reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 103 - INJURY PREVENTION AND CONTROL › Section 103.3 - Confidentiality

Current through Reg. 49, No. 28; July 12, 2024
(a) All information
				and records relating to injuries received by the local health authority or the
				department, including information electronically submitted to the Texas EMS
				& Trauma Registries and information from injury investigations, are
				sensitive, confidential, and not public records.
(b) These records shall be held in a secure
				place and accessed only by authorized personnel. All communications pertaining
				to these records shall be clearly labeled "Confidential" and will follow
				established departmental internal protocols and procedures.
(c) Information or records relating to any
				personal injury may not be released or made public on subpoena or otherwise,
				except that release may be made:
(1) for
				statistical purposes, if released in a manner that prevents the identification
				of any person;
(2) with the consent
				of each person identified in the information released; or
(3) to medical personnel in a medical
				emergency to the extent necessary to protect the health or life of the named
				person.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 103 - INJURY PREVENTION AND CONTROL › Section 103.4 - Who Shall Report and List of Reportable Injuries and Events

Current through Reg. 49, No. 28; July 12, 2024
Injuries and events listed below to be reported are defined
				  in §
									103.2 of
				  this title (relating to Definitions).
(1) EMS Provider--All EMS runs.
(2) Justice of the peace --
(A) Submersion injuries.
(B) Traumatic brain injuries.
(C) Spinal cord injuries.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 103 - INJURY PREVENTION AND CONTROL › Section 103.5 - Reporting Requirements for EMS Providers

Current through Reg. 49, No. 28; July 12, 2024
(a) General Information.
(1) All data must be transmitted
				electronically to the Texas EMS & Trauma Registries within ninety calendar
				days of the date of call for assistance; monthly submissions are
				recommended.
(2) EMS providers must
				report no reportable data (NRD) to the Registries monthly for any given month
				with no runs.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 103 - INJURY PREVENTION AND CONTROL › Section 103.6 - Reporting Requirements for Physicians, Medical Examiners, and Justices of the Peace

Current through Reg. 49, No. 28; July 12, 2024
(a) General
				Information.
be transmitted electronically to the Texas EMS & Trauma
				  Registries within ninety calendar days of the date of examination; monthly
				  submissions are recommended.
(b) Data Elements and Methods.
(1) Data elements defined by the appropriate
				data dictionaries for all required reportable events, must be submitted to the
				department's online Registries.
(2) If a specialized reporting system exists
				for a required reportable event, then the case or suspected case must be
				submitted to all relevant reporting systems.
(3) Hospitals can report the data elements as
				defined by the appropriate data dictionaries to the Registries on behalf of
				physicians.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 103 - INJURY PREVENTION AND CONTROL › Section 103.7 - Reporting Requirements for Hospitals

Current through Reg. 49, No. 28; July 12, 2024
(a) General Information.
(1) All data must be transmitted
				electronically to the Texas EMS & Trauma Registries within ninety calendar
				days of the date of discharge from their facility; monthly submissions are
				recommended.
(2) Hospitals must
				report no reportable data (NRD) to the Registries monthly for any given month
				with no required reportable event.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 103 - INJURY PREVENTION AND CONTROL › Section 103.8 - Reporting Requirements for Acute or Post-Acute Rehabilitation Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) General
				Information.
(1) All data must be transmitted
				electronically to the Texas EMS & Trauma Registries within ninety calendar
				days of the date of discharge from their facility; monthly submissions are
				recommended.
(2) Acute or
				post-acute rehabilitation facilities must report no reportable data (NRD) to
				the Registries monthly for any given month with no required reportable
				event.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 104 - CHILDREN PARTICIPATING IN RODEOS › Section 104.1 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of these sections is to establish standards for
				  protective vests and bull riding helmets for children who participate in
				  rodeos; and requirements for an education program on safety, including the
				  proper use of protective gear for children planning to participate in rodeos.
				  These standards are implemented under Health and Safety Code, Chapter
				  768.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 104 - CHILDREN PARTICIPATING IN RODEOS › Section 104.2 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in these sections,
				  shall have the following meanings, unless the context clearly indicates
				  otherwise.
(1) Bull riding helmet--A
				rodeo helmet that is designed to provide substantial protection for a person's
				head and face during bull riding.
(2) Child or Children--A person under 18
				years of age.
(3) National Health
				Education Standards (NHES)--A statement from The Joint Committee on National
				Health Education Standards.
National Health Education Standards:
				Achieving Excellence
(2nd Edition). Atlanta: American Cancer Society,
				2007, a nationally-accepted framework of health standards and expectations
				which aligns curriculum, instruction and assessment practices to promote
				personal, family and community health.
(4) Promote--A primary or secondary school
				that helps or encourages; or advertises or advocates for a rodeo event to exist
				or flourish; or, encourages or advertises rodeo ticket or rodeo-related
				merchandise sales; or demonstrates acceptance of rodeo through advertising or
				other print or electronic publicity such as posters, Web sites or radio
				announcements.
(5) Protective
				vest--Protective clothing that covers a person's chest and torso to prevent or
				mitigate injury to those areas.
(6)
				Rodeo--An exhibition or competition, without regard to whether the participants
				are compensated, involving activities related to cowboy skills, including:
(A) riding a horse, with or without a saddle,
				with the goal of remaining on the horse while it attempts to throw off the
				rider;
(B) riding a bull;
(C) roping an animal, including roping as
				part of a team;
(D) wrestling a
				steer; and
(E) riding a horse in a
				pattern around preset barrels or other obstacles.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 104 - CHILDREN PARTICIPATING IN RODEOS › Section 104.3 - Standards for Protective Vests and Bull Riding Helmets for Children Who Participate in Rodeos

Current through Reg. 49, No. 28; July 12, 2024
A child may not engage in, and a parent or legal guardian of
				  the child may not knowingly or recklessly permit the child to engage in, bull
				  riding, including engaging in bull riding outside a rodeo for the purpose of
				  practicing bull riding, unless the child is wearing a protective vest and bull
				  riding helmet. To satisfy the requirement of this section, the following
				  applies.
(1) The bull riding helmet
				worn by the child must meet the American Society for Testing and Materials
				(ASTM) standards for "Protective Headgear with Faceguard Used in Bull Riding; F
				2530-05" or the most current version of the standards.
(2) The protective vest worn by the child
				must meet ASTM standards for "Body Protectors Used in Horse Sports and
				Horseback Riding; F 1937 - 04" or the most current version of the
				standards.
(3) These standards
				apply to the following.
(A) Rodeos associated
				with primary and secondary schools.
(B) Schools that sponsor, advertise or
				promote; or, are otherwise associated with a rodeo in which children who attend
				the school are likely to participate.
(C) Children who are participating in or
				engaging in bull riding outside a rodeo for the purpose of practicing bull
				riding.
(D) A parent or legal
				guardian of a child engaging in bull riding including outside the rodeo for the
				purpose of practice.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 104 - CHILDREN PARTICIPATING IN RODEOS › Section 104.4 - Requirements for an Educational Program on Safety

Current through Reg. 49, No. 28; July 12, 2024
(a) Applies only to a primary or secondary
				school that sponsors, advertises or promotes; or, otherwise is associated with
				a rodeo in which children who attend the school are likely to
				participate.
(b) Not more than one
				year before the first day of a rodeo associated with a primary or secondary
				school, the school will conduct a mandatory education program each school year
				on safety for children planning on participating in the rodeo.
(c) A child may not participate in a rodeo
				associated with a child's school during a school year unless the child has
				completed the educational program.
(d) The educational program will have the
				following requirements.
(1) The educational
				program must cover the proper use of rodeo protective gear.
(2) Criteria for program development should
				be based on the NHES for designing injury prevention and safety
				curricula.
(3) Information taught
				must reflect the required age-appropriate TEKS that promote healthy behavior
				and reduce personal risk as it relates to injury prevention.
(4) The method of delivery of the educational
				program may be an instructional video or any other instructional medium that
				contains information consistent with the TEKS and NHES.
(5) Compliance with this section is
				equivalent to approval by the Department of State Health Services.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 104 - CHILDREN PARTICIPATING IN RODEOS › Section 104.5 - Compliance Date of Rules

Current through Reg. 49, No. 28; July 12, 2024
To allow preparation for children to fully participate in
				  rodeos, these rules will be effective August 1, 2011.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 111 - SPECIAL HEALTH SERVICES › Section 111.2 - Memorandum of Understanding Concerning Hospitals and Long-Term Care Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) The Texas
				Department of Health adopts by reference a memorandum of understanding entered
				into by the Texas Department of Health, the Texas Department of Human Services,
				and the Texas Department of Mental Health and Mental Retardation concerning the
				responsibilities, regulation, and/or funding of hospitals and long-term care
				facilities.
(b) Copies of the
				memorandum of understanding are filed in the Associateship of Special Health
				Services, Texas Department of Health, 1100 West 49th Street, Austin, Texas
				78756, and may be reviewed during regular business hours.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 111 - SPECIAL HEALTH SERVICES › Section 111.3 - Reporting Obligation by the Department of Agency Regulatory Survey Information

Current through Reg. 49, No. 28; July 12, 2024
(a) Each
				department, bureau, and division which surveys the quality of professional
				nursing care provided in health care facilities or agencies shall report in
				writing any unsafe nursing care to the Board of Nurse Examiners. This unsafe
				nursing care involves any registered nurse that the department has reason to
				believe exposed or is likely to expose patients or other persons unnecessarily
				to risk of harm because of unprofessional conduct, failure to care adequately
				for a patient, failure to conform to the minimum standards of acceptable
				professional nursing practice, or impaired status.
(b) The written report to the Board of Nurse
				Examiners shall be submitted by the surveyor to his or her immediate supervisor
				within the department. This report shall be subject to the established
				department internal review procedure. All reports to the Board of Nurse
				Examiners shall be transmitted from the office of the associate commissioner
				from which it originated.
(c) The
				department may opt to report a nurse suspected of or impaired by dependency on
				chemicals or by mental illness to the peer assistance program (approved by the
				Board of Nurse Examiners) in lieu of reporting to the Board of Nurse
				Examiners.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 113 - SPECIAL HEALTH SERVICES PERMITS › Section 113.1 - Processing Permits for Special Health Services Professionals

Current through Reg. 49, No. 28; July 12, 2024
(a) Purpose. The
				purpose of this section is to describe the time periods by which the department
				processes applications for licensure, certification, registration, and
				permitting of special health services professionals.
(b) First time period. The first period is a
				time from the receipt of an application to the date of issuance of a written
				notice that the application is complete or that additional specific information
				is required. A written notice stating the application has been approved may be
				sent in lieu of the notice of acceptance of a complete application. The time
				periods for each application are as follows:
(1) Dietitians. The letter of application
				acceptance for licensure and provisional licensure is 14 days; the letter of
				deficiency is 14 days; and the issuance of renewal license and provisional
				license is 20 days.
(2) Massage
				therapists. The letter of application acceptance for registration, instructor
				approval, and school approval is 14 days; the letter of deficiency is 14 days;
				and the issuance of renewal registration is 20 days.
(3) Athletic trainers. The letter of
				application acceptance for licensure is 14 days; the letter of deficiency is 30
				days; and the issuance of renewal license is 20 days.
(4) Medication aides. The letter of
				application acceptance/ ineligibility for permit is 14 days; the letter of
				deficiency is 14 days; and the issuance of renewal permit is 20 days.
(5) Professional counselors. The letter of
				application acceptance for licensure is 20 days; the letter of deficiency is 20
				days; and the issuance of license renewal after receipt of documentation of all
				renewal requirements is 10 days.
(6) Respiratory therapists. The letter of
				application acceptance for certificate or temporary permit is 14 days. The
				notice of acceptance may include a statement that an application for temporary
				permit received more than 45 days from the date of the applicant's graduation
				will be held pending until the applicant is within 45 days of graduation; the
				letter of deficiency is 14 days; and the issuance of renewal certificate after
				receipt of documentation of all renewal requirements is 14 days.
(7) Speech-language
				pathologists/audiologists. The letter of application acceptance for licensure
				is 15 days; the letter of deficiency is 15 days; the letter of application
				acceptance for temporary certificate of registration is 150 days; and the
				issuance of license renewal after receipt of documentation of all renewal
				requirements is 14 days.
(8)
				Medical radiologic technologists. The letter of application acceptance for all
				categories is 21 days; the letter of deficiency for all categories is 21 days;
				and the issuance of renewal certificate is 21 days.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 113 - SPECIAL HEALTH SERVICES PERMITS › Section 113.2 - Time Periods for Processing and Issuing Licenses for Health Care Providers

Current through Reg. 49, No. 28; July 12, 2024
(a) Definitions.
				The following words and terms, when used in this section, shall have the
				following meaning, unless the context clearly indicates otherwise.
(1) Health care providers-Licensed home
				health agencies, ambulatory surgical centers, birthing centers, and abortion
				facilities.
(2) Small business-A
				corporation, partnership, sole proprietorship, or other legal entity that is
				formed for the purpose of making a profit, that is independently owned and
				operated, and that has either fewer than 100 employees or less than $1 million
				in annual gross receipts.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter A - GENERAL PROVISIONS › Section 117.1 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
(a) The purpose of
				  this chapter is to implement Health and Safety Code, Chapter 251, which
				  requires an end stage renal disease facility providing routine, repetitive,
				  outpatient dialysis to be licensed by the Department of State Health
				  Services.
(b) This chapter provides
				  minimum standards for the equipment used by the facility; water treatment and
				  reuse; sanitary and hygienic conditions; quality assessment and performance
				  improvement; indicators of quality of care; provision and coordination of
				  treatment and services; qualifications and supervision of the professional
				  staff, including physicians and other personnel; clinical records; curricula
				  and instructors used to train dialysis technicians; the competency evaluation
				  of dialysis technicians; enforcement standards, fire prevention and safety
				  requirements; and physical plant and construction requirements.
(c) Compliance with this chapter does not
				  constitute release from the more stringent requirements of other applicable
				  federal, state, or local codes and ordinances. This chapter shall be followed
				  where it is more stringent than other codes and ordinances.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter A - GENERAL PROVISIONS › Section 117.2 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this chapter,
					 shall have the following meanings, unless the context clearly indicates
					 otherwise.
(1) Action level--The point
				  at which steps shall be taken to interrupt the trend towards unacceptable
				  levels.
(2) Administrator--A person
				  who is delegated the responsibility for the implementation and proper
				  application of policies, programs, and services established for the end stage
				  renal disease facility.
(3)
				  Advanced practice registered nurse (APRN)--A registered nurse who is currently
				  licensed and authorized by the Texas Board of Nursing to practice.
(4) Adverse event--An event that results in
				  unintended harm to the patient by an act of commission or omission rather than
				  by the underlying disease or condition of the patient or those events affecting
				  patient's family members, visitors, or staff.
(5) Affiliate--An applicant or owner which
				  is:
(A) a corporation--includes each officer,
				  consultant, stockholder with a direct ownership of at least 5.0%, subsidiary,
				  and parent company;
(B) a limited
				  liability company--includes each officer, member, and parent company;
(C) an individual--includes:
(i) an individual;
(ii) an individual's spouse if the spouse is
				  actively involved in the management of the facility;
(iii) each partnership and each partner
				  thereof of which the individual or any affiliate of the individual is a
				  partner; and
(iv) each corporation
				  in which the individual is an officer, consultant, or stockholder with direct
				  ownership of at least 5.0%.
(D) a partnership--includes each partner and
				  any parent company; and
(E) a group
				  of co-owners under any other business arrangement--includes each officer,
				  consultant, or the equivalent under the specific business arrangement and each
				  parent company.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter B - APPLICATION AND ISSUANCE OF A LICENSE › Section 117.11 - General Requirements for a License

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility shall obtain a license prior
				  to admitting patients.
(b) A
				  facility shall prominently and conspicuously display the license in a public
				  area of the licensed premises that is readily visible to patients, employees,
				  and visitors.
(c) A facility
				  license shall not be altered.
(d) A
				  facility license shall not be transferred or assigned. The facility shall
				  comply with the provisions of §
										117.12(a)
				  of this title (relating to Application and Issuance of Initial License) in the
				  event of a change in the ownership.
(e) The following facilities are not required
				  to be licensed under this chapter:
(1) a home
				  and community support services agency licensed under Health and Safety Code,
				  Chapter 142, Subchapter A, with a home dialysis designation;
(2) a hospital licensed under Health and
				  Safety Code, Chapter 241, Subchapter B, that provides dialysis only to:
(A) individuals receiving inpatient services
				  from the hospital; or
(B)
				  individuals temporarily receiving outpatient services from the hospital due to
				  a disaster declared by the governor or a federal disaster declared by the
				  president of the United States occurring in this state or another state during
				  the term of the disaster declaration; or
(3) the office of a physician unless the
				  office is used primarily as an end stage renal disease facility.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter B - APPLICATION AND ISSUANCE OF A LICENSE › Section 117.12 - Application and Issuance of Initial License

Current through Reg. 49, No. 28; July 12, 2024
(a) The applicant shall comply with the
				  following before the projected opening date of the facility:
(1) the applicant shall submit an accurate
				  and complete application form;
(2)
				  the applicant shall submit the appropriate license fee as required in §
											117.16 of this
				  title (relating to Fees); and
(3)
				  as of February 9, 2009, the applicant for a new facility or for an existing
				  facility that is increasing the number of in-center dialysis treatment stations
				  in existing facilities shall have an isolation room or shall provide a waiver
				  by the Centers for Medicare and Medicaid Services. The waiver shall demonstrate
				  that there is sufficient capacity in the geographic area for isolation rooms
				  for hepatitis B positive patients. An applicant may submit a written request
				  for waiver through the Texas Department of State Health Services, Health
				  Facility Compliance Group, Mail Code 1979, P.O. Box 149347, Austin, Texas,
				  78714-9347 for transmission to CMS.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter B - APPLICATION AND ISSUANCE OF A LICENSE › Section 117.13 - Application and Issuance of Renewal License

Current through Reg. 49, No. 28; July 12, 2024
(a) The department may send a renewal notice
				  to a facility up to 90 calendar days prior to the expiration date of a license.
(1) If the facility has not received the
				  renewal notice from the department at least 30 calendar days before the
				  expiration date, the facility shall notify the department and request a renewal
				  application for a license.
(2) If
				  the facility fails to submit the application and fee at least 15 calendar days
				  before the expiration date of the license, the department shall send to the
				  facility a letter advising that, unless the license is renewed, the facility
				  shall cease operations upon the expiration of the license.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter B - APPLICATION AND ISSUANCE OF A LICENSE › Section 117.14 - Changes in Status

Current through Reg. 49, No. 28; July 12, 2024
(a) A change of
				  ownership occurs when there is a change in the person legally responsible for
				  the operation of the facility, whether by lease or by ownership. If a corporate
				  licensee amends its articles of incorporation to revise its name, this
				  subsection does not apply, except that the corporation shall notify the
				  department not later than the 10th calendar day after the effective date of the
				  name change. The sale of stock of a corporate licensee does not cause this
				  subsection to apply.
(1) The new owner shall
				  submit an application for an initial license to the department at least 60 days
				  before the date of the change of ownership. The application shall be in
				  accordance with subsections (a) and (b) of this section. The applicant shall
				  include the effective date of the change of ownership. The new owner shall be
				  responsible for previous regulatory violations, and shall ensure compliance
				  with all rules and regulations.
(2)
				  The inspection required by subsection (h) of this section may be waived by the
				  department.
(3) When the new owner
				  has complied with the provisions of subsections (a) and (b) of this section,
				  the department shall issue a license which shall be effective the date of the
				  change of ownership.
(4) The
				  expiration date of the license shall be in accordance with subsection (e)(2) of
				  this section.
(5) The previous
				  owner's license shall be void on the effective date of the new owner's
				  license.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter B - APPLICATION AND ISSUANCE OF A LICENSE › Section 117.15 - Inactive Status and Closure

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  department will automatically retire the license of an ESRD facility in which
				  services are suspended or not provided for more than 60 days, unless the
				  facility sends a written request to place the license on inactive status. To be
				  eligible for inactive status, the facility must be in good standing with no
				  pending legal actions or investigations.
(1)
				  If granted, inactive status is limited to 60 days. The licensee is responsible
				  for all licensure fees and for proper maintenance of client records while on
				  inactive status.
(2) To reactivate
				  the license, the facility shall submit a written request to reactivate the
				  license no later than the date the inactivation period expires.
(3) If the license is not reactivated, it
				  will be automatically retired at the end of the 60 day deactivation
				  period.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter B - APPLICATION AND ISSUANCE OF A LICENSE › Section 117.16 - Fees

Current through Reg. 49, No. 28; July 12, 2024
(a) General.
(1) All fees paid to the department are
				  nonrefundable.
(2) All fees shall
				  be paid to the department.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter B - APPLICATION AND ISSUANCE OF A LICENSE › Section 117.17 - Time Periods for Processing and Issuing a License

Current through Reg. 49, No. 28; July 12, 2024
(a) General.
(1) The date a license application is
				  received is the date the application reaches the department.
(2) An application for an initial license is
				  complete when the department has received, reviewed, and found acceptable the
				  information described in §
											117.12
				  of this title (relating to Application and Issuance of Initial
				  License).
(3) An application for a
				  renewal license is complete when the department has received, reviewed and
				  found acceptable the information described in §
											117.13
				  of this title (relating to Application and Issuance of Renewal
				  License).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter B - APPLICATION AND ISSUANCE OF A LICENSE › Section 117.18 - Inspections

Current through Reg. 49, No. 28; July 12, 2024
(a) The department
				  may conduct an inspection at any time to verify compliance with the statute or
				  this chapter. By applying for or holding a license, the facility consents to
				  entry and inspection of the facility by the department or representative of the
				  department in accordance with the statute and this chapter.
(1) An authorized representative of the
				  department (surveyor) may enter the premises of a license applicant or license
				  holder at reasonable times during business hours to conduct an on-site
				  inspection incidental to the issuance of a license, and at other times as the
				  department considers necessary to ensure compliance with:
(A) the statute or this chapter;
(B) an order of the commissioner;
(C) a court order granting injunctive
				  relief;
(D) a corrective action
				  plan; or
(E) other enforcement
				  action(s).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter B - APPLICATION AND ISSUANCE OF A LICENSE › Section 117.19 - Exceptions to These Rules

Current through Reg. 49, No. 28; July 12, 2024
(a) All ESRD
				  facilities are required to maintain continuous compliance with these rules. The
				  rules do not prohibit the request for temporary exceptions. These may include
				  alternative concepts, methods, procedures, techniques, Food and Drug
				  Administration (FDA) approved equipment, facilities during an emergency
				  disaster situation, or for the conducting of pilot projects or research.
				  Requests for temporary exceptions to these rules shall:
(1) be submitted to the department in
				  writing;
(2) identify the specific
				  rule for which an exception is requested;
(3) describe in detail the specific
				  circumstances which are believed by facility administration to justify the
				  exception;
(4) describe in detail
				  what alternatives were considered, if any, and why alternatives (including
				  compliance with the rule) were not selected;
(5) demonstrate that the proposed exception
				  is desirable to maintain or improve the health and safety of the patients, will
				  not jeopardize patient health and safety, and will maintain patient access to
				  care;
(6) describe the proposed
				  duration of the exception; and
(7)
				  requests for exceptions for facilities during emergency disaster situations
				  shall be submitted to Health Facility Compliance Group of the Patient Quality
				  Care Unit for the department:
(A) may only be
				  granted in an emergency situation for a maximum of 120 days, with a single
				  renewal period for an additional 120 days;
(B) the facility shall develop an action plan
				  to resolve the staffing crisis situation;
(C) the facility shall submit the action plan
				  to the department not later than the 60th calendar day after the department
				  grants the exception;
(D) during
				  the period of exception to staffing requirements, the facility shall monitor
				  outcome data related to quality of care and report these outcomes on a monthly
				  basis to the department; and
(E) an
				  exemption from clinical records for evacuees; except that the facility shall
				  assess and document the hepatitis and tuberculosis status of the affected
				  patient(s). The following items shall be obtained at a minimum:
(i) patient's name, address, date of birth,
				  payor information if available; and
(ii) name, address, and telephone number of
				  patient's usual dialysis facility.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter C - MINIMUM STANDARDS FOR EQUIPMENT, WATER TREATMENT AND REUSE, AND SANITARY AND HYGIENIC CONDITIONS › Section 117.31 - Equipment

Current through Reg. 49, No. 28; July 12, 2024
(a) All equipment
				  used by a facility, including backup equipment, shall be FDA approved, operated
				  in accordance with the manufacturer's direction for use, and maintained free of
				  defects which could be a potential hazard to patients, staff, or visitors.
				  Maintenance and repair of all equipment shall be performed by qualified staff
				  or contract personnel.
(1) Staff shall be
				  able to identify malfunctioning equipment and report such equipment to the
				  appropriate staff for immediate repair.
(2) Medical equipment that malfunctions shall
				  be clearly labeled and immediately removed from service until the malfunction
				  is identified and corrected.
(3) A
				  record of all maintenance and repairs shall be maintained.
(4) After repairs or alterations are made to
				  any equipment or system, the equipment or system shall be thoroughly tested for
				  proper operation and disinfected before returning to service.
(5) A facility shall comply with the Federal
				  Food, Drug, and Cosmetic Act, 21 United States Code (USC), §360i(b),
				  concerning reporting when a medical device as defined in
				  21 USC
				  §321(h) has or may have
				  caused or contributed to the injury or death of a patient of the
				  facility.
(6) Completion of the
				  requirements listed in paragraphs (1) - (5) of this subsection shall be
				  documented on the facility's equipment or system repair log.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter C - MINIMUM STANDARDS FOR EQUIPMENT, WATER TREATMENT AND REUSE, AND SANITARY AND HYGIENIC CONDITIONS › Section 117.32 - Water Treatment, Dialysate Concentrates, and Reuse

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility shall meet the requirements of
				  this section. A facility may follow more stringent requirements than the
				  minimum standards required by this section.
(1) The facility owner and medical director
				  shall each demonstrate responsibility for the water treatment and dialysate
				  supply systems to protect hemodialysis patients from adverse effects arising
				  from known chemical and microbial contaminates that may be found in water and
				  improperly prepared dialysate, to ensure that the dialysate is correctly
				  formulated and meets the requirements of all applicable quality
				  standards.
(2) The facility owner
				  and medical director shall each assure that policies and procedures related to
				  water treatment, dialysate, and reuse are understandable and accessible to the
				  operator(s), and that the training program includes quality testing, risks and
				  hazards of improperly prepared concentrate, and bacterial issues.
(3) The facility owner and medical director
				  shall be informed prior to any alteration of, or any device being added to, the
				  water system.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter D - MINIMUM STANDARDS FOR PATIENT CARE AND TREATMENT › Section 117.41 - Governing Body

Current through Reg. 49, No. 28; July 12, 2024
(a) There shall be
				  an identified governing body responsible for the organization, management,
				  control, and operation of the facility, including the appointment of the
				  facility's medical director as defined in §
										117.2(48) of this
				  title (relating to Definitions).
(1) A
				  qualified medical director is a physician who is board certified in internal
				  medicine by the American Board of Internal Medicine or pediatrics by the
				  American Board of Pediatrics or is board certified in nephrology or pediatric
				  nephrology, and has at least 12 months of experience providing care to patients
				  receiving dialysis.
(2) A facility
				  may request a waiver to appoint or retain as medical director a physician who
				  does not meet one or more of the qualifications in paragraph (1) of this
				  subsection. The waiver shall explain why a physician meeting the board
				  certification requirement is not available and include a resume of the
				  physician the facility seeks to appoint or retain. A written request for waiver
				  shall be made through the Texas Department of State Health Services, Health
				  Facility Compliance Group, Mail Code 1979, P.O. Box 149347, Austin, Texas,
				  78714-9347 for transmission to CMS.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter D - MINIMUM STANDARDS FOR PATIENT CARE AND TREATMENT › Section 117.44 - Indicators of Quality of Care

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Each facility shall submit an annual report to the department through reports
				  required by the Centers for Medicare and Medicaid Services or the department's
				  designee to include aggregate data on specified indicators of the quality of
				  care provided to patients. Examples of indicators include:
(1) anemia management;
(2) measures of the adequacy of
				  dialysis;
(3) vascular access
				  management; and
(4) hospitalization
				  rate.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter D - MINIMUM STANDARDS FOR PATIENT CARE AND TREATMENT › Section 117.48 - Incident Reports

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility
				  shall report the following incident(s) to the department within ten working
				  days:
(1) death of a dialysis patient, which
				  occurs in the facility, at home, or in a hospital;
(2) hospital transfers;
(3) conversion of staff or a patient to
				  hepatitis B surface antigen (HbsAg) positive;
(4) involuntary transfer or discharge of a
				  patient; and
(5) a fire in the
				  facility.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter D - MINIMUM STANDARDS FOR PATIENT CARE AND TREATMENT › Section 117.49 - Miscellaneous Policies and Protocols

Current through Reg. 49, No. 28; July 12, 2024
A licensed end stage renal disease facility shall not
					 discriminate based on a patient's disability and shall comply with Texas Health
					 and Safety Code Chapter 161, Subchapter S (relating to Allocation of Kidneys
					 and Other Organs Available for Transplant).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter E - DIALYSIS TECHNICIANS › Section 117.61 - General Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) An
				  individual may not act as a dialysis technician unless that individual is
				  trained and competent under this subchapter.
(b) Trainees shall be identified as such
				  during any time spent in the patient treatment area.
(c) Until the successful completion of the
				  competency evaluation, the trainee may provide patient care only as part of a
				  training program and under the immediate supervision of a registered nurse or
				  an assigned preceptor. A preceptor shall be a licensed nurse or dialysis
				  technician who has one year of experience in hemodialysis obtained within the
				  last 24 months, a recommendation by the supervising nurse to be a preceptor,
				  and a current competency skills checklist on file in the facility.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter E - DIALYSIS TECHNICIANS › Section 117.62 - Training Curricula and Instructors

Current through Reg. 49, No. 28; July 12, 2024
(a) Each training program for dialysis
				  technicians shall develop a written curriculum with objectives specified for
				  each section.
(b) The training
				  curricula for dialysis technicians shall include the following minimum
				  components:
(1) introduction to dialytic
				  therapies to include history and major issues as follows:
(A) history of dialysis;
(B) definitions and terminology;
(C) communication skills;
(D) ethics and confidentiality;
(E) multidisciplinary process;
(F) roles of other team members;
				  and
(G) information about renal
				  organizations and resources;
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter E - DIALYSIS TECHNICIANS › Section 117.64 - Documentation of Competency

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  training program is required to provide a document to the trainee on the
				  successful completion of the training program and competency evaluation. This
				  document shall indicate that the program completed met the requirements of this
				  subchapter.
(b) The document
				  described in subsection (a) of this section may be accepted by another facility
				  that may later employ the dialysis technician. Each employing facility shall
				  have newly hired experienced dialysis technicians complete a written test and a
				  competency checklist in accordance with §117.63(c), (d), and (e) of this
				  title (relating to Competency Evaluation) within two weeks of hire.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter E - DIALYSIS TECHNICIANS › Section 117.65 - Prohibited Acts

Current through Reg. 49, No. 28; July 12, 2024
Performance of the following acts by any dialysis
					 technician who is not a licensed vocational nurse is prohibited:
(1) initiation of patient
				  education;
(2) alteration of
				  ordered treatment, including shortening of the treatment time;
(3) initiation or discontinuation of dialysis
				  via a central catheter, manipulation of a central catheter, or dressing changes
				  for a central catheter;
(4)
				  administration of any medications other than normal saline, heparin, lidocaine,
				  or oxygen, which may only be administered in the course of a routine dialysis
				  treatment;
(5) administration of
				  blood or blood products;
(6)
				  performance of nonaccess site arterial puncture;
(7) acceptance of physician orders;
(8) provision of hemodialysis treatment to
				  pediatric patients less than 35 kilograms;
(9) alteration of the level of electrolytes
				  in dialysate through the use of additive(s) ("spiking"); and
(10) initiation or discontinuation of
				  dialysis via an implantable port.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter F - CORRECTIVE ACTION PLAN AND ENFORCEMENT › Section 117.82 - Voluntary Appointment of a Temporary Manager

Current through Reg. 49, No. 28; July 12, 2024
(a) A person holding a controlling interest
				  in a facility may, at any time, request the department to assume the management
				  of the facility through the appointment of a temporary manager in accordance
				  with Health and Safety Code, §
										251.091.
(b) After receiving the request, the
				  department may enter into an agreement providing for the appointment of a
				  temporary manager to manage the facility under conditions considered
				  appropriate by both parties, if the department considers the appointment
				  desirable.
(c) An agreement under
				  this section shall:
(1) specify all terms and
				  conditions of the temporary manager's appointment and authority; and
(2) preserve all rights of individuals served
				  by the facility granted by law.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter F - CORRECTIVE ACTION PLAN AND ENFORCEMENT › Section 117.83 - Involuntary Appointment of a Temporary Manager

Current through Reg. 49, No. 28; July 12, 2024
(a) Under Health and Safety Code, §
										251.092,
				  the department may request the attorney general to bring an action in the name
				  and on behalf of the state for the appointment of a temporary manager to manage
				  a facility if:
(1) the facility is operating
				  without a license;
(2) the
				  department has denied, suspended, or revoked the facility's license but the
				  facility continues to operate;
(3)
				  the license denial, suspension, or revocation proceedings against the facility
				  are pending, and the department determines that an imminent or reasonably
				  foreseeable threat to the health and safety of a patient of the facility
				  exists;
(4) the department
				  determines that an emergency exists that presents an immediate threat to the
				  health and safety of a patient of the facility;
(5) the facility is closing and arrangements
				  for the care of patients by other licensed facilities have not been made before
				  closure; or
(6) the department
				  determines a level three corrective action plan under §
											117.81(b)(6)
				  of this title (relating to Corrective Action Plan) that includes appointment of
				  an involuntary temporary manager is necessary to address serious or
				  life-threatening conditions at the facility.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter F - CORRECTIVE ACTION PLAN AND ENFORCEMENT › Section 117.84 - Disciplinary Action

Current through Reg. 49, No. 28; July 12, 2024
(a) The department
				  may deny, suspend, or revoke a license if the applicant or facility:
(1) fails to comply with any provision of the
				  statute;
(2) fails to comply with
				  any provision of this chapter;
(3)
				  commits fraud, misrepresentation, or concealment of a material fact on any
				  documents required to be submitted to the department or required to be
				  maintained by the facility pursuant to this chapter;
(4) aids, abets, or permits the commission of
				  an illegal act;
(5) fails to comply
				  with an order of the commissioner or another enforcement procedure under the
				  statute; or
(6) fails to comply
				  with applicable requirements within a designated probation period.