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 E - RESIDENT RIGHTS › Section 554.411 - Work

Current through Reg. 49, No. 28; July 12, 2024
The resident has the right to:
(1) refuse to perform services for the
				  facility; and
(2) perform services
				  for the facility, if the resident chooses, when:
(A) the facility has documented the
				  resident's need or desire for work in the care plan;
(B) the care plan specifies the nature of the
				  services performed and whether the services are voluntary or paid;
(C) compensation for paid services is at or
				  above prevailing rates; and
(D) the
				  resident agrees to the work arrangement described in the care plan.
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 E - RESIDENT RIGHTS › Section 554.412 - Mail

Current through Reg. 49, No. 28; July 12, 2024
The resident has the right to privacy in written
					 communications, including the right to:
(1) send and receive mail promptly that is
				  unopened;
(2) request facility
				  staff to help open and read incoming mail and help address and post outgoing
				  mail;
(3) have access to
				  stationery, postage, and writing implements at the resident's own
				  expense.
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 E - RESIDENT RIGHTS › Section 554.413 - Access and Visitation Rights

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  resident has the right to have access to, and the facility must provide
				  immediate access to a resident to, the following:
(1) in Medicaid-certified facilities, any
				  representative of the Secretary of Health and Human Services;
(2) any representative of the State of
				  Texas;
(3) the resident's
				  individual physician;
(4) the State
				  Ombudsman;
(5) a certified
				  ombudsman;
(6) any representative
				  of the protection and advocacy system for individuals with intellectual or
				  developmental disabilities established under the Developmental Disabilities
				  Assistance and Bill of Rights Act, 42 USC Chapter 144, Subchapter I, Part
				  C;
(7) any representative of the
				  protection and advocacy system for individuals with mental illness established
				  under the Protection and Advocacy for Mentally Ill Individuals Act, 42 USC
				  Chapter 114, Subchapter I;
(8)
				  subject to the resident's right to deny or withdraw consent at any time,
				  immediate family or other relatives of the resident;
(9) subject to reasonable restrictions and
				  the resident's right to deny or withdraw consent at any time, others who are
				  visiting with the consent of the resident; and
(10) the resident representative.
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 E - RESIDENT RIGHTS › Section 554.414 - Telephone

Current through Reg. 49, No. 28; July 12, 2024
(a) The resident
				  has the right to have reasonable access to the use of a telephone, other than a
				  pay phone, where calls can be made without being overheard, and which can also
				  be used for making calls to summon help in case of emergency.
(b) The facility must permit residents to
				  contract for private telephones at their own expense.
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 E - RESIDENT RIGHTS › Section 554.415 - Postmortem Procedures

Current through Reg. 49, No. 28; July 12, 2024
The facility must have policies regarding postmortem
					 procedures, including soliciting and meeting the resident's or families'
					 requests regarding notification of a death, disposition of possessions or
					 personal property, and choice of funeral homes.
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 E - RESIDENT RIGHTS › Section 554.416 - Personal Property

Current through Reg. 49, No. 28; July 12, 2024
The resident has the right to retain and use personal
					 possessions, including some furnishings, and appropriate clothing as space
					 permits, unless to do so would infringe upon the rights or health and safety of
					 other residents. Reasons for any limitations are documented in the resident's
					 clinical record.
(1) If the resident
				  dies, personal property must be transferred to the estate or the person
				  designated by the resident.
(2) If
				  it is donated or sold to the facility by the resident or estate, the
				  transaction must be documented.
(3)
				  If the resident dies and there is no resident representative or family and no
				  arrangements have been made for the disposition of property, the facility must
				  dispose of property according to the Texas Property Code, Title 6, Chapter 71
				  (concerning Escheat of Property) and according to the Texas Estates Code,
				  Chapter 551 (concerning Payment of Certain Estates to State).
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 E - RESIDENT RIGHTS › Section 554.417 - Married Couples

Current through Reg. 49, No. 28; July 12, 2024
A resident must be ensured privacy for visits with the
					 resident's spouse. The resident has the right to share a room with the
					 resident's spouse when married residents live in the same facility and both
					 spouses consent to the arrangement.
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 E - RESIDENT RIGHTS › Section 554.419 - Advance Directives

Current through Reg. 49, No. 28; July 12, 2024
(a) Competent
				  adults may issue advance directives in accordance with applicable laws. An
				  advance directive has the meaning as defined in Texas Health and Safety Code,
				  §
										166.002.
(b) A facility must maintain policies and
				  procedures implementing the following with respect to all adult residents:
(1) The facility must:
(A) maintain written policies regarding the
				  implementation of advance directives; and
(B) include a clear and precise statement of
				  any procedure the facility is unwilling or unable to provide or withhold in
				  accordance with an advance directive.
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 E - RESIDENT RIGHTS › Section 554.420 - Documentation for the Delegation of Long-Term Care Resident's Rights

Current through Reg. 49, No. 28; July 12, 2024
(a) The delegation
				  of resident rights may occur in three cases:
(1) when a competent individual chooses to
				  allow another to act for him, such as with a Durable Power of
				  Attorney;
(2) when the resident has
				  been adjudicated to be incompetent by a court of law and a guardian has been
				  appointed; or
(3) when the
				  physician has determined that, for medical reasons, the resident is incapable
				  of understanding and exercising such rights. The Health and Safety Code,
				  Chapter 313, Consent to Medical Treatment, provides guidance under certain
				  circumstances when a resident is comatose, incapacitated, or otherwise mentally
				  or physically incapable of communication.
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 E - RESIDENT RIGHTS › Section 554.421 - Refusal of Certain Transfers in Medicaid-Certified Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) A resident has
				  the right to refuse a transfer to another room within the facility, if the
				  purpose of the transfer is:
(1) to relocate a
				  resident of a skilled nursing facility (SNF) from the distinct part of the
				  facility that is an SNF to a part of the facility that is not an SNF;
(2) to relocate a resident of a nursing
				  facility from the distinct part of the facility that is a nursing facility to a
				  distinct part of the facility that is an SNF; or
(3) solely for the convenience of the
				  staff.
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 E - RESIDENT RIGHTS › Section 554.422 - Authorized Electronic Monitoring (AEM)

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility must permit a resident or the
				  resident's guardian or legal representative to monitor the resident's room
				  through the use of electronic monitoring devices.
(b) A facility may not refuse to admit an
				  individual and may not discharge a resident because of a request to conduct
				  authorized video monitoring.
(c)
				  The Texas Department of Human Services (DHS) Information Regarding Authorized
				  Electronic Monitoring form must be signed by or on behalf of all new residents
				  upon admission. The form must be completed and signed by or on behalf of all
				  current residents by July 1, 2003. A copy of the form must be maintained in the
				  active portion of the resident's clinical record.
Attached
					 Graphic
(d) A
				  resident, or the resident's guardian or legal representative, who wishes to
				  conduct AEM must request AEM by giving a completed, signed, and dated DHS
				  Request for Authorized Electronic Monitoring form to the administrator or
				  designee. A copy of the form must be maintained in the active portion of the
				  resident's clinical record.
(1) If a resident
				  has capacity to request AEM and has not been judicially declared to lack the
				  required capacity, only the resident may request AEM, notwithstanding the terms
				  of any durable power of attorney or similar instrument.
(2) If a resident has been judicially
				  declared to lack the capacity required to request AEM, only the guardian of the
				  resident may request AEM.
(3) If a
				  resident does not have capacity to request AEM and has not been judicially
				  declared to lack the required capacity, only the legal representative of the
				  resident may request AEM.
(A) A resident's
				  physician makes the determination regarding the capacity to request AEM.
				  Documentation of the determination must be made in the resident's clinical
				  record.
(B) When a resident's
				  physician determines the resident lacks capacity to request AEM, a person from
				  the following list, in order of priority, may act as the resident's legal
				  representative for the limited purpose of requesting AEM:
(i) a person named in the resident's medical
				  power of attorney or other advance directive;
(ii) the resident's spouse;
(iii) an adult child of the resident who has
				  the waiver and consent of all other qualified adult children of the resident to
				  act as the sole decision-maker;
(iv) a majority of the resident's reasonably
				  available adult children;
(v) the
				  resident's parents; or
(vi) the
				  individual clearly identified to act for the resident by the resident before
				  the resident became incapacitated or the resident's nearest living
				  relative.
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 E - RESIDENT RIGHTS › Section 554.423 - Model Drug Testing Policy

Current through Reg. 49, No. 28; July 12, 2024
The Texas Department of Human Services (DHS) is required to
					 provide a model drug testing policy to nursing facilities under the Health and
					 Safety Code, § 242.050. A nursing facility is not required to perform drug
					 testing on its employees or applicants for employment. Although this policy
					 only covers drugs, coverage of alcohol may be added. Before implementing any
					 drug testing policy, including the following model policy, DHS recommends that
					 a facility discuss the policy with its attorney.
(1) Policy.
(A) (NURSING FACILITY NAME) has a vital
				  interest in maintaining a safe, healthy, and efficient working environment.
				  Being under the influence of a drug on the job poses serious safety and health
				  risks to the user, co-workers, and residents. The use, sale, purchase,
				  transfer, or possession of an illegal drug in the workplace poses unacceptable
				  risks for safe, healthy, and efficient operations.
(B) (NURSING FACILITY NAME) has the
				  obligation to maintain a safe, healthy and efficient workplace for all of its
				  employees and residents, and to protect the facility's property, information,
				  equipment, operations, and reputation.
(C) (NURSING FACILITY NAME) recognizes its
				  obligation to its residents to provide services that are free of the influence
				  of illegal drugs and endeavors through this policy to provide drug-free
				  services.
(D) (NURSING FACILITY
				  NAME) complies with federal and state rules, regulations, or laws that relate
				  to the maintenance of a workplace free from illegal drugs.
(E) All employees are required to abide by
				  the terms of this policy and to notify management of any criminal drug statute
				  conviction for a violation that occurred in the workplace no later than five
				  days after such conviction.
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 E - RESIDENT RIGHTS › Section 554.424 - Wheelchair Self-Release Seat Belts

Current through Reg. 49, No. 28; July 12, 2024
(a) For the purposes of this section, a
				  "self-release seat belt" is a seat belt on a resident's wheelchair that the
				  resident demonstrates the ability to fasten and release without assistance. A
				  self-release seat belt is not a restraint.
(b) Except as provided in subsection (c) of
				  this section, a facility must allow a resident to use a self-release seat belt
				  if:
(1) the resident or the resident's legal
				  guardian requests that the resident use a self-release seat belt;
(2) the resident consistently demonstrates
				  the ability to fasten and release the self-release seat belt without
				  assistance;
(3) the use of the
				  self-release seat belt is documented in and complies with the resident's
				  comprehensive care plan; and
(4)
				  the facility receives written authorization, signed by the resident or the
				  resident's legal guardian, for the resident to use the self-release seat
				  belt.
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 F - ADMISSION, TRANSFER, AND DISCHARGE RIGHTS IN MEDICAID-CERTIFIED FACILITIES › Section 554.501 - Admissions Policy for Medicaid-Certified Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) The facility must establish and implement
				  an admissions policy.
(b) The
				  facility must not request or require:
(1) a
				  resident or a potential resident to waive the resident's or potential
				  resident's rights, including the resident's or potential resident's rights to
				  Medicare or Medicaid;
(2) oral or
				  written assurance that a resident or a potential resident is not eligible for,
				  or will not apply for, Medicare or Medicaid benefits; and
(3) a resident or a potential resident to
				  waive potential facility liability for losses of personal property.
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 F - ADMISSION, TRANSFER, AND DISCHARGE RIGHTS IN MEDICAID-CERTIFIED FACILITIES › Section 554.502 - Transfer and Discharge in Medicaid-Certified Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) Examples.
				  Transfer and discharge includes movement of a resident to a bed outside the
				  certified facility, whether that bed is in the same physical plant or not.
				  Transfer and discharge does not refer to movement within the same certified
				  facility.
(b) Transfer and
				  discharge requirements. The facility must permit each resident to remain in the
				  facility and must not transfer or discharge the resident from the facility
				  unless:
(1) the transfer or discharge is
				  necessary for the resident's welfare, and the resident's needs cannot be met in
				  the facility;
(2) the transfer or
				  discharge is appropriate because the resident's health has improved
				  sufficiently so the resident no longer needs the services provided by the
				  facility;
(3) the safety of
				  individuals in the facility is endangered due to the clinical or behavioral
				  status of the resident;
(4) the
				  health of other individuals in the facility would otherwise be
				  endangered;
(5) the resident has
				  failed, after reasonable and appropriate notice, to pay for (or to have paid
				  under Medicare or Medicaid) a stay at the facility. Nonpayment applies if the
				  resident does not submit the necessary paperwork for third party payment or
				  after the third party, including Medicare or Medicaid, denies the claim and the
				  resident refuses to pay for the resident's stay. For a resident who becomes
				  eligible for Medicaid after admission to a facility, the facility may charge a
				  resident only allowable charges under Medicaid;
(6) the resident or resident representative
				  requests a voluntary transfer or discharge; or
(7) the facility ceases to operate as a
				  nursing facility and no longer provides resident care.
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 F - ADMISSION, TRANSFER, AND DISCHARGE RIGHTS IN MEDICAID-CERTIFIED FACILITIES › Section 554.503 - Notice of Bed-Hold Policy and Return to Medicaid-Certified Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) Notice before
				  transfer. Before a nursing facility transfers a resident to a hospital or a
				  resident goes on therapeutic leave, the nursing facility must provide written
				  information to the resident or resident representative that specifies:
(1) the duration of the bed-hold policy under
				  the Medicaid State Plan, if any, during which the resident is permitted to
				  return and resume residence in the facility;
(2) the reserved bed payment policy, in the
				  State plan;
(3) the facility's
				  policies regarding bed-hold periods, which must be consistent with subsection
				  (c) of this section, permitting a resident to return; and
(4) the information specified in §
				  554.502 of this subchapter (relating to Transfer and Discharge in
				  Medicaid-certifiedFacilities).
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 F - ADMISSION, TRANSFER, AND DISCHARGE RIGHTS IN MEDICAID-CERTIFIED FACILITIES › Section 554.504 - Equal Access to Quality Care in Medicaid-Certified Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility must
				  provide equal access to quality care regardless of diagnosis, severity of
				  condition, or payment source.
(b)
				  A facility must establish, maintain, and implement identical policies and
				  practices regarding transfer, discharge, and the provision of services under
				  the Medicaid State Plan for all individuals regardless of source of
				  payment.
(c) The facility may
				  charge any amount for services furnished to non-Medicaid residents consistent
				  with the notice requirement in § 554.403(i) and (j) of this chapter
				  (relating to Notice of Rights and Services).
(d) HHSC is not required to offer additional
				  services on behalf of a recipient other than services provided in the State
				  Plan.
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 F - ADMISSION, TRANSFER, AND DISCHARGE RIGHTS IN MEDICAID-CERTIFIED FACILITIES › Section 554.505 - Discharge Planning in Medicaid-Certified Facilities

Current through Reg. 49, No. 28; July 12, 2024
Discharge planning must be done by appropriate facility
					 staff in accordance with the provisions outlined in § 554.803 of Title 40
					 (relating to Discharge Summary (Discharge Plan of Care)).
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 G - FREEDOM FROM ABUSE, NEGLECT, AND EXPLOITATION › Section 554.601 - Freedom from Abuse, Neglect, and Exploitation

Current through Reg. 49, No. 28; July 12, 2024
(a) General. The resident has the right to be
				  free from abuse, neglect, misappropriation of resident property, and
				  exploitation as defined in § 554.101 of this chapter (relating to
				  Definitions). This includes freedom from any physical or chemical restraint not
				  required to treat the resident's medical symptoms.
(b) Abuse. The resident has the right to be
				  free from verbal, sexual, physical and mental abuse, corporal punishment, and
				  involuntary seclusion.
(c) Policies
				  and procedures. The facility must develop and implement written policies and
				  procedures that prohibit and prevent mistreatment, abuse, neglect, and
				  exploitation of a resident, and misappropriation of a resident's property.
(1) The facility must:
(A) not use verbal, mental, sexual, or
				  physical abuse, corporal punishment, or involuntary seclusion;
(B) not employ or otherwise engage an
				  individual who has:
(i) been found guilty of
				  abuse, neglect, exploitation, misappropriation of property, or mistreatment of
				  a resident by a court of law;
(ii)
				  had a finding entered into the state nurse aide registry concerning abuse,
				  neglect, exploitation or mistreatment of a resident, or misappropriation of a
				  resident's property;
(iii) been
				  convicted of any crime contained in §
													250.006, Texas
				  Health and Safety Code; or
(iv) a
				  disciplinary action in effect against the individual's professional license by
				  a state licensure body as a result of a finding of abuse, neglect,
				  exploitation, mistreatment of a resident or misappropriation of a resident's
				  property.
(C) report any
				  knowledge it has of actions by a court of law against an employee, which would
				  indicate unfitness for service as a nurse aide or other staff to the state
				  nurse aide registry or licensing authority.
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 G - FREEDOM FROM ABUSE, NEGLECT, AND EXPLOITATION › Section 554.602 - Incidents of Abuse, Neglect, and Exploitation Reportable to the Texas Health and Human Services Commission and Law Enforcement Agencies by Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) In response to
				  allegations of abuse, neglect, exploitation, or mistreatment, the facility
				  must:
(1) ensure that all alleged violations
				  involving abuse, neglect, exploitation or mistreatment, including injuries of
				  unknown source and misappropriation of resident property are reported:
(A) immediately to the administrator of the
				  facility and to HHSC Complaint and Incident Intake, but no later than two hours
				  after the allegation is made, if the events that cause the allegation involve
				  abuse, or result in serious bodily injury; or
(B) no later than 24 hours after the
				  allegation is made to the administrator of the facility and to HHSC Complaint
				  and Incident Intake, if the events that cause the allegation do not involve
				  abuse and do not result in serious bodily injury;
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 G - FREEDOM FROM ABUSE, NEGLECT, AND EXPLOITATION › Section 554.604 - Complaint Investigation

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  complaint is any allegation received by the Texas Department of Human Services
				  (DHS) other than an incident reported by facility staff. These allegations
				  include, but are not limited to, abuse, neglect, exploitation, or violation of
				  state or federal standards.
(b) DHS
				  will furnish the facility with a notification of the complaint received and a
				  summary of the complaint, without identifying the source of the
				  complaint.
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 G - FREEDOM FROM ABUSE, NEGLECT, AND EXPLOITATION › Section 554.606 - Reporting of Resident Death Information

Current through Reg. 49, No. 28; July 12, 2024
(a) All licensed facilities must report to
				  HHSC the death of any resident in the facility and any resident who is
				  transferred from the facility to a hospital and who dies within 24 hours after
				  transfer.
(b) The facility must
				  submit to HHSC Complaint and Incident Intake a standard HHSC form within ten
				  working days after the last day of the month in which a resident death occurs.
				  The form must include:
(1) name of
				  deceased;
(2) social security
				  number of the deceased;
(3) date of
				  death; and
(4) name and address of
				  the institution.
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 H - QUALITY OF LIFE › Section 554.701 - Quality of Life

Current through Reg. 49, No. 28; July 12, 2024
(a) Each resident
				  must receive, and the facility must provide, the necessary care and services to
				  attain or maintain the highest practicable, physical, mental, and psychosocial
				  well-being consistent with the resident's comprehensive assessment and care
				  plan.
(1) Based on the comprehensive
				  assessment of a resident and consistent with the resident's needs and choices,
				  the facility must provide the necessary care and services to ensure that a
				  resident's abilities in activities of daily living do not diminish unless
				  circumstances of the resident's clinical condition demonstrate that such
				  diminution was unavoidable.
(2)
				  This includes the facility ensuring that:
(A)
				  a resident is given the appropriate treatment and services to maintain or
				  improve the ability to carry out the activities of daily living, including
				  those specified in subsection (b) of this section;
(B) a resident who is unable to carry out
				  activities of daily living receives the necessary services to maintain good
				  nutrition, grooming, and personal and oral hygiene; and
(C) personnel provide basic life support,
				  including CPR, to a resident requiring such emergency care prior to the arrival
				  of emergency medical personnel and subject to related physician orders and the
				  resident's advance directives.
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 H - QUALITY OF LIFE › Section 554.702 - Activities

Current through Reg. 49, No. 28; July 12, 2024
(a) The facility
				  must provide, based on the comprehensive assessment and care plan and the
				  preferences of each resident, an ongoing program to support a resident in the
				  resident's choice of activities, both facility-sponsored group and individual
				  activities and independent activities, designed to meet the interests of and
				  support the physical, mental, and psychosocial well-being of each resident,
				  encouraging both independence and interaction in the community.
(b) The activities program must be directed
				  by a qualified professional who is a qualified therapeutic recreation
				  specialist or an activities professional who:
(1) is eligible for certification as a
				  therapeutic recreation specialist or as an activities professional by a
				  recognized accrediting body, such as the National Council for Therapeutic
				  Recreation Certification, on or after October 1, 1990, the Consortium for
				  Therapeutic Recreation/Activities Certification, or the National Certification
				  Council for Activity Professionals;
(2) has two years of experience in a social
				  or recreational program within the last five years, one of which was full-time
				  in a therapeutic activities program;
(3) is a qualified occupational therapist or
				  occupational therapy assistant; or
(4) has completed an activity director
				  training course approved by a recognized credentialing body, such as the
				  National Certification Council for Activity Professionals, National Council for
				  Therapeutic Recreation Certification, or the Consortium for Therapeutic
				  Recreation/Activities Certification, Inc.
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 H - QUALITY OF LIFE › Section 554.703 - Social Services General Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) The facility must provide
				  medically-related social services to attain the highest practicable physical,
				  mental, or psychosocial well-being of each resident.
(1) A facility with more than 120 beds must
				  employ a qualified social worker on a full-time basis.
(2) A facility of 120 beds or less must
				  employ or contract with a qualified social worker (or in lieu thereof, a social
				  worker who is licensed by the Texas State Board of Social Worker Examiners, and
				  who meets the requirements of subsection (b)(2) of this section) to provide
				  social services a sufficient amount of time to meet the needs of the
				  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 H - QUALITY OF LIFE › Section 554.704 - Social Services Process

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  The facility must ensure that psychosocial assessment and care planning are
				  completed and reviewed or updated as provided in § 554.801 and §
				  554.802 of Title 40 (relating to Resident Assessment and Comprehensive Care
				  Plans).
(b) If indicated by the
				  Resident Assessment Instrument (RAI) and/or the resident's need, an in-depth
				  psychosocial assessment is required. The social service needs of each resident
				  must be identified and addressed by the direct provision of services or by
				  arranging access to 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 H - QUALITY OF LIFE › Section 554.706 - Resident Group and Family Council

Current through Reg. 49, No. 28; July 12, 2024
(a) A resident has the right to organize and
				  participate in resident groups in a facility.
(b) A facility must assist a resident who
				  requires assistance to attend resident group meetings.
(c) A resident has the right to have a family
				  member or other resident representative meet in the facility with the family or
				  resident representative of other residents in the facility and organize a
				  family council. A family council may:
(1)
				  make recommendations to the facility proposing policy and operational decisions
				  affecting resident care and quality of life; and
(2) promote educational programs and projects
				  intended to promote the health and happiness of 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 I - RESIDENT ASSESSMENT › Section 554.801 - Resident Assessment

Current through Reg. 49, No. 28; July 12, 2024
A facility must conduct, initially and periodically, a
					 comprehensive, accurate, standardized, reproducible assessment of a resident's
					 functional capacity. The facility must electronically transmit to CMS
					 resident-entry-and-death-in-facility tracking records required by the RAI; and
					 OBRA assessments, including admission, annual, quarterly, significant change,
					 significant correction, and discharge assessments.
(1) Admission orders. At the time a resident
				  is admitted, the facility must have physician orders for the resident's
				  immediate care.
(2) Comprehensive
				  assessments.
(A) A facility must make a
				  comprehensive assessment of a resident's needs, strengths, goals, life history,
				  and preferences, using the current RAI process, including the MDS, Care Area
				  Assessment process, and the Utilization Guidelines specified by HHSC and
				  approved by CMS. The current RAI process is found in the MDS 3.0 manual posted
				  by CMS on
http://www.cms.gov
.
(B) A facility must conduct an additional
				  assessment and document the summary information if the MDS indicates an
				  additional assessment on a care area is required.
(C) A facility must conduct a comprehensive
				  assessment of a resident as follows:
(i)
				  within 14 calendar days after admission, excluding readmissions in which there
				  is no significant change in the resident's physical or mental condition. For
				  purposes of this section, "readmission" means a return to the facility
				  following a temporary absence for hospitalization or for therapeutic
				  leave;
(ii) within 14 calendar days
				  after the facility determines, or should have determined, that there has been a
				  significant change in the resident's physical or mental condition. For purposes
				  of this section, a "significant change" means a major decline or improvement in
				  the resident's status that will not normally resolve itself without further
				  intervention by staff or by implementing standard disease-related clinical
				  interventions, that has an impact on more than one area of the resident's
				  health status, and requires interdisciplinary review or revision of the
				  comprehensive care plan, or both; and
(iii) not less often than once every 12
				  months.
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 I - RESIDENT ASSESSMENT › Section 554.802 - Comprehensive Person-Centered Care Planning

Current through Reg. 49, No. 28; July 12, 2024
(a) Baseline care plans.
(1) The facility must develop and implement a
				  baseline care plan for each resident that includes the instructions needed to
				  provide effective and person-centered care of the resident that meet
				  professional standards of quality care. The baseline care plan must:
(A) be developed within 48 hours of a
				  resident's admission;
(B) include
				  the minimum healthcare information necessary to properly care for a resident,
				  including:
(i) initial goals based on
				  admission orders;
(ii) physician
				  orders;
(iii) dietary
				  orders;
(iv) therapy
				  services;
(v) social services;
				  and
(vi) PASRR recommendation, if
				  applicable.
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 I - RESIDENT ASSESSMENT › Section 554.803 - Discharge Summary (Discharge Plan of Care)

Current through Reg. 49, No. 28; July 12, 2024
(a) Discharge planning. The facility must
				  develop and implement an effective discharge planning process.
(1) The facility's discharge planning process
				  must:
(A) ensure that the discharge needs of
				  each resident are identified and result in the development of a discharge plan
				  for each resident;
(B) include
				  regular re-evaluation of a resident to identify changes that require
				  modification of the discharge plan and update the discharge plan to reflect
				  these changes;
(C) involve the
				  interdisciplinary team in the ongoing process of developing the discharge
				  plan;
(D) consider caregiver or
				  support person availability and the resident's or caregiver's or support
				  person's capacity and capability to perform required care, as part of the
				  identification of discharge needs;
(E) involve the resident and resident
				  representative in the development of the discharge plan and inform the resident
				  and resident representative of the final plan;
(F) address the resident's goals of care and
				  treatment preferences; and
(G)
				  document that a resident has been asked about their interest in receiving
				  information regarding returning to the community.
(i) If the resident indicates an interest in
				  returning to the community, the facility must document any referrals to local
				  contact agencies or other appropriate entities made for this purpose.
(ii) Facilities must update a resident's
				  comprehensive care plan and discharge plan as appropriate, in response to
				  information received from referrals to local contact agencies or other
				  appropriate entities.
(iii) If
				  discharge to the community is determined to not be feasible, the facility must
				  document who made the determination and why.
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 I - RESIDENT ASSESSMENT › Section 554.804 - Capacity Assessment for Self Care and Financial Management

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility will
				  perform a Capacity Assessment for Self Care and Financial Management for
				  persons who will be referred to a court for guardianship if the person:
(1) is elderly, which is defined as a person
				  60 years of age or older; or
(2)
				  has mental retardation or a developmental disability; or
(3) is suspected of being a person with
				  mental retardation or a developmental disability.
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 I - RESIDENT ASSESSMENT › Section 554.805 - Permanency Planning for a Resident Under 22 Years of Age

Current through Reg. 49, No. 28; July 12, 2024
(a) Definitions. The following words and
				  terms, when used in this subchapter, have the following meanings, unless the
				  context clearly indicates otherwise.
(1)
				  Permanency planning--A philosophy and planning process that focuses on the
				  outcome of family support by facilitating a permanent living arrangement, with
				  the primary feature of an enduring and nurturing parental relationship.
				  Family-directed planning empowers the family of a child under the age of 18 to
				  direct the development of supports and services that meet the child and
				  family's personal outcomes as related to that child. Person-directed planning
				  empowers the child who is between 18 and 22 years of age to direct the
				  development of a plan of supports and services that meets the needs for
				  self-determination.
(2) Child--A
				  person with a developmental disability who is under 22 years of age.
(3) CRCG (Community resource coordination
				  group)--A local interagency group composed of public and private agencies that
				  develops service plans for individuals whose needs can be met only through
				  interagency coordination and cooperation. The group's role and responsibilities
				  are described in the Memorandum of Understanding on Coordinated Services to
				  Persons Needing Services from More Than One Agency, available on the Health and
				  Human Services Commission website at
				  www.hhsc.state.tx.us/crcg/crcg.htm.
(4) Emergency situation--An unexpected
				  situation involving a child's health, safety, or welfare, of which a person of
				  ordinary prudence would determine that the LAR should be informed, such as:
(A) a child needing emergency medical
				  care;
(B) a child being removed
				  from his residence by law enforcement;
(C) a child leaving his residence without
				  notifying staff and not being located; and
(D) a child being moved from his residence to
				  protect the child (for example, because of a hurricane, fire, or
				  flood).
(5) LAR (legally
				  authorized representative)--A person authorized by law to act on behalf of a
				  resident with regard to a matter described in this subchapter, which may
				  include a parent, guardian, managing conservator of a minor individual, a
				  guardian of an adult individual, or legal representative of a deceased
				  individual.
(6) Permanency
				  planner--A person assigned by DADS to conduct permanency planning activities
				  for a child who resides in a 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 J - QUALITY OF CARE › Section 554.901 - Quality of Care

Current through Reg. 49, No. 28; July 12, 2024
Based on the comprehensive assessment of a resident, the
					 facility must ensure that a resident receives treatment and care in accordance
					 with professional standards of practice, the comprehensive person-centered care
					 plan, and the resident's choices, including the following:
(1) Vision and hearing. To ensure that a
				  resident receives proper treatment and assistive devices to maintain vision and
				  hearing abilities, the facility must, if necessary, assist the resident:
(A) in making appointments; and
(B) by arranging for transportation to and
				  from the office of a practitioner specializing in the treatment of vision or
				  hearing impairment or the office of a professional specializing in the
				  provision of vision or hearing assistive devices.
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 J - QUALITY OF CARE › Section 554.904 - Behavioral Health Services

Current through Reg. 49, No. 28; July 12, 2024
Each resident must receive and the facility must provide
					 the necessary behavioral health care and services to attain or maintain the
					 highest practicable physical, mental, and psychosocial well-being, in
					 accordance with the comprehensive assessment and care plan.
(1) The facility must have sufficient staff
				  who provide direct services to a resident with the appropriate competencies and
				  skills sets to provide nursing and related services to assure resident safety
				  and attain or maintain the highest practicable physical, mental, and
				  psychosocial well-being of each resident. This is determined by resident
				  assessments and individual comprehensive care plans and considering the number,
				  acuity and diagnoses of the facility's resident population in accordance with
				  § 554.1931 of this chapter (relating to Facility Assessment). These
				  competencies and skills sets include knowledge of and appropriate training and
				  supervision for:
(A) caring for a resident
				  with mental and psychosocial disorders, as well as a resident with a history of
				  trauma or post-traumatic stress disorder, that have been identified in the
				  facility assessment conducted pursuant to § 554.1931 of this chapter;
				  and
(B) implementing
				  non-pharmacological interventions.
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 J - QUALITY OF CARE › Section 554.910 - Quality Assurance Early Warning System

Current through Reg. 49, No. 28; July 12, 2024
The Health and Human Services Commission (HHSC) uses an
					 early warning system to detect conditions that could be detrimental to the
					 health, safety, and welfare of residents.
(1) Quality-of-care monitors conduct visits
				  that may be announced or unannounced and may occur on any day and at any time,
				  including nights, weekends, and holidays.
(2) Quality-of-care monitors may visit a
				  facility:
(A) with a history of resident care
				  deficiencies;
(B) that is
				  identified as a medium risk through the early warning system; or
(C) that requests a visit.
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 J - QUALITY OF CARE › Section 554.911 - Rapid Response Teams

Current through Reg. 49, No. 28; July 12, 2024
(a) A rapid
				  response team is comprised of one or more Health and Human Services Commission
				  (HHSC) quality-of-care monitors and visits a facility that:
(1) is identified as high risk through the
				  early warning system described in § 554.910 of this subchapter (relating
				  to Quality Assurance Early Warning System); or
(2) has committed three violations that
				  constitute an immediate threat to health and safety relating to abuse or
				  neglect of a resident as described in § 554.2107 of this chapter (relating
				  to Revocation of a License by the HHSC Executive Commissioner).