reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter E - LICENSURE SURVEYS › Division 2 - THE SURVEY PROCESS › Section 558.523 - Personnel Requirements for a Survey

Current through Reg. 49, No. 28; July 12, 2024
(a) For an initial survey, the administrator
					 or alternate administrator must be present at the entrance conference,
					 available in person or by telephone during the survey, and present in person at
					 the exit conference.
(b) For a
					 survey other than an initial survey, the administrator or alternate
					 administrator must be available in person or by telephone during the entrance
					 conference and the survey and must be present in person at the exit
					 conference.
(c) The supervising
					 nurse or alternate supervising nurse must be available in person or by
					 telephone, if necessary, to provide information unique to the duties and
					 functions of the position during the survey.
(d) If a required individual is unavailable
					 during the survey process and is not at the agency when the surveyor arrives,
					 the surveyor makes reasonable attempts to contact the individual.
(e) If a surveyor arrives during regular
					 business hours and the agency is closed, an administrator, alternate
					 administrator, or a designated agency representative must provide the surveyor
					 entry to the agency within two hours after the surveyor's arrival at the
					 agency. The administrator must designate in writing the agency representatives
					 who may grant entry to a surveyor. The agency must comply with notice
					 requirements described in § 558.210 of this chapter (relating to Agency
					 Operating Hours).
(f) If the
					 surveyor is unable to contact a required individual or the agency fails to
					 comply with subsection (e) of this section, the surveyor may recommend
					 enforcement action against the agency.
(g) If compliance with this section would
					 cause an interruption in client care being provided by the administrator, the
					 alternate administrator, the supervising nurse, or the alternate supervising
					 nurse, the administrator must contact its backup service provider to ensure
					 continued client care.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter E - LICENSURE SURVEYS › Division 2 - THE SURVEY PROCESS › Section 558.525 - Survey Procedures

Current through Reg. 49, No. 28; July 12, 2024
(a) Before
					 beginning a survey, a surveyor holds an entrance conference, as specified in
					 §558.523 of this division (relating to Personnel Requirements for a
					 Survey), to explain the purpose of the survey and the survey process and
					 provides an opportunity to ask questions.
(b) During a survey, a surveyor:
(1) conducts at least three home visits to
					 determine an agency's compliance with licensing requirements;
(2) reviews any agency records that the
					 surveyor believes are necessary to determine an agency's compliance with
					 licensing requirements; and
(3)
					 evaluates an agency's compliance with each standard.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter E - LICENSURE SURVEYS › Division 2 - THE SURVEY PROCESS › Section 558.527 - Post-Survey Procedures

Current through Reg. 49, No. 28; July 12, 2024
(a) After a survey
					 is completed, the surveyor holds an exit conference with the administrator or
					 alternate administrator to inform the agency of the preliminary
					 findings.
(b) An agency may make an
					 audio recording of the exit conference only if the agency:
(1) records two tapes
					 simultaneously;
(2) allows the
					 surveyor to review the tapes; and
(3) gives the surveyor the tape of the
					 surveyor's choice before leaving the agency.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter F - ENFORCEMENT › Section 558.601 - Enforcement Actions

Current through Reg. 49, No. 28; July 12, 2024
(a) Enforcement
				  actions. HHSC may take the following enforcement actions against an agency:
(1) license suspension;
(2) immediate license suspension;
(3) license revocation;
(4) immediate license revocation;
(5) administrative penalties; and
(6) denial of license application.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter F - ENFORCEMENT › Section 558.602 - Administrative Penalties

Current through Reg. 49, No. 28; July 12, 2024
(a) Assessing
				  penalties. HHSC may assess an administrative penalty against a person who
				  violates:
(1) the Statute;
(2) a provision in this chapter for which a
				  penalty may be assessed; or
(3)
				  Texas Occupations Code §
											102.001
				  (relating to Soliciting Patients; Offense) or §102.006 (relating to
				  Failure to Disclose; Offense), if related to the provision of home health,
				  hospice, or personal assistance services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter F - ENFORCEMENT › Section 558.603 - Court Action

Current through Reg. 49, No. 28; July 12, 2024
(a) If a person
				  operates an agency without a license issued under this chapter, the person is
				  liable for a civil penalty of not less than $1,000 or more than $2,500 for each
				  day of violation.
(b) If a person
				  violates the licensing requirements of the Statute, HHSC may petition the
				  district court to restrain the person from continuing the violation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter F - ENFORCEMENT › Section 558.604 - Surrender or Expiration of a License

Current through Reg. 49, No. 28; July 12, 2024
(a) After a survey in which a surveyor cited
				  deficiencies, an agency may surrender its license or allow its license to
				  expire to avoid enforcement action by HHSC.
(b) If an agency surrenders its license
				  before the expiration date, the agency must return its original license and
				  provide the following information to HHSC :
(1) the effective date of closure;
(2) the location of client records;
(3) the name and address of the client record
				  custodian;
(4) a statement signed
				  and dated by the license holder agreeing to the surrender of the license;
				  and
(5) the disposition of active
				  clients at the time of closure.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter G - HOME HEALTH AIDES › Section 558.701 - Home Health Aides

Current through Reg. 49, No. 28; July 12, 2024
(a) A home health
				  aide may be used by an agency providing licensed home health services if the
				  aide meets one of the following requirements:
(1) a minimum of one year of full-time
				  experience in direct client care in an institutional setting (hospital or
				  nursing facility);
(2) one year of
				  full-time experience within the last five years in direct client care in an
				  agency setting;
(3) satisfactorily
				  completed a training and competency evaluation program that complies with the
				  requirements of this section;
(4)
				  satisfactorily completed a competency evaluation program that complies with the
				  requirements of this section;
(5)
				  submitted to the agency documentation from the director of programs or the dean
				  of a school of nursing that states that the individual is a nursing student who
				  has demonstrated competency in providing basic nursing skills in accordance
				  with the school's curriculum; or
(6) listed on the HHSC nurse aide registry
				  (NAR) with no finding against the aide relating to client abuse or neglect or
				  misappropriation of client property.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 1 - HOSPICE GENERAL PROVISIONS › Section 558.801 - Subchapter H Applicability

Current through Reg. 49, No. 28; July 12, 2024
(a) This
					 subchapter applies to an agency licensed with the hospice services category. An
					 agency licensed to provide hospice services must adopt and enforce written
					 policies in accordance with this subchapter.
(b) A hospice that provides inpatient care
					 directly in its own inpatient unit must comply with the additional standards in
					 Division 7 of this subchapter (relating to Hospice Inpatient Units).
(c) A hospice that provides hospice care to a
					 resident of a skilled nursing facility, nursing facility, or an intermediate
					 care facility for individuals with an intellectual disability or related
					 conditions, must comply with the additional standards in Division 8 of this
					 subchapter (relating to Hospices that Provide Hospice Care to Residents of a
					 Skilled Nursing Facility, Nursing Facility, or Intermediate Care Facility for
					 Individuals with an Intellectual Disability or Related Conditions).
(d) A Medicare-certified hospice agency must
					 comply with the Medicare Conditions of Participation in 42 CFR Part 418,
					 Hospice Care.
(e) A person who is
					 not licensed to provide hospice services may not use the word "hospice" in a
					 title or description of a facility, organization, program, service provider, or
					 services or use any other words, letters, abbreviations, or insignia indicating
					 or implying that the person holds a license to provide hospice
					 services.
(f) For the purposes of
					 this subchapter, the term "attending practitioner:"
(1) includes a physician or an advanced
					 practice nurse identified by a hospice client at the time he or she elects to
					 receive hospice services as having the most significant role in the
					 determination and delivery of the client's medical care; and
(2) is synonymous with "attending physician,"
					 as defined in
					 42
					 CFR §
													418.3.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 2 - INITIAL AND COMPREHENSIVE ASSESSMENT OF A HOSPICE › Section 558.810 - Hospice Initial Assessment

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 hospice RN must complete an initial assessment of a client where hospice
					 services will be delivered within 48 hours after the election of hospice care,
					 unless the client's physician, the client, or the client's legal representative
					 requests that the initial assessment be completed in less than 48
					 hours.
(b) The initial assessment
					 must assess a client's immediate physical, psychosocial, and emotional status
					 related to the terminal illness and related conditions. The information
					 gathered must be used by the hospice to begin the plan of care and to provide
					 care and services to treat a client's and a client's family's immediate care
					 and support needs.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 2 - INITIAL AND COMPREHENSIVE ASSESSMENT OF A HOSPICE › Section 558.811 - Hospice Comprehensive Assessment

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 The hospice must conduct and document a client-specific comprehensive
					 assessment that identifies a client's need for hospice care and services. The
					 comprehensive assessment must:
(1) identify
					 the client's physical, psychosocial, emotional, and spiritual needs related to
					 the terminal illness that must be addressed in order to promote the client's
					 well-being, comfort, and dignity throughout the dying process;
(2) include all areas of hospice care related
					 to the palliation and management of the client's terminal illness and related
					 conditions;
(3) accurately reflect
					 the client's health status at the time of the comprehensive assessment and
					 include information to establish and monitor a plan of care; and
(4) identify the caregiver's and family's
					 willingness and capability to care for the client.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 2 - INITIAL AND COMPREHENSIVE ASSESSMENT OF A HOSPICE › Section 558.812 - Update of the Hospice Comprehensive Assessment

Current through Reg. 49, No. 28; July 12, 2024
(a) The hospice interdisciplinary team, in
					 collaboration with a client's attending practitioner, if any, must update the
					 client's comprehensive assessment as frequently as the condition of the client
					 requires, but no less than every 15 days.
(b) The update of the comprehensive
					 assessment must include:
(1) changes that
					 have taken place since the initial assessment;
(2) information on the client's progress
					 toward desired outcomes; and
(3) a
					 reassessment of the client's response to care.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 2 - INITIAL AND COMPREHENSIVE ASSESSMENT OF A HOSPICE › Section 558.813 - Hospice Client Outcome Measures

Current through Reg. 49, No. 28; July 12, 2024
(a) The
					 comprehensive assessment must include data elements that allow the hospice to
					 measure client outcomes. The hospice must measure and document data in the same
					 way for all clients.
(b) The data
					 elements must:
(1) consider aspects of care
					 related to hospice and palliation;
(2) be an integral part of the comprehensive
					 assessment;
(3) be documented by
					 the hospice in a systematic and retrievable way for each client;
(4) be used by the hospice in individual
					 client care planning and in the coordination of a client's services;
					 and
(5) be used in the aggregate
					 for the hospice's quality assessment and performance improvement
					 program.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 3 - HOSPICE INTERDISCIPLINARY TEAM, CARE PLANNING, AND COORDINATION OF SERVICES › Section 558.820 - Hospice Interdisciplinary Team

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 hospice must designate an interdisciplinary team (IDT) composed of persons who
					 work together to meet the physical, medical, psychosocial, emotional, and
					 spiritual needs of a hospice client and family facing terminal illness and
					 bereavement. The IDT members must provide the care and services offered by the
					 hospice and all the members of the IDT must supervise the care and services the
					 hospice provides.
(b) An IDT must
					 include persons who are qualified and competent to practice in the following
					 professional roles:
(1) a physician who is an
					 employee or under contract with the hospice, who may also be the hospice
					 medical director or physician designee;
(2) an RN;
(3) a social worker; and
(4) a pastoral or other counselor.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 3 - HOSPICE INTERDISCIPLINARY TEAM, CARE PLANNING, AND COORDINATION OF SERVICES › Section 558.821 - Hospice Plan of Care

Current through Reg. 49, No. 28; July 12, 2024
(a) A hospice must
					 designate an interdisciplinary team (IDT) to prepare a written plan of care for
					 a client in consultation with the client's attending practitioner, if any, the
					 client or the client's legal representative, and the primary caregiver, if any
					 of them so desire.
(b) The IDT must
					 develop an individualized written plan of care for each client. The plan of
					 care must reflect client and family goals and interventions based on the
					 problems identified in the initial, comprehensive, and updated comprehensive
					 assessments.
(c) The hospice must
					 provide care and services to a client and the client's family in accordance
					 with an individualized written plan of care established by the hospice
					 IDT.
(d) The client's plan of care
					 must include all services necessary for the palliation and management of the
					 terminal illness and related conditions. The plan of care must include:
(1) interventions to manage pain and
					 symptoms;
(2) a detailed statement
					 of the scope and frequency of services necessary to meet the specific client
					 and family needs;
(3) measurable
					 outcomes anticipated from implementing and coordinating the plan of
					 care;
(4) drugs and treatments
					 necessary to meet the needs of the client;
(5) medical supplies and equipment necessary
					 to meet the needs of the client; and
(6) the IDT's documentation, in the client
					 record, of the client's or the client's legal representative's level of
					 understanding, involvement, and agreement with the plan of care, in accordance
					 with the hospice's policies.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 3 - HOSPICE INTERDISCIPLINARY TEAM, CARE PLANNING, AND COORDINATION OF SERVICES › Section 558.822 - Review of the Hospice Plan of Care

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 hospice interdisciplinary team, in collaboration with a client's attending
					 practitioner, if any, must review, revise and document the individualized plan
					 of care as frequently as the client's condition requires, but no less than
					 every 15 days.
(b) A revised plan
					 of care must include information from the client's updated comprehensive
					 assessment and must note the client's progress toward outcomes and goals
					 specified in the plan of care.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 3 - HOSPICE INTERDISCIPLINARY TEAM, CARE PLANNING, AND COORDINATION OF SERVICES › Section 558.823 - Coordination of Services by the Hospice

Current through Reg. 49, No. 28; July 12, 2024
In addition to the requirements in § 558.288 of this
						chapter (relating to Coordination of Services), a hospice must develop and
						maintain a system of communication and integration in accordance with its
						written policy on coordination of services. The policy must:
(1) ensure that the interdisciplinary team
					 maintains responsibility for directing, coordinating, and supervising the care
					 and services provided to a client;
(2) provide for and ensure the ongoing
					 sharing of information between all hospice personnel providing care and
					 services in all settings, whether the care and services are provided directly
					 or under contract; and
(3) provide
					 for an ongoing sharing of information with other non-hospice health care
					 providers furnishing services unrelated to the terminal illness and related
					 conditions.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 4 - HOSPICE CORE SERVICES › Section 558.830 - Provision of Hospice Core Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 hospice must routinely provide substantially all core services directly by
					 hospice employees in a manner consistent with accepted standards of practice. A
					 hospice must provide the following core services:
(1) physician services;
(2) nursing services;
(3) medical social services; and
(4) counseling services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 4 - HOSPICE CORE SERVICES › Section 558.831 - Hospice Physician Services

Current through Reg. 49, No. 28; July 12, 2024
(a) The
					 hospice medical director, physician employees, and contracted physicians of the
					 hospice, in conjunction with a client's attending practitioner, if any, are
					 responsible for the palliation and management of a client's terminal illness
					 and related conditions.
(b) A
					 physician employee or a contracted physician must function under the
					 supervision of the hospice medical director.
(c) A physician employee or a contracted
					 physician must meet the requirement in subsection (a) of this section by either
					 providing physician services directly or by coordinating a client's care with
					 the attending practitioner.
(d) If
					 an attending practitioner is unavailable, the medical director, a hospice
					 physician employee, or a contracted physician is responsible for meeting the
					 medical needs of the client.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 4 - HOSPICE CORE SERVICES › Section 558.832 - Hospice Nursing Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 hospice must provide nursing services by or under the supervision of an RN. An
					 RN must ensure that the nursing needs of a client are met as identified in the
					 client's initial assessment, comprehensive assessment, and updated
					 assessments.
(b) An advanced
					 practice nurse providing nursing services to a client and acting within the
					 nurse's scope of practice may write orders for the client in accordance with a
					 hospice's written policies and applicable State law, including the Texas
					 Occupations Code Chapter 157, Authority of Physician to Delegate Certain
					 Medical Acts; Texas Occupations Code Chapter 301, Nurses; and Texas Health and
					 Safety Code Chapter 481, Texas Controlled Substances Act, and Chapter 483,
					 Dangerous Drugs.
(c) A hospice may
					 provide highly specialized nursing services under contract if the hospice
					 provides such nursing services to a client so infrequently that providing them
					 by a hospice employee would be impracticable and prohibitively expensive. A
					 hospice may determine that a nursing service, such as complex wound care,
					 infusion specialties, and pediatric nursing, is highly specialized by the
					 nature of the service and the level of nursing skill required to be proficient
					 in the service.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 4 - HOSPICE CORE SERVICES › Section 558.833 - Hospice Medical Social Services

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Medical social services must be provided to a client by a qualified social
					 worker. A qualified hospice social worker must meet one of the following
					 requirements:
(1) active licensure in the
					 state of Texas as a master social worker (MSW) and one year of social work
					 experience in a health care setting; or
(2) active licensure in the state of Texas as
					 a baccalaureate social worker, one year of social work experience in a health
					 care setting, and if employed by a hospice after December 2, 2008, must be
					 supervised by a qualified MSW.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 4 - HOSPICE CORE SERVICES › Section 558.834 - Hospice Counseling Services

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Counseling services must be available to a client and family to assist the
					 client and family in minimizing the stress and problems that arise from the
					 terminal illness, related conditions, and the dying process.
(b) Counseling services must include
					 bereavement, dietary, and spiritual counseling.
(1) Bereavement counseling. Bereavement
					 counseling means emotional, psychosocial, and spiritual support and services
					 provided before and after the death of the client to assist with issues related
					 to grief, loss, and adjustment. A hospice must have an organized program for
					 the provision of bereavement services furnished under the supervision of a
					 qualified professional with experience or education in grief or loss
					 counseling. A hospice must:
(A) develop a
					 bereavement plan of care that notes the kind of bereavement services to be
					 offered to the client's family and other persons and the frequency of service
					 delivery;
(B) make bereavement
					 services available to a client's family and other persons in the bereavement
					 plan of care for up to one year following the death of the client;
(C) extend bereavement counseling to
					 residents of a skilled nursing facility, a nursing facility, or an intermediate
					 care facility for individuals with an intellectual disability or related
					 conditions when appropriate and as identified in the bereavement plan of care;
					 and
(D) ensure that bereavement
					 services reflect the needs of the bereaved.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 5 - HOSPICE NON-CORE SERVICES › Section 558.840 - Provision of Hospice Non-Core Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 hospice must provide the following non-core services in a manner consistent
					 with accepted standards of practice:
(1)
					 physical therapy services;
(2)
					 occupational therapy services;
(3)
					 speech-language pathology services;
(4) hospice aide and hospice homemaker
					 services; and
(5)
					 volunteers.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 5 - HOSPICE NON-CORE SERVICES › Section 558.841 - Physical Therapy, Occupational Therapy, and Speech-Language Pathology Services

Current through Reg. 49, No. 28; July 12, 2024
Physical therapy services, occupational therapy services,
						and speech-language pathology services must be available and, when provided,
						offered by the hospice in a manner consistent with accepted standards of
						practice.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 5 - HOSPICE NON-CORE SERVICES › Section 558.842 - Hospice Aide Services

Current through Reg. 49, No. 28; July 12, 2024
(a) Hospice
					 aide services must be provided by a hospice aide who meets the training and
					 competency evaluation requirements, or the competency evaluation requirements
					 specified in §558.843 of this division (relating to Hospice Aide
					 Qualifications).
(b) A client's
					 hospice aide services must be:
(1) ordered by
					 the designated interdisciplinary team (IDT);
(2) included in the client's plan of
					 care;
(3) performed by a hospice
					 aide in accordance with State law and applicable rules, including 22 TAC
					 Chapter 224 (relating to Delegation of Nursing Tasks by Registered Professional
					 Nurses to Unlicensed Personnel for Clients with Acute Conditions or in Acute
					 Care Environments), and 22 TAC Chapter 225 (relating to RN Delegation to
					 Unlicensed Personnel and Tasks Not Requiring Delegation in Independent Living
					 Environments For Clients with Stable and Predictable Conditions); and
(4) consistent with a hospice aide's
					 documented training and competency skills.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 5 - HOSPICE NON-CORE SERVICES › Section 558.843 - Hospice Aide Qualifications

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 hospice must use a qualified hospice aide to provide hospice aide services. A
					 qualified hospice aide is a person who has successfully completed:
(1) a training program and competency
					 evaluation program that complies with the requirements in subsections (c) and
					 (d) of this section; or
(2) a
					 competency evaluation program that complies with the requirements in subsection
					 (d) of this section.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 5 - HOSPICE NON-CORE SERVICES › Section 558.844 - Hospice Homemaker Services

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Homemaker services must be provided by a qualified hospice homemaker as
					 described in §558.845 of this division (relating to Hospice Homemaker
					 Qualifications).
(b) A member of a
					 client's designated interdisciplinary team (IDT) must coordinate and supervise
					 the homemaker services provided and prepare written instructions for the duties
					 a hospice homemaker performs.
(c)
					 Hospice homemaker services may include assistance in maintaining a safe and
					 healthy environment and services to enable the client and the client's family
					 to carry out the hospice treatment plan. Hospice homemaker services do not
					 include providing personal care or any hands-on services.
(d) A hospice homemaker must report all
					 concerns about a client or the client's family to the member of the IDT
					 responsible for coordinating the hospice homemaker services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 5 - HOSPICE NON-CORE SERVICES › Section 558.845 - Hospice Homemaker Qualifications

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 hospice must use a qualified hospice homemaker to provide hospice homemaker
					 services. A qualified hospice homemaker is a person who:
(1) successfully completes an agency's
					 hospice orientation and training as specified in subsection (b) of this
					 section; or
(2) is a qualified
					 hospice aide as described in §558.843 of this division (relating to
					 Hospice Aide Qualifications).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 5 - HOSPICE NON-CORE SERVICES › Section 558.846 - Services Provided Under a State Medicaid Personal Care Benefit

Current through Reg. 49, No. 28; July 12, 2024
(a) If a client receives services under a
					 state Medicaid personal care benefit, a hospice may use the services provided
					 under the Medicaid personal care benefit to the extent the hospice would
					 routinely use the services of a hospice client's family in implementing the
					 client's plan of care.
(b) The
					 hospice must coordinate its hospice aide and homemaker services with the
					 Medicaid personal care benefit to ensure that the client receives the hospice
					 aide and homemaker services the client needs.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 6 - HOSPICE ORGANIZATION AND ADMINISTRATION OF SERVICES › Section 558.850 - Organization and Administration of Hospice Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A hospice must organize, manage, and
					 administer its hospice program to provide hospice care and support services to
					 a client, the client's caregivers, and the client's family that are necessary
					 for the palliation and management of a client's terminal illness and related
					 conditions. A hospice must provide hospice care and support services that:
(1) optimize the client's comfort and
					 dignity; and
(2) are consistent
					 with the client's and the client's family's needs and goals with priority given
					 to the client's needs and goals.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 6 - HOSPICE ORGANIZATION AND ADMINISTRATION OF SERVICES › Section 558.851 - Hospice Services Provided by a Licensed Person

Current through Reg. 49, No. 28; July 12, 2024
(a) Services provided by a licensed person
					 directly or under contract by a hospice must be authorized, delivered, and
					 supervised only by a qualified licensed person who practices under the
					 hospice's policies and procedures. For the purpose of this section, services
					 provided by a licensed person include skilled nursing care, physical therapy,
					 occupational therapy, speech language pathology, and medical social
					 services.
(b) A licensed person
					 providing hospice services directly or under contract must:
(1) actively participate in the coordination
					 of all aspects of a client's hospice care, in accordance with accepted
					 standards of practice, including participating in ongoing interdisciplinary
					 comprehensive assessments, developing and evaluating the plan of care, and
					 contributing to client and family counseling and education; and
(2) participate in the hospice's quality
					 assessment and performance improvement program and hospice-sponsored in-service
					 training.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 6 - HOSPICE ORGANIZATION AND ADMINISTRATION OF SERVICES › Section 558.852 - Hospice Governing Body and Administrator

Current through Reg. 49, No. 28; July 12, 2024
(a) The hospice must have a governing body
					 that assumes full legal authority and responsibility for the management of the
					 hospice, the provision of all hospice services, its fiscal operations, and
					 continuous quality assessment and performance improvement.
(b) The governing body must appoint an
					 administrator who:
(1) meets the
					 qualifications and conditions specified in § 558.244(a)(1) and (2) of this
					 chapter (relating to Administrator Qualifications and Conditions and
					 Supervising Nurse Qualifications); and
(2) reports to the governing body or persons
					 serving as the governing body.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 6 - HOSPICE ORGANIZATION AND ADMINISTRATION OF SERVICES › Section 558.853 - Hospice Infection Control Program

Current through Reg. 49, No. 28; July 12, 2024
(a) In addition to the requirements in §
					 558.285 of this chapter (relating to Infection Control), a hospice must
					 maintain an effective infection control program that protects clients,
					 families, visitors, and hospice personnel by preventing and controlling
					 infections and communicable diseases.
(b) A hospice must follow accepted standards
					 of practice to prevent the transmission of infections and communicable
					 diseases, including the use of standard precautions.
(c) A hospice must maintain a coordinated
					 agency-wide program for the surveillance, identification, prevention, control,
					 and investigation of infectious and communicable diseases that is an integral
					 part of the hospice's quality assessment and performance improvement program.
					 The infection control program must include:
(1) a method of identifying infectious and
					 communicable disease problems; and
(2) a plan for implementing the appropriate
					 actions that are expected to result in improvement and disease
					 prevention.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 6 - HOSPICE ORGANIZATION AND ADMINISTRATION OF SERVICES › Section 558.854 - Hospice Professional Management Responsibility

Current through Reg. 49, No. 28; July 12, 2024
(a) A hospice that has a written contract
					 with another agency, person, or organization to furnish services must retain
					 administrative and financial management and oversight of staff and services for
					 all contracted services to ensure the provision of quality care.
(b) In addition to the requirements in §
					 558.289 of this chapter (relating to Independent Contractors and Arranged
					 Services), a hospice's written contracts must require that all services are:
(1) authorized by the hospice;
(2) furnished in a safe and effective manner
					 by qualified personnel; and
(3)
					 delivered in accordance with a client's plan of care.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 6 - HOSPICE ORGANIZATION AND ADMINISTRATION OF SERVICES › Section 558.855 - Criminal Background Checks

Current through Reg. 49, No. 28; July 12, 2024
(a) In
					 addition to the requirements in § 558.247 of this chapter (relating to
					 Verification of Employability and Use of Unlicensed Persons), a hospice must
					 conduct a criminal history check on all hospice employees and volunteers with
					 direct client contact or access to client records to verify each employee's or
					 volunteer's criminal history report does not include a conviction that bars
					 employment under Texas Health and Safety Code §
											250.006,
					 or a conviction that the hospice determines is a contraindication to
					 employment.
(b) In addition to the
					 requirements in § 558.289 of this chapter (relating to Independent
					 Contractors and Arranged Services), hospice contracts to provide inpatient care
					 must require that all contracted entities conduct a criminal history check on
					 contracted staff who have direct client contact or access to client records to
					 verify each contract staff's criminal history report does not include a
					 conviction that bars employment under Texas Health and Safety Code §
											250.006.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 6 - HOSPICE ORGANIZATION AND ADMINISTRATION OF SERVICES › Section 558.856 - Hospice Alternate Delivery Sites

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 If a hospice operates an ADS, the hospice must comply with this
					 section.
(b) A Medicare-certified
					 hospice agency must have an ADS approved by CMS before providing
					 Medicare-reimbursed hospice services to Medicare clients from the
					 ADS.
(c) An ADS must be part of the
					 hospice and must share administration, supervision, and services with the
					 parent agency.
(d) In addition to
					 the requirements in § 558.242 of this chapter (relating to Organizational
					 Structure and Lines of Authority), the lines of authority and professional and
					 administrative control must be clearly delineated in the hospice's
					 organizational structure and in practice and must be traced to the parent
					 agency.
(e) The hospice must
					 continually monitor and manage all services provided by its ADS to ensure that
					 services are delivered in a safe and effective manner and to ensure that a
					 client and the client's family receives the necessary care and services
					 outlined in the plan of care.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 6 - HOSPICE ORGANIZATION AND ADMINISTRATION OF SERVICES › Section 558.857 - Hospice Staff Training

Current through Reg. 49, No. 28; July 12, 2024
In addition to the requirements in § 558.245 of this
						chapter (relating to Staffing Policies), a hospice must:
(1) provide orientation about the hospice
					 philosophy, and about supportive palliative care, to all employees and
					 contracted staff who have client and family contact;
(2) provide an initial orientation for an
					 employee that addresses the employee's specific job duties;
(3) assess the skills and competence of all
					 persons furnishing care, including volunteers furnishing services, and, as
					 necessary, provide in-service training and education programs where
					 required;
(4) have written policies
					 and procedures describing its methods for assessing competency; and
(5) maintain a written description of the
					 in-service training provided during the previous 12 months.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 6 - HOSPICE ORGANIZATION AND ADMINISTRATION OF SERVICES › Section 558.858 - Hospice Medical Director

Current through Reg. 49, No. 28; July 12, 2024
(a) A hospice
					 must designate in writing one physician to serve as its medical director. The
					 medical director must be a doctor of medicine or osteopathy who is an employee
					 or under contract with the hospice. The medical director may also be a
					 volunteer physician under the control of the hospice.
(b) A hospice must designate in writing a
					 physician designee to assume the same responsibilities and obligations as the
					 medical director when the medical director is not available.
(c) A hospice may contract for a physician to
					 serve as its medical director with either a self-employed physician or a
					 physician employed by a professional entity or physicians group. The contract
					 for medical director services must specify the name of the physician who
					 assumes the medical director responsibilities and obligations.
(d) The medical director or physician
					 designee assumes responsibility for the medical component of a hospice's client
					 care program.
(e) The medical
					 director or physician designee must review a client's clinical information and
					 provide written initial certification that the client's life expectancy is
					 anticipated to be six months or less if the client's terminal illness runs its
					 normal course.
(f) Before each
					 recertification period for the client, the medical director or physician
					 designee must review the client's clinical information and provide written
					 recertification of the client's terminal illness.
(g) When determining the client's life
					 expectancy is six months or less, the medical director or physician designee
					 must consider:
(1) the primary terminal
					 condition;
(2) related diagnoses,
					 if any;
(3) current subjective and
					 objective medical findings;
(4)
					 current medication and treatment orders; and
(5) information about the medical management
					 of any of the client's conditions unrelated to the terminal illness.