reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter D - SERVICE REQUIREMENTS › Section 568.63 - Nursing Services

Current through Reg. 49, No. 28; July 12, 2024
(a) Nursing
				  services in treatment plan. A hospital shall provide nursing services to a
				  patient in accordance with a treatment plan developed in accordance with §
				  568.61 of this subchapter (relating to Inpatient Mental Health Treatment and
				  Treatment Planning).
(b)
				  Organization of nursing staff. The hospital shall have a written description of
				  the organizational hierarchy and responsibilities of the nursing staff.
(c) Director of psychiatric
				  nursing (DPN). A hospital shall have a DPN who:
(1) has administrative authority over the
				  nursing staff;
(2) directs,
				  monitors, and evaluates the nursing services provided;
(3) for a hospital licensed under Texas
				  Health and Safety Code Chapter 577 and Chapter 510 of this title (relating to
				  Private Psychiatric Hospitals and Crisis Stabilization Units), reports directly
				  to the administrator; and
(4) for
				  an identifiable mental health services unit in a hospital licensed under Texas
				  Health and Safety Code Chapter 241, and 25 TAC Chapter 133 (relating to
				  Hospital Licensing), reports directly to the chief nursing officer as described
				  in 25 TAC §
											133.41(relating
				  to Hospital Functions and Services) or reports directly to a registered nurse
				  (RN) who reports directly to the chief nursing officer.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter D - SERVICE REQUIREMENTS › Section 568.64 - Social Services

Current through Reg. 49, No. 28; July 12, 2024
(a) Social
				  services in treatment plan. A hospital shall provide social services to a
				  patient in accordance with a treatment plan developed in accordance with §
				  568.61 of this subchapter (relating to Inpatient Mental Health Treatment and
				  Treatment Planning).
(b) Director
				  of social services. A hospital shall have a director of social services who
				  directs, monitors, and evaluates the social services provided.
(c) Qualifications of director of social
				  services. The director of social services shall:
(1) be a licensed master social worker; or
(2) be a licensed social worker
				  who is enrolled in a graduate program accredited by the Council on Social Work
				  Education, receiving eight hours per month of clinical consultation from a
				  licensed master social worker with three years of experience in the provision
				  of psychiatric social work, and summarizing, in writing, the content of each
				  consultation with the licensed master social worker including clinical issues
				  discussed and recommendations made by the licensed master social worker
				  regarding such issues.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter D - SERVICE REQUIREMENTS › Section 568.65 - Therapeutic Activities

Current through Reg. 49, No. 28; July 12, 2024
(a) Therapeutic
				  activities in treatment plan. If ordered by the patient's treating physician, a
				  hospital shall provide therapeutic activities to the patient in accordance with
				  a treatment plan developed in accordance with § 568.61 of this subchapter
				  (relating to Inpatient Mental Health Treatment and Treatment Planning).
(b) Assessment.
(1) If ordered by the patient's treating
				  physician, an occupational therapist, a therapeutic recreation specialist, or a
				  staff member under the supervision of an occupational therapist or a
				  therapeutic recreation specialist shall conduct a therapeutic activities
				  assessment of the patient.
(2) The
				  assessment shall include an evaluation of the patient in the following domains:
(A) sensory;
(B) cognitive;
(C) social;
(D) physical;
(E) emotional; and
(F) leisure.
(3) If a staff member under the supervision
				  of an occupational therapist or a therapeutic recreation specialist conducts
				  the therapeutic activities assessment, the results of the assessment shall be
				  signed by the occupational therapist or a therapeutic recreation evidencing
				  approval of such results.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter D - SERVICE REQUIREMENTS › Section 568.66 - Psychological Services

Current through Reg. 49, No. 28; July 12, 2024
(a) Psychological
				  services in treatment plan. If ordered by a patient's treating physician, a
				  hospital shall provide psychological services to the patient in accordance with
				  a treatment plan developed in accordance with § 568.61 of this subchapter
				  (relating to Inpatient Mental Health Treatment and Treatment Planning).
(b) Assessment. If ordered by a
				  patient's treating physician, a licensed psychologist shall conduct a
				  psychological assessment of the patient.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter D - SERVICE REQUIREMENTS › Section 568.67 - Protection of a Patient

Current through Reg. 49, No. 28; July 12, 2024
(a) Modifying the
				  environment and monitoring the patient. A hospital shall protect a patient by
				  taking the following measures:
(1) modifying
				  the hospital environment based on the patient's needs, including:
(A) providing furnishings that do not present
				  safety hazards to the patient;
(B)
				  securing or removing objects that are hazardous to the patient; and
(C) installing any necessary safety
				  devices;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter E - DISCHARGE › Section 568.82 - Discharge Notices and Release of Minors

Current through Reg. 49, No. 28; July 12, 2024
(a) Discharge notice to family or legally
				  authorized representative (LAR).
(1) In
				  accordance with Texas Health and Safety Code §
											576.007,
				  before discharging a patient who is an adult, a hospital shall make a
				  reasonable effort to notify the patient's family of the discharge, if the
				  patient grants permission for the notification.
(2) Except as provided by 42 CFR Part 2 and
				  subsection (b) of this section, before discharging a patient who is at least 16
				  years of age, a hospital shall make a reasonable effort to notify the patient's
				  LAR of the discharge.
(3) Except
				  as provided by subsection (b) of this section, before discharging a patient who
				  is younger than 16 years of age, a hospital shall notify the patient's LAR of
				  the discharge.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter E - DISCHARGE › Section 568.83 - Discharge of a Voluntary Patient Requesting Discharge

Current through Reg. 49, No. 28; July 12, 2024
(a) Request for discharge. If a hospital is
				  informed that a voluntary patient desires to leave the hospital or a voluntary
				  patient or the patient's legally authorized representative (LAR), when
				  applicable, requests that the patient be discharged, the hospital shall, in
				  accordance with Texas Health and Safety Code §
										572.004:
(1) inform the patient or the patient's LAR
				  that the request must be in writing and signed, timed, and dated by the
				  requestor; and
(2) if necessary,
				  and as soon as possible, assist the patient in creating a written request for
				  discharge and present it to the patient for the patient's signature.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter E - DISCHARGE › Section 568.84 - Discharge of an Involuntary Patient

Current through Reg. 49, No. 28; July 12, 2024
(a) Discharge from emergency detention.
(1) Except as provided by § 568.26 of
				  this chapter (relating to Voluntary Treatment Following Involuntary Admission),
				  and in accordance with Texas Health and Safety Code §
											573.023(b)
				  and §
											573.021(b),
				  a hospital shall immediately discharge a patient under emergency detention if
				  either of the following occurs:
(A) the
				  administrator or the administrator's designee determines, based on a
				  physician's determination, that the patient no longer meets the criteria
				  described in § 568.23(c)(1) of this chapter (relating to Emergency
				  Detention); or
(B) except as
				  provided in paragraphs (2) and (3) of this subsection, 48 hours elapse from the
				  time the patient was presented to the hospital and the hospital has not
				  obtained a court order for further detention of the patient.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter G - STAFF DEVELOPMENT › Section 568.121 - Staff Member Training

Current through Reg. 49, No. 28; July 12, 2024
(a) Staff
				  member training shall be in accordance with § 301.331 of this title
				  (relating to Competency and Credentialing).
(1) A hospital administrator, or
				  administrator's designee, shall:
(A) ensure
				  that services are provided by staff members who are operating within their
				  scope of their license, credentialing, job description, or contract
				  specification, and in accordance with applicable state law and rule, including
				  25 TAC Chapter 415, Subchapter F (relating to Interventions in Mental Health
				  Services);
(B) define
				  competency-based expectations for each hospital staff position and ensure each
				  staff member receives initial training before the staff member assumes
				  responsibilities required by the hospital and annually throughout the staff
				  member's employment with the hospital;
(C) provide hospital staff live, interactive,
				  instructor-led electronic or face-to-face training competency-based training;
				  and
(D) require all staff members
				  to demonstrate required competencies delineated in § 301.331(a)(3)(A) of
				  this title, including:
(i) identifying,
				  preventing, and reporting abuse and neglect of patients and unprofessional or
				  unethical conduct in the hospital, as defined by Texas Health and Safety Code
				  §
													161.131 (relating to
				  Definitions);
(ii) identifying,
				  preventing, and reporting abuse, neglect, and exploitation as follows, in
				  accordance with Texas Health and Safety Code §
													161.133
				  (relating to In-service Training):
(I)
				  residential staff must receive eight hours of training;
(II) training must be conducted in person,
				  and not through teleconferencing, web-based video conferencing, or other
				  technology;
(III) a hospital must
				  ensure all new employees receive training on abuse, neglect, and exploitation;
				  and
(IV) a hospital may provide
				  abuse, neglect, and exploitation training to staff or may choose to contract
				  with an outside entity to provide the training;
(iii) preserving and protecting dignity and
				  rights of a patient in accordance with 25 TAC Chapter 404, Subchapter E
				  (relating to Rights of Persons Receiving Mental Health Services); and
(iv) preserving and protecting
				  confidentiality of a patient's information in accordance with Texas Health and
				  Safety Code Chapter 611 or Chapter 241, Subchapter G, as applicable, 42 CFR
				  Part 2, and 45 CFR Parts 160 and 164.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter H - PERFORMANCE IMPROVEMENT › Section 568.141 - Quality Assessment and Performance Improvement Program

Current through Reg. 49, No. 28; July 12, 2024
(a) Scope and content of program. A hospital
				  shall develop, implement, and maintain an effective, ongoing, hospital-wide,
				  data-driven quality assessment and performance improvement program. The program
				  shall:
(1) reflect the complexity of the
				  hospital's organization and services;
(2) involve all the hospital's services;
(3) specify the frequency and
				  detail of data collected; and
(4)
				  focus on high-risk, high-volume, and problem-prone areas in the hospital.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter H - PERFORMANCE IMPROVEMENT › Section 568.142 - Reporting and Investigating Sentinel Events

Current through Reg. 49, No. 28; July 12, 2024
A hospital shall develop and implement written procedures
					 to identify, report, and investigate sentinel events. The procedures shall
					 include:
(1) a description of the
				  process by which a staff member reports a sentinel event, including a
				  requirement that a sentinel event be reported by a staff member within at least
				  one hour after a staff member becomes aware of the incident;
(2) a requirement that, within 24 hours of a
				  sentinel event being reported, the administrator designate a committee to
				  investigate the sentinel event that includes a physician, a Registered Nurse
				  (RN), and any other staff members determined appropriate by the administrator;
				  and
(3) a requirement that, within
				  45 days of the sentinel event being reported, the committee will determine and
				  document:
(A) the cause or causes of the
				  sentinel event;
(B) whether the
				  cause or causes are random or a pattern of error in the hospital's processes or
				  systems;
(C) any improvements to
				  the hospital's processes or systems that may reduce the occurrence of similar
				  incidents in the future;
(D) how
				  such improvements will be implemented including a timeline for implementation;
(E) the staff members responsible
				  for such implementation; and
(F) a
				  method to determine whether the improvements identified were effective in
				  reducing the occurrence of similar incidents.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter H - PERFORMANCE IMPROVEMENT › Section 568.143 - Response to External Reviews

Current through Reg. 49, No. 28; July 12, 2024
A hospital shall develop and implement a written plan to
					 evaluate the effectiveness of any plan of correction the hospital submits to an
					 external review entity, including HHSC, the Centers for Medicare and Medicaid
					 Services, or the accrediting organization.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter H - PERFORMANCE IMPROVEMENT › Section 568.144 - Advisory Committee for Nurse Staffing

Current through Reg. 49, No. 28; July 12, 2024
(a) Advisory committee members.
(1) A hospital shall establish an advisory
				  committee that meets the requirements of Texas Health and Safety Code Chapter
				  161, Subchapter D (relating to Medical Committees, Medical Peer Review
				  Committees, and Compliance Officers).
(2) At least one-third of the advisory
				  committee shall be registered nurses (RNs) who provide direct patient care at
				  least 50 percent of their work time and at least one of the RNs shall be from
				  either infection control, quality assurance, or risk management.
(3) For an identifiable mental health
				  services unit in a hospital licensed under Texas Health and Safety Code Chapter
				  241 (relating to Hospitals) and 25 TAC Chapter 133 (relating to Hospital
				  Licensing), the advisory committee may be the advisory committee required by 25
				  TAC §
											133.41(relating
				  to Hospital Functions and Services).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 570 - LONG-TERM CARE PROVIDER RULES DURING A PUBLIC HEALTH EMERGENCY OR DISASTER › Subchapter B - ASSISTED LIVING FACILITIES › Section 570.111 - Visitation

Current through Reg. 49, No. 28; July 12, 2024
(a) An assisted living facility's visitation
				  policies and procedures may change during a public health emergency or
				  disaster. Assisted living facility (ALF) visitation policies and procedures may
				  not be more restrictive than guidance or directives issued by HHSC, DSHS,
				  executive or local orders.
(b) An
				  ALF may not prohibit a resident from receiving in-person visitation with a
				  religious counselor during a public health emergency or disaster on request
				  from the resident, resident's legally authorized representative (LAR), or
				  resident's family member unless a federal law or a federal agency requires the
				  facility to prohibit in-person visitation during a public health
				  emergency.
(c) An ALF must adopt
				  policies and procedures for in-person visitation with a religious counselor
				  during a public health emergency or disaster. These policies and procedures:
(1) must comply with the minimum health and
				  safety requirements for in-person visitation with religious counselors
				  developed by HHSC;
(2) may include
				  reasonable time, place, and manner restrictions on in-person visitation with
				  religious counselors to:
(A) mitigate the
				  spread of a communicable disease; and
(B) address the resident's medical
				  condition;
(3) must
				  include special consideration for residents receiving end-of-life care;
				  and
(4) may condition in-person
				  visitation with a religious counselor on the religious counselor's compliance
				  with an ALF's guidelines, policies, and procedures for in-person visitation
				  with a religious counselor.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 570 - LONG-TERM CARE PROVIDER RULES DURING A PUBLIC HEALTH EMERGENCY OR DISASTER › Subchapter B - ASSISTED LIVING FACILITIES › Section 570.113 - Essential Caregiver Visits

Current through Reg. 49, No. 28; July 12, 2024
(a) A resident
				  or the resident's legally authorized representative (LAR), if the resident is
				  unable, has the right to designate at least one essential caregiver.
(b) An assisted living facility (ALF) must
				  permit essential caregiver visits except as provided by subsection (j) of this
				  section.
(c) An ALF must allow
				  essential caregiver visits to occur outdoors, in the resident's bedroom, or in
				  another area designated for visitation by the ALF upon request by a resident or
				  resident's LAR.
(d) An ALF must
				  develop a visitation policy that permits an essential caregiver to visit the
				  resident for at least two hours each day.
(e) An ALF must have procedures in place to
				  enable physical contact between the resident and the essential
				  caregiver.
(f) The ALF must develop
				  safety protocols for essential caregiver visits. The safety protocols may not
				  be more stringent for essential caregivers than safety protocols for
				  staff.
(g) An ALF must obtain the
				  signature of the essential caregiver certifying that the essential caregiver
				  will follow the facility's safety protocols for essential caregiver
				  visits.
(h) An ALF may revoke an
				  essential caregiver designation if the caregiver violates the facility's safety
				  protocols or rules adopted under this chapter.
(i) If an ALF revokes a person's designation
				  as an essential caregiver under subsection (h) of this section:
(1) the resident or the resident's LAR has
				  the right to immediately designate another person as the essential
				  caregiver;
(2) within 24 hours
				  after the revocation, the facility must inform the resident or the resident's
				  legally authorized representative, in writing, of the right to appeal the
				  revocation and the procedures for filing an appeal with the Texas Health and
				  Human Services Commission (HHSC) Appeals Division by:
(A) email at
				  OCC_Appeals_ContestedCases@hhs.texas.gov; or
(B) mail at HHSC Appeals Division, P.O. Box
				  149030, MC W-613, Austin, TX 78714-9030; and
(3) the ALF must comply with a hearing
				  officer's decision regarding an appeal of an essential caregiver
				  revocation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 570 - LONG-TERM CARE PROVIDER RULES DURING A PUBLIC HEALTH EMERGENCY OR DISASTER › Subchapter D - HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 2 - HOSPICE AGENCIES OPERATING AN INPATIENT FACILITY › Section 570.325 - Visitation

Current through Reg. 49, No. 28; July 12, 2024
(a) A hospice agency operating a hospice
					 inpatient unit's visitation policies and procedures may change during a public
					 health emergency or disaster. A hospice agency operating a hospice inpatient
					 unit's policies and procedures may not be more restrictive than directives
					 issued by HHSC, DSHS, executive orders, or local orders.
(b) A hospice agency operating a hospice
					 inpatient unit must permit a religious counselor to visit a resident at the
					 request of the resident.
(c) A
					 hospice agency operating a hospice inpatient unit may not prohibit a client
					 from receiving in-person visitation with a religious counselor during a public
					 health emergency on request from the client, client's legally authorized
					 representative (LAR), or client's family member unless a federal law or a
					 federal agency requires the facility to prohibit in-person visitation during a
					 public health emergency.
(d) A
					 hospice agency operating a hospice inpatient unit must adopt policies and
					 procedures for in-person visitation with a religious counselor during a public
					 health emergency or disaster. These policies and procedures:
(1) must comply with the minimum health and
					 safety requirements for in-person visitation with religious counselors
					 developed by HHSC;
(2) may include
					 reasonable time, place, and manner restrictions on in-person visitation with
					 religious counselors to:
(A) mitigate the
					 spread of a communicable disease; and
(B) address the resident's medical
					 condition;
(3) must
					 include special consideration for residents receiving end-of-life care;
					 and
(4) may require religious
					 counselors to comply with a hospice agency operating a hospice inpatient unit's
					 guidelines, policies, and procedures for in-person visitation with a religious
					 counselor.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 570 - LONG-TERM CARE PROVIDER RULES DURING A PUBLIC HEALTH EMERGENCY OR DISASTER › Subchapter D - HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 2 - HOSPICE AGENCIES OPERATING AN INPATIENT FACILITY › Section 570.327 - Essential Caregiver Visits

Current through Reg. 49, No. 28; July 12, 2024
(a) A resident
					 or the resident's legally authorized representative (LAR), if the resident is
					 unable, has the right to designate at least one essential caregiver.
(b) A hospice agency operating a hospice
					 inpatient unit must permit essential caregiver visits except as provided by
					 subsection (i) of this section.
(c)
					 A hospice agency operating a hospice inpatient unit must develop a visitation
					 policy that permits an essential caregiver to visit the resident for at least
					 two hours each day.
(d) A hospice
					 agency operating a hospice inpatient unit must have procedures in place to
					 enable physical contact between the resident and the essential
					 caregiver.
(e) A hospice agency
					 operating a hospice inpatient unit must develop safety protocols for essential
					 caregiver visits. The safety protocols may not be more stringent for essential
					 caregivers than safety protocols for staff.
(f) A hospice agency operating a hospice
					 inpatient unit must obtain the signature of the essential caregiver certifying
					 that the essential caregiver will follow the facility's safety protocols for
					 essential caregiver visits.
(g) A
					 hospice agency operating a hospice inpatient unit may revoke an essential
					 caregiver designation if the caregiver violates the facility's safety protocols
					 or rules adopted under this chapter.
(h) If a hospice agency operating a hospice
					 inpatient unit revokes a person's designation as an essential caregiver under
					 subsection (g) of this section:
(1) the
					 resident or the resident's LAR has the right to immediately designate another
					 person as the essential caregiver;
(2) within 24 hours after the revocation, the
					 hospice agency operating a hospice inpatient unit must inform the resident or
					 the resident's LAR, in writing, of the right to appeal the revocation and the
					 with the Texas Health and Human Services Commission (HHSC) Appeals Division by:
(A) email at
					 OCC_Appeals_ContestedCases@hhs.texas.gov; or
(B) mail at HHSC Appeals Division, P.O. Box
					 149030, MC W-613, Austin, TX 78714-9030; and
(3) the hospice agency operating a hospice
					 inpatient unit must comply with a hearing officer's decision regarding an
					 appeal of an essential caregiver revocation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 570 - LONG-TERM CARE PROVIDER RULES DURING A PUBLIC HEALTH EMERGENCY OR DISASTER › Subchapter F - NURSING FACILITIES › Section 570.513 - Visitation

Current through Reg. 49, No. 28; July 12, 2024
(a) A nursing facility's visitation policies
				  and procedures may change during a public health emergency or disaster in
				  response to directives issued by the Centers for Medicare and Medicaid Services
				  (CMS), HHSC, or DSHS. Nursing facility (NF) visitation policies and procedures
				  may not be more restrictive than directives issued by CMS, HHSC, DSHS,
				  executive orders, or local orders.
(b) A NF must permit a religious counselor to
				  visit a resident at the request of the resident.
(c) A NF may not prohibit a resident from
				  receiving in-person visitation with a religious counselor during a public
				  health emergency on request from the resident, resident's legally authorized
				  representative (LAR), or resident's family member unless a federal law or a
				  federal agency requires the facility to prohibit in-person visitation during a
				  public health emergency.
(d) A NF
				  must adopt policies and procedures for in-person visitation with a religious
				  counselor during a public health emergency or disaster. These policies and
				  procedures:
(1) must comply with the minimum
				  health and safety requirements for in-person visitation with religious
				  counselors developed by HHSC;
(2)
				  may include reasonable time, place, and manner restrictions on in-person
				  visitation with religious counselors to:
(A)
				  mitigate the spread of a communicable disease; and
(B) address the resident's medical
				  condition;
(3) must
				  include special consideration for residents receiving end-of-life care;
				  and
(4) may require religious
				  counselors to comply with a NF's guidelines, policies, and procedures for
				  in-person visitation with a religious counselor.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 570 - LONG-TERM CARE PROVIDER RULES DURING A PUBLIC HEALTH EMERGENCY OR DISASTER › Subchapter F - NURSING FACILITIES › Section 570.514 - Essential Caregiver Visits

Current through Reg. 49, No. 28; July 12, 2024
(a) A resident
				  or the resident's legally authorized representative (LAR), if the resident is
				  unable, has the right to designate at least one essential caregiver.
(b) A nursing facility (NF) must permit
				  essential caregiver visits except as provided by subsection (j) of this
				  section.
(c) A NF must allow
				  essential caregiver visits to occur outdoors, in the resident's bedroom when
				  possible, or in another area upon request by a resident or resident's
				  LAR.
(d) A NF must develop a
				  visitation policy that permits an essential caregiver to visit the resident for
				  at least two hours each day.
(e) A
				  NF must have procedures in place to enable physical contact between the
				  resident and the essential caregiver, if the resident chooses to have physical
				  contact.
(f) A NF must develop
				  safety protocols for essential caregiver visits. The safety protocols may not
				  be more stringent for essential caregivers than safety protocols for
				  staff.
(g) A NF must obtain the
				  signature of the essential caregiver certifying that the essential caregiver
				  will follow the NF's safety protocols for essential caregiver visits.
(h) A NF may revoke an essential caregiver
				  designation if the caregiver violates the NF's safety protocols or rules
				  adopted under this chapter.
(i) If
				  A NF revokes a person's designation as an essential caregiver under subsection
				  (h) of this section:
(1) the resident or the
				  resident's LAR has the right to immediately designate another person as the
				  essential caregiver;
(2) within 24
				  hours after the revocation, the facility must inform the resident or the
				  resident's LAR, in writing, of the right to appeal the revocation and the
				  procedures for filing an appeal with the Texas Health and Human Services
				  Commission (HHSC) Appeals Division by:
(A)
				  email at OCC_Appeals_ContestedCases@hhs.texas.gov; or
(B) mail at HHSC Appeals Division, P.O. Box
				  149030, MC W-613, Austin, TX 78714-9030; and
(3) the NF must comply with a hearing
				  officer's decision regarding an appeal of an essential caregiver
				  revocation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 570 - LONG-TERM CARE PROVIDER RULES DURING A PUBLIC HEALTH EMERGENCY OR DISASTER › Subchapter G - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS › Section 570.611 - Visitation

Current through Reg. 49, No. 28; July 12, 2024
(a) An intermediate care facility for
				  individuals with an intellectual disability or related conditions (ICF/IID)
				  visitation policies and procedures may change during a public health emergency
				  or disaster. ICF/IID visitation policies and procedures may not be more
				  restrictive than directives issued by HHSC, DSHS, executive orders, or local
				  orders.
(b) An ICF/IID must permit
				  a religious counselor to visit an individual at the request of the
				  individual.
(c) An ICF/IID may
				  prohibit in-person visitation with a religious counselor during a public health
				  emergency if a federal law or federal agency requires the facility to prohibit
				  in-person visitation during that period.
(d) An ICF/IID must permit end-of-life visits
				  and immediately communicate any changes in an individual's condition that would
				  qualify the individual for end-of-life visits to the individual's
				  representative.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 570 - LONG-TERM CARE PROVIDER RULES DURING A PUBLIC HEALTH EMERGENCY OR DISASTER › Subchapter G - INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS › Section 570.613 - Essential Caregiver Visits

Current through Reg. 49, No. 28; July 12, 2024
(a) An
				  individual, or the individual's legally authorized representative (LAR), if the
				  individual is unable, has the right to designate at least one essential
				  caregiver.
(b) An intermediate care
				  facility for individuals with an intellectual disability or related conditions
				  (ICF/IID) must permit essential caregiver visits except as provided by
				  subsection (i) of this section.
(c)
				  An ICF/IID must develop a visitation policy that permits an essential caregiver
				  to visit the individual for at least two hours each day.
(d) An ICF/IID must have procedures in place
				  to enable physical contact between the individual and the essential
				  caregiver.
(e) An ICF/IID must
				  develop safety protocols for essential caregiver visits. The safety protocols
				  may not be more stringent for essential caregivers than safety protocols for
				  staff.
(f) An ICF/IID must obtain
				  the signature of the essential caregiver certifying that the essential
				  caregiver will follow the ICF/IID's safety protocols for essential caregiver
				  visits.
(g) An ICF/IID may revoke
				  an essential caregiver designation if the caregiver violates the facility's
				  safety protocols or rules adopted under this chapter.
(h) If an ICF/IID revokes a person's
				  designation as an essential caregiver under subsection (g) of this section:
(1) the individual or the individual's
				  legally authorized representative has the right to immediately designate
				  another person as the essential caregiver;
(2) within 24 hours after the revocation, the
				  ICF/IID must inform the individual or the individual's LAR, in writing, of the
				  right to an appeal the revocation and the procedures for filing an appeal with
				  the Texas Health and Human Services Commission (HHSC) Appeals Division by:
(A) email at
				  OCC_Appeals_ContestedCases@hhs.texas.gov; or
(B) mail at HHSC Appeals Division, P.O. Box
				  149030, MC W-613, Austin, TX 78714-9030; and
(3) the ICF/IID must comply with a hearing
				  officer's decision regarding an appeal of an essential caregiver
				  revocation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 570 - LONG-TERM CARE PROVIDER RULES DURING A PUBLIC HEALTH EMERGENCY OR DISASTER › Subchapter H - HOME AND COMMUNITY-BASED SERVICES › Section 570.711 - Visitation

Current through Reg. 49, No. 28; July 12, 2024
(a) This section does not apply to host
				  home/companion care, unless otherwise specified.
(b) A program provider's visitation policies
				  and procedures may change during a public health emergency or disaster. A
				  program provider's visitation policies and procedures may not be more
				  restrictive than directives issued by HHSC, DSHS, executive orders, or local
				  orders.
(c) A program provider must
				  permit a religious counselor to visit an individual at the request of the
				  individual.
(d) A program provider
				  may prohibit in-person visitation with a religious counselor during a public
				  health emergency if a federal law or federal agency requires the residence to
				  prohibit in-person visitation during that period.
(e) A program provider must permit
				  end-of-life visits and immediately communicate any changes in an individual's
				  condition that would qualify the individual for end-of-life visits to the
				  individual's representative.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 570 - LONG-TERM CARE PROVIDER RULES DURING A PUBLIC HEALTH EMERGENCY OR DISASTER › Subchapter H - HOME AND COMMUNITY-BASED SERVICES › Section 570.713 - Essential Caregiver Visits

Current through Reg. 49, No. 28; July 12, 2024
(a) An
				  individual, or individual's legally authorized representative (LAR), if the
				  individual is unable, has the right to designate at least one essential
				  caregiver.
(b) A program provider
				  must permit essential caregiver visits except as provided by subsection (i) of
				  this section.
(c) A program
				  provider must develop a visitation policy that permits an essential caregiver
				  to visit the individual for at least two hours each day.
(d) A program provider must have procedures
				  in place to enable physical contact between the individual and the essential
				  caregiver.
(e) A program provider
				  must develop safety protocols for essential caregiver visits. The safety
				  protocols may not be more stringent for essential caregivers than safety
				  protocols for staff.
(f) A program
				  provider must obtain the signature of the essential caregiver certifying that
				  the essential caregiver will follow the program provider's safety protocols for
				  essential caregiver visits.
(g) A
				  program provider may revoke an essential caregiver designation if the caregiver
				  violates the program provider's safety protocols or rules adopted under this
				  chapter.
(h) If a program provider
				  revokes a person's designation as an essential caregiver under subsection (g)
				  of this section:
(1) the individual, or
				  individual's LAR, has the right to immediately designate another person as the
				  essential caregiver;
(2) within 24
				  hours after the revocation, the program provider must inform the individual or
				  the individual's legally authorized representative, in writing, of the right to
				  an appeal the revocation and the procedures for filing an appeal with the Texas
				  Health and Human Services Commission (HHSC) Appeals Division by:
(A) email at
				  OCC_Appeals_ContestedCases@hhs.texas.gov; or
(B) mail at HHSC Appeals Division, P.O. Box
				  149030, MC W-613, Austin, TX 78714-9030; and
(3) a program provider must comply with a
				  hearing officer's decision regarding an appeal of an essential caregiver
				  revocation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 600 - LIMITED SERVICES RURAL HOSPITALS › Section 600.1 - Limited Services Rural Hospital

Current through Reg. 49, No. 28; July 12, 2024
(a) Based on Texas
				Health and Safety Code (HSC) Chapter 241, Subchapter K (relating to Limited
				Services Rural Hospital), as added by Senate Bill 1621, 86th Legislature,
				Regular Session, 2019, the Texas Health and Human Services Commission (HHSC)
				adopts this emergency rule to establish requirements for qualified rural
				hospitals to apply to HHSC for a limited services rural hospital (LSRH) license
				and forego any conflicting inpatient license and operational requirements, to
				protect public health and safety of rural communities until HHSC adopts
				standard rules for LSRH licensure in the Texas Administrative Code.
(b) To the extent this emergency rule
				conflicts with Texas Administrative Code Title 25 (25 TAC) Chapter 133
				(relating to Hospital Licensing), this emergency rule controls.
(c) In this section, "qualified rural
				hospital" means a hospital that meets the requirements to be designated as a
				rural emergency hospital under the Code of Federal Regulations Part 42 (42 CFR)
				§485.502 (relating to Definitions), and §485.506 (relating to
				Designation and certification of REHs) that is currently licensed under HSC
				Chapter 241 (relating to Hospitals); and is:
(1) located in a rural area, as defined by
				United State Code Title 42 Section 1395ww(d)(2)(D); or
(2) designated by the Centers for Medicare
				and Medicaid Services as a critical access hospital, rural referral center, or
				sole community hospital.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 711 - INVESTIGATIONS OF INDIVIDUALS RECEIVING SERVICES FROM CERTAIN PROVIDERS › Subchapter A - INTRODUCTION › Section 711.1 - What is the purpose of this chapter?

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this chapter is to:
(1) implement Human Resources Code (HRC),
				  Chapter 48, Subchapter F, and Texas Family Code §
										261.404;
(2) describe:
(A) Adult Protective Services (APS)
				  investigations of allegations of abuse, neglect, and exploitation involving:
(i) adults or children receiving services
				  from a provider, as that term is defined in HRC § 48.251(9), if the person
				  alleged or suspected to have committed the abuse, neglect, or exploitation is a
				  provider;
(ii) adults or children
				  who live in a residence that is owned, operated, or controlled by a provider in
				  the home and community-based services (HCS) waiver program described by §
												534.001(11)(B),
				  Government Code, regardless of whether the individual is receiving services
				  under the home and community-based services (HCS) waiver program; and
(iii) children receiving services from a home
				  and community support services agency licensed under Chapter 142, Health and
				  Safety Code, if the person alleged or suspected to have committed the abuse,
				  neglect, or exploitation is an officer, employee, agent, contractor, or
				  subcontractor of the home and community support services agency; and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 711 - INVESTIGATIONS OF INDIVIDUALS RECEIVING SERVICES FROM CERTAIN PROVIDERS › Subchapter A - INTRODUCTION › Section 711.3 - How are the terms in this chapter defined?

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this chapter,
					 have the following meanings, unless the context clearly indicates
					 otherwise:
(1) Adult--An adult is a
				  person:
(A) 18 years of age or older;
				  or
(B) under 18 years of age who:
(i) is or has been married; or
(ii) has had the disabilities of minority
				  removed pursuant to the Texas Family Code, Chapter 31.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 711 - INVESTIGATIONS OF INDIVIDUALS RECEIVING SERVICES FROM CERTAIN PROVIDERS › Subchapter A - INTRODUCTION › Section 711.5 - What does APS investigate under this chapter?

Current through Reg. 49, No. 28; July 12, 2024
(a) When the alleged perpetrator is a direct
				  provider, or is unknown, and the alleged victim is an individual receiving
				  services, APS investigates the following allegation types:
(1) physical abuse;
(2) sexual abuse;
(3) verbal/emotional abuse;
(4) neglect; and
(5) exploitation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 711 - INVESTIGATIONS OF INDIVIDUALS RECEIVING SERVICES FROM CERTAIN PROVIDERS › Subchapter A - INTRODUCTION › Section 711.7 - What does APS not investigate under this chapter?

Current through Reg. 49, No. 28; July 12, 2024
APS does not investigate:
(1) if another branch of HHSC or another
				  state agency is responsible under state law for the investigation;
(2) general complaints such as:
(A) rights violations;
(B) daily administrative
				  operations;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 711 - INVESTIGATIONS OF INDIVIDUALS RECEIVING SERVICES FROM CERTAIN PROVIDERS › Subchapter A - INTRODUCTION › Section 711.11 - How is physical abuse defined?

Current through Reg. 49, No. 28; July 12, 2024
In this chapter, when the alleged perpetrator is a direct
					 provider, physical abuse is defined as:
(1) an act or failure to act performed
				  knowingly, recklessly, or intentionally, including incitement to act, which
				  caused or may have caused physical injury or death to an individual receiving
				  services;
(2) an act of
				  inappropriate or excessive force or corporal punishment, regardless of whether
				  the act results in a physical injury to an individual receiving services;
				  or
(3) the use of chemical or
				  bodily restraints or seclusion on an individual receiving services not in
				  compliance with federal and state laws and regulations, including:
(A) 25 TAC Chapter 415, Subchapter F
				  (relating to Interventions in Mental Health Programs);
(B) 25 TAC Chapter 404, Subchapter E
				  (relating to Rights of Persons Receiving Mental Health Services);
(C) 40 TAC Chapter 3, Subchapter F (relating
				  to Restraints);
(D) 40 TAC Chapter
				  90, Subchapter C (relating to Standards for Licensure);
(E) 40 TAC Chapter 2, Subchapter G (relating
				  to Role and Responsibilities of a Local Authority);
(F) 40 TAC Chapter 9, Subchapter D (relating
				  to Home and Community-based Services (HCS) Program and Community First Choice
				  (CFC));
(G) 40 TAC Chapter 9,
				  Subchapter N (relating to Texas Home Living (TxHmL) Program and Community First
				  Choice (CFC));
(H) 26 TAC Chapter
				  558, Subchapter H (relating to Standards Specific to Agencies Licensed to
				  Provide Hospice Services );
(I) 40
				  TAC Chapter 42, Subchapter D (relating to Additional Program Provider
				  Provisions);
(J) 1 TAC Chapter 353,
				  Subchapter C (relating to Member Bill of Rights); and
(K) 40 TAC Chapter 45, Subchapter H (relating
				  to Additional DSA Requirements).