Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING › Subchapter D - MINIMUM STANDARDS FOR LICENSED ABORTION FACILITIES › Section 139.53 - Medical and Clinical Services

Current through Reg. 49, No. 28; July 12, 2024
(a) Surgical
				  abortion.
(1) The medical consultant shall be
				  responsible for implementing and supervising the medical and clinical policies
				  of the facility.
(2) All medical
				  and clinical services of the facility, with the exception of the abortion
				  procedure, shall be provided under the direction of a physician or registered
				  nurse who assumes responsibility for the clinical employees' performance in the
				  facility.
(3) A licensed abortion
				  facility shall ensure that a surgical consent form is signed by the patient
				  prior to the procedure being started, that the patient is informed of the risks
				  and the benefits of the procedure, and that the patient recognizes the
				  alternatives to abortion. Informed consent shall be in accordance with rules
				  adopted by the Texas Medical Disclosure Panel under §
											601.2
				  of this title (relating to Procedures Requiring Full Disclosure of Specific
				  Risks and Hazards--List A), §
											601.4
				  of this title (relating to Disclosure and Consent Form), and Health and Safety
				  Code §
											171.011
				  (relating to Informed Consent Required), and §171.012 (relating to
				  Voluntary Informed Consent).
(4) A
				  licensed abortion facility shall ensure that the attending physician, advanced
				  practice registered nurse, or physician assistant has obtained and documented a
				  preoperative history, physical exam, and laboratory studies, including
				  verification of pregnancy.
(5) A
				  licensed abortion facility shall ensure that:
(A) the attending physician examines each
				  patient immediately prior to surgery to evaluate the risk to the procedure;
				  and
(B) the person administering
				  the anesthetic agent(s) examines the patient immediately prior to surgery to
				  evaluate the risk of anesthesia.
(6) The administration of anesthesia shall be
				  in accordance with §
											139.59 of
				  this subchapter (relating to Anesthesia Services).
(7) A surgical abortion shall be performed
				  only by a physician.
(8) A
				  physician, advanced practice registered nurse, physician assistant, registered
				  nurse, or licensed vocational nurse shall be in the facility whenever there is
				  a patient in the procedure room or recovery room. While a patient is in the
				  procedure room or recovery room she shall not be left unattended.
(9) The recovery room(s) at the facility
				  shall be supervised by a physician, advanced practice registered nurse,
				  physician assistant, or registered nurse. This supervisor shall be available
				  for recovery room staff within a recommended 10 minutes with a maximum required
				  15 minutes while any patient is in the recovery room.
(10) A physician shall be available for the
				  facility while any patient is in the recovery room within a recommended 10
				  minutes and a maximum required 15 minutes.
(11) The facility shall ensure that a patient
				  is fully reactive and her vital signs are stable before discharging the patient
				  from the facility upon written order by the attending physician.
(12) All fetal tissue shall be examined
				  grossly at the time of the procedure. In the absence of visible fetal parts or
				  placenta, the tissue may be examined by magnification for the detection of
				  villi. If this examination is inconclusive, the tissue shall be sent to a
				  pathology lab. The results of the tissue examination shall be recorded in the
				  patient's clinical record.
(13) A
				  facility shall meet the requirements set forth by the department in
				  §§
											1.131-
				  1.137 of
				  this title (relating to Definition, Treatment, and Disposition of Special Waste
				  from Health Care-Related Facilities).