made and for whom payment was
					 received. Medicaid-certified facilities must also comply with the following
					 requirements.
(1) The facility must
				  make financial records and supporting documents available at any time within
				  working hours and without prior notification for review by the Texas Department
				  of Human Services, the Department of Health and Human Services, and the Texas
				  attorney general's Medicaid Fraud Control Unit.
(2) The facility must keep the financial
				  records in the facility for a minimum of three years and 90 days after the
				  termination of the contract period or for three years after the end of the
				  federal fiscal year in which services were provided if there was a provider
				  agreement/contract with no specific termination date in effect. The facility
				  must also keep for the same period of time supporting fiscal documents and
				  other records necessary to ensure claims for federal matching funds.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1925 - Financial Condition

Current through Reg. 49, No. 28; July 12, 2024
(a) Effective
				  December 1, 2008, minimum standards of financial condition require the
				  applicant or license holder to have sufficient financial resources to:
(1) satisfy obligations at the time they come
				  due; and
(2) ensure at all times
				  the delivery of essential care and services, such as nursing or dietary
				  services, or utilities.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1926 - Medicaid Hospice Services

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  When a nursing facility (NF) contracts for hospice services for residents, the
				  nursing facility must:
(1) have a written
				  contract for the provision of arranged services, which must be signed by
				  authorized representatives of the NF and hospice and must include the
				  following:
(A) the services to be
				  provided;
(B) a stipulation that
				  hospice-related services performed by NF staff may be provided only with the
				  express authorization of the hospice;
(C) how the contracted services are to be
				  coordinated, supervised, and evaluated by the hospice and the NF;
(D) delineation of the roles of the hospice
				  and the NF in the admission process, recipient and family assessment, and the
				  interdisciplinary team case conferences;
(E) a requirement for documentation of
				  services furnished; and
(F) the
				  qualifications of the personnel providing the services;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1928 - Volunteer Program

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  facility must promote a volunteer program designed to assist in meeting the
				  social and emotional needs of the residents.
(b) A volunteer council may be utilized to
				  solicit community involvement in the volunteer program.
(c) The facility should promote volunteer
				  programs designed to provide social, emotional, educational, and sensory
				  opportunities for its pediatric residents.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1929 - Staff Development

Current through Reg. 49, No. 28; July 12, 2024
Each facility must develop, implement and maintain
					 effective training programs of orientation, training, and continuing in-service
					 education to develop the skills of its staff, including all new and existing
					 staff; individuals providing services under a contractual arrangement; and
					 volunteers, consistent with their expected roles. Effective November 28, 2019,
					 a facility must determine the amount and types of training necessary based on a
					 facility assessment as specified at § 554.1931 of this subchapter
					 (relating to Facility Assessment) and as described in § 554.1001 of this
					 chapter (relating to Nursing Services) .
(1) As part of orientation and annually, each
				  employee must receive instruction regarding:
(A) Human Immunodeficiency Virus (HIV), as
				  outlined in the educational information provided by the Texas Department of
				  State Health Services Model Workplace Guidelines. At a minimum the HIV
				  curriculum must include:
(i) modes of
				  transmission;
(ii) methods of
				  prevention;
(iii) behaviors related
				  to substance abuse;
(iv)
				  occupational precautions;
(v)
				  current laws and regulations concerning the rights of an acquired immune
				  deficiency syndrome/HIV-infected individual; and
(vi) behaviors associated with HIV
				  transmission which are in violation of Texas law;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1930 - Blood and Blood Products

Current through Reg. 49, No. 28; July 12, 2024
If the facility stores and transfers blood or blood
					 products, the facility must meet the conditions established for certification
					 of hospitals that are contained in 42 Code of Federal Regulations
					 §482.27(d)(1)-(6).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1931 - Facility Assessment

Current through Reg. 49, No. 28; July 12, 2024
The facility must conduct and document a facility-wide
					 assessment to determine what resources are necessary to care for its residents
					 competently during both day-to-day operations and emergencies. The facility
					 must review and update that assessment, as necessary, and at least annually.
					 The facility must also review and update this assessment whenever there is, or
					 the facility plans for, any change that would require a substantial
					 modification to any part of this assessment. The facility must address or
					 include:
(1) the facility's resident
				  population, including:
(A) both the number of
				  residents and the facility's resident capacity;
(B) the care required by the resident
				  population considering the types of diseases, conditions, physical and
				  cognitive disabilities, overall acuity, and other pertinent facts that are
				  present within that population;
(C)
				  the staff competencies that are necessary to provide the level and types of
				  care needed for the resident population;
(D) the physical environment, equipment,
				  services, and other physical plant considerations that are necessary to care
				  for this population; and
(E) any
				  ethnic, cultural, or religious factors that may potentially affect the care
				  provided by the facility, including activities and food and nutrition
				  services;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1934 - Educational Requirements for Persons under Age 22

Current through Reg. 49, No. 28; July 12, 2024
(a) A nursing facility that accepts
				  school-age residents, ages 3 through 21, must provide assurances to the Texas
				  Department of Human Services (DHS) that it has:
(1) established a written cooperative
				  agreement with the local independent school district that includes:
(A) general responsibilities of the facility
				  and the school district in delivering appropriate and mutually supportive
				  services to eligible school-age residents;
(B) a provision allowing the school district
				  staff to access, with appropriate consent of the eligible resident or guardian,
				  the facility's resident record and assessment information to avoid unnecessary
				  duplication of services;
(C) a
				  provision allowing the school district staff an opportunity to participate in
				  or provide information for the facility's admission, programmatic, and
				  discharge-planning meetings when the educational needs of an eligible resident
				  are being considered; and
(D) a
				  provision allowing the NF staff to participate in or provide information to the
				  school district's admission, review, and dismissal (ARD) committee during its
				  deliberations about each eligible school-age resident; and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1935 - Automated External Defibrillators

Current through Reg. 49, No. 28; July 12, 2024
(a) In this section:
(1) "automated external defibrillator" means
				  a heart monitor and defibrillator that:
(A)
				  has received approval from the United States Food and Drug Administration of
				  its premarket notification filed under United States Code, Title 21,
				  §360(k);
(B) is capable of
				  recognizing the presence or absence of ventricular fibrillation or rapid
				  ventricular tachycardia;
(C) is
				  capable of determining, without interpretation of cardiac rhythm by an
				  operator, whether defibrillation should be performed; and
(D) after determining that defibrillation
				  should be performed, automatically charges and requests delivery of an
				  electrical impulse to an individual's heart; and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter T - ADMINISTRATION › Section 554.1936 - Guardianship Orders for a Nursing Facility Resident

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility must request a copy of any
				  current court order appointing a guardian and letters of guardianship for a
				  resident or a resident's estate from the resident's nearest relative or the
				  person responsible for the resident's support.
(b) A facility must request the court order
				  and letters of guardianship:
(1) when a
				  facility admits an individual; and
(2) when the facility becomes aware a
				  guardian is appointed after the facility admits a resident.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter U - INSPECTIONS, SURVEYS, AND VISITS › Section 554.2002 - Procedural Requirements-Licensure Inspections and Surveys

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) An inspection may be conducted by an
				  individual qualified surveyor or by a team, of which at least one member is a
				  qualified surveyor.
(c) To
				  determine standard compliance which cannot be verified during regular working
				  hours, night or weekend inspections may be conducted to cover specific segments
				  of operation and will be completed with the least possible interference to
				  staff and residents.
(d) Generally,
				  all inspections, surveys, complaint investigations and other visits, whether
				  routine or non-routine, made for the purpose of determining the appropriateness
				  of resident care and day-to-day operations of a facility will be unannounced;
				  any exceptions must be justified. Releasing advance information of an
				  unannounced inspection is a third degree felony, as provided in §
										242.045
				  of the Health and Safety Code.
(e)
				  Certain visits may be announced, including, but not limited to, consultation
				  visits to determine how a physical plant may be expanded or upgraded and visits
				  to determine the progress of physical plant construction or repairs, equipment
				  installation or repairs, or systems installation or repairs or conditions when
				  certain emergencies arise, such as fire, windstorm, or malfunctioning or
				  nonfunctioning of electrical or mechanical systems.
(f) Persons authorized to receive advance
				  information on unannounced inspections include:
(1) citizen advocates invited to attend
				  inspections, as described in subsection (g) of this section;
(2) the State Ombudsman, a certified
				  ombudsman, and an ombudsman intern who are authorized to attend and participate
				  in inspections;
(3) representatives
				  of the United States Department of Health and Human Services whose programs
				  relate to the Medicare/Medicaid Long Term Care Program; and
(4) representatives of HHSC whose programs
				  relate to the Medicare/Medicaid long term care program.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter U - INSPECTIONS, SURVEYS, AND VISITS › Section 554.2004 - Determinations and Actions Pursuant to Inspections

Current through Reg. 49, No. 28; July 12, 2024
(a) DADS determines if a facility meets the
				  licensing rules, including both physical plant and facility operation
				  requirements.
(b) Violations of
				  regulations will be listed on forms designed for the purpose of the inspection
				  or will be listed in letter form when administrative penalties are being
				  proposed.
(c) At the conclusion of
				  an inspection, survey, or investigation, the violations will be discussed in an
				  exit conference with the facility's management. A written list of the
				  violations will be left with the facility at the time of the exit conference;
				  any additional violation that may be determined during review of field notes or
				  preparation of the official final list will be communicated to the facility in
				  writing within 10 working days after the exit conference. DADS gives the
				  facility an additional exit conference regarding the additional
				  violations.
(d) Not later than the
				  fifth working day after the date a facility receives the final statement of
				  violations under this section, the facility must provide a copy of the
				  statement to a representative of the facility's family council.
(e) Within 10 working days after receipt of
				  the final statement of violations, the facility must submit an acceptable plan
				  of correction to the regional director, except plans of correction under §
				  554.2112(i) of this chapter (relating to Administrative Penalties). An
				  acceptable plan of correction must address the following areas:
(1) how corrective action will be
				  accomplished for those residents affected by the violations;
(2) how the facility will identify other
				  residents with the potential to be affected by the same violations;
(3) what measures will be put into place or
				  systemic changes made to ensure the violations will not recur;
(4) how the facility will monitor its
				  corrective actions to ensure that the violations are being corrected and will
				  not recur; and
(5) when corrective
				  action will be completed.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter U - INSPECTIONS, SURVEYS, AND VISITS › Section 554.2006 - Reporting Incidents and Complaints

Current through Reg. 49, No. 28; July 12, 2024
(a) Each incident or complaint report must
				  reflect the reporting person's belief that a resident has been or will be
				  abused or neglected and must contain the following information:
(1) the address or phone number of the person
				  making the report so that DADS can contact the person for any additional
				  information, except for an anonymous report;
(2) the name and address of the
				  resident;
(3) the name and address
				  of the person responsible for the care of the resident, if available;
(4) information required by DADS guidelines,
				  when the report is an incident; and
(5) any other relevant information. Relevant
				  information includes the reporter's or complainant's basis or cause for
				  reporting and his or her belief that a resident's physical or mental health or
				  welfare has been or may be adversely affected by abuse or neglect caused by
				  another person or persons, and any other information DADS considers relevant
				  for the report.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter U - INSPECTIONS, SURVEYS, AND VISITS › Section 554.2008 - Investigations of Incidents and Complaints

Current through Reg. 49, No. 28; July 12, 2024
(a) In accordance with a memorandum of
				  understanding between DADS and the Texas Department of Family and Protective
				  Services (DFPS) (relating to Memorandum of Understanding Concerning Protective
				  Services for the Elderly), DADS will receive and investigate reports of abuse,
				  neglect, and exploitation of elderly and disabled persons or other residents
				  living in facilities licensed under this chapter. In investigating allegations
				  of abuse and neglect of children residing in facilities, the definitions of
				  "abuse," "neglect," and "person responsible for a child's care, custody, or
				  welfare" are those found in §
										261.001 of the Texas
				  Family Code.
(b) DADS will
				  investigate complaints of abuse, neglect, or exploitation when the act occurs
				  in the facility, when such 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. Complaints of abuse, neglect, or exploitation not
				  meeting this criteria will be referred to DFPS.
(c) The primary purpose of an investigation
				  is the protection of the resident. If, before the completion of an
				  investigation, DADS determines that the immediate removal of the resident is
				  necessary to protect the resident from further abuse or neglect, DADS will
				  petition a court to allow the immediate removal of the resident from the
				  facility.
(d) Investigations under
				  this section are conducted in accordance with Texas Health and Safety Code,
				  § 260A.007.
(e) Investigations
				  of reports do not preclude actions under the provisions of Subchapter V of this
				  chapter (relating to Enforcement).
(f) If the initial phase of an incident or
				  complaint investigation concludes that no abuse or neglect adversely affecting
				  the physical or mental health or welfare of a resident has occurred, no further
				  investigation will be undertaken.
(g) The individual reporting the alleged
				  abuse or neglect or other complaint, the resident, the resident's family, any
				  person designated by the resident to receive information concerning the
				  resident, and the facility will be notified of the results of DADS
				  investigation of a reported case of abuse or neglect or other
				  complaint.