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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 3 - AGENCY ADMINISTRATION › Section 558.260 - Continuing Education in Administration of Agencies

Current through Reg. 49, No. 28; July 12, 2024
(a) In addition to the qualifications and
					 conditions described in §558.244 of this division (relating to
					 Administrator Qualifications and Conditions and Supervising Nurse
					 Qualifications), an administrator and alternate administrator must complete 12
					 clock hours of continuing education within each 12-month period beginning with
					 the date of designation. The 12 clock hours of continuing education must
					 include at least two of the following topics and may include other topics
					 related to the duties of an administrator:
(1) any one of the educational training
					 subjects listed in §558.259(d) of this division (relating to Initial
					 Educational Training in Administration of Agencies);
(2) development and interpretation of agency
					 policies;
(3) basic principles of
					 management in a licensed health-related setting;
(4) ethics;
(5) quality improvement;
(6) risk assessment and management;
(7) financial management;
(8) skills for working with clients,
					 families, and other professional service providers;
(9) community resources; or
(10) marketing.
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.281 - Client Care Policies

Current through Reg. 49, No. 28; July 12, 2024
An agency must adopt and enforce a written policy that
						specifies the agency's client care practices. The written policy must include
						the following elements if covered under the scope of services provided by the
						agency:
(1) initial assessment,
					 reassessment;
(2) start of care,
					 placing services on hold, transfer, and discharge;
(3) intravenous services;
(4) care of the pediatric client;
(5) triaging clients in the event of
					 disaster;
(6) how to handle
					 emergencies in the home;
(7) safety
					 of staff;
(8) procedures the staff
					 will perform for clients, such as dressing changes, Foley catheter changes,
					 wound irrigation, administration of medication;
(9) psychiatric nursing procedures;
(10) patient and caregiver teaching relating
					 to disease process/procedures;
(11)
					 care planning;
(12) care of a
					 client who has a terminal illness or a terminal prognosis;
(13) receiving physician orders;
(14) performing waived testing;
(15) medication monitoring; and
(16) anything else pertaining to 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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.283 - Advance Directives

Current through Reg. 49, No. 28; July 12, 2024
(a) An agency must
					 maintain a written policy regarding implementation of advance directives. The
					 policy must comply with the Advance Directives Act, Texas Health and Safety
					 Code Chapter 166. The policy must include a clear and precise statement of any
					 procedure the agency is unwilling or unable to provide or withhold in
					 accordance with an advance directive.
(b) The agency must provide written notice to
					 a client of the written policy required by subsection (a) of this section. The
					 notice must be provided at the earlier of:
(1) the time the client is admitted to
					 receive services from the agency; or
(2) the time the agency begins providing care
					 to 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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.284 - Laboratory Services

Current through Reg. 49, No. 28; July 12, 2024
An agency that provides laboratory services must adopt
						and enforce a written policy to ensure that the agency meets applicable
						requirements of 42 United States Code (USC) §263a, concerning
						certification and certificates of waiver of a clinical laboratory (CLIA 1988).
						The section
						42 USC §
												263a applies to all agencies with
						laboratories that examine human specimens to provide information for the
						diagnosis, prevention, or treatment of any disease or impairment of, or the
						assessment of the health of, human beings.
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.285 - Infection Control

Current through Reg. 49, No. 28; July 12, 2024
An agency must adopt and enforce written policies
						addressing infection control, including the prevention of the spread of
						infectious and communicable disease. The policies must:
(1) ensure compliance by the agency, its
					 employees, and its contractors with:
(A)
					 Texas Health and Safety Code Chapter 81, relating to prevention and control of
					 communicable diseases;
(B)
					 Occupational Safety and Health Administration regulations relating to
					 Bloodborne Pathogens at,
					 29 CFR Part
					 1910.1030, and Appendix A to that section ;
					 and
(C) Texas Health and Safety
					 Code Chapter 85, Subchapter I, concerning the prevention of the transmission of
					 human immunodeficiency virus and hepatitis B virus; and
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.286 - Disposal of Special or Medical Waste

Current through Reg. 49, No. 28; July 12, 2024
(a) An agency must adopt and enforce a
					 written policy for the safe handling and disposal of biohazardous waste and
					 materials, if applicable.
(b) An
					 agency that generates special or medical waste while providing home health
					 services must dispose of the waste according to the requirements in 25 TAC
					 Chapter 1, Subchapter K (relating to Definition, Treatment, and Disposition of
					 Special Waste from Health Care-Related Facilities). An agency must provide both
					 verbal and written instructions to the agency's clients regarding the proper
					 procedure for disposing of sharps. For purposes of this subsection, sharps
					 include hypodermic needles, hypodermic syringes with attached needles, scalpel
					 blades, razor blades, disposable razors, disposable scissors used in medical
					 procedures, and intravenous stylets and rigid introducers.
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.287 - Quality Assessment and Performance Improvement

Current through Reg. 49, No. 28; July 12, 2024
(a) Quality Assessment and Performance
					 Improvement (QAPI) Program.
(1) An agency
					 must maintain a QAPI Program that is implemented by a QAPI Committee. The QAPI
					 Program must be ongoing, focused on client outcomes that are measurable, and
					 have a written plan of implementation. The QAPI Committee must review and
					 update or revise the plan of implementation at least once within a calendar
					 year, or more often if needed. The QAPI Program must include:
(A) a system that measures significant
					 outcomes for optimal care. The QAPI Committee must use the measures in the care
					 planning and coordination of services and events. The measures must include the
					 following as appropriate for the scope of services provided by the agency:
(i) an analysis of a representative sample of
					 services furnished to clients contained in both active and closed
					 records;
(ii) a review of:
(I) negative client care outcomes;
(II) complaints and incidents of
					 unprofessional conduct by licensed staff and misconduct by unlicensed
					 staff;
(III) infection control
					 activities;
(IV) medication
					 administration and errors; and
(V)
					 effectiveness and safety of all services provided, including:
(-a-) the competency of the agency's clinical
					 staff;
(-b-) the promptness of
					 service delivery; and
(-c-) the
					 appropriateness of the agency's responses to client complaints and
					 incidents;
(iii) a determination that services have been
					 performed as outlined in the individualized service plan, care plan, or plan of
					 care; and
(iv) an analysis of
					 client complaint and satisfaction survey data; and
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.288 - Coordination of Services

Current through Reg. 49, No. 28; July 12, 2024
(a) An agency must
					 adopt and enforce a written policy regarding coordination of services to ensure
					 the effective exchange of information, reporting, and coordination of client
					 services among:
(1) all agency personnel
					 providing care and services, whether the care and services are provided
					 directly or under arrangement;
(2)
					 the agency and other providers of health care services involved in the care of
					 a client, if known by the agency; and
(3) the agency and a licensed facility, group
					 home, foster home, or boarding home facility in which a client
					 resides.
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.289 - Independent Contractors and Arranged Services

Current through Reg. 49, No. 28; July 12, 2024
(a) Independent contractors. If an agency
					 uses independent contractors, there must be a contract between each independent
					 contractor that performs services and the agency. The contract must be enforced
					 by the agency and clearly designate:
(1) that
					 clients are accepted for care only by the agency;
(2) the services to be provided by the
					 contractor and how they will be provided (i.e. per visit, per hours,
					 etc.);
(3) the necessity of the
					 contractor to conform to all applicable agency policies, including personnel
					 qualifications;
(4) the
					 contractor's responsibility for participating in developing the plan of care,
					 care plan, or individualized service plan;
(5) the way services will be coordinated and
					 evaluated by the agency in accordance with §558.288 of this division
					 (relating to Coordination of Services);
(6) the procedures for:
(A) submitting information and documentation
					 by the contractor, in accordance with the agency's client record
					 policies;
(B) scheduling of visits
					 by the contractor or the agency;
(C) periodic client evaluation by the
					 contractor; and
(D) determining
					 charges and reimbursement payable by the agency for the contractor's services
					 under the contract.
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.290 - Backup Services and After-Hours Care

Current through Reg. 49, No. 28; July 12, 2024
(a) Backup services. An agency must adopt and
					 enforce a written policy to ensure that backup services are available when an
					 agency employee or contractor is not available to deliver the services.
(1) Backup services may be provided by an
					 agency employee, a contractor, or the client's designee who is willing and able
					 to provide the necessary services.
(2) If the client's designee has agreed to
					 provide backup services required by this section, the agency must have the
					 designee sign a written agreement to be the backup service provider. The agency
					 must keep the agreement in the client's file.
(3) An agency must not coerce a client to
					 accept backup 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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.291 - Agency Dissolution

Current through Reg. 49, No. 28; July 12, 2024
An agency must adopt and enforce a written policy that
						describes the agency's written contingency plan.
(1) The plan must be implemented in the event
					 of dissolution to assure continuity of client care.
(2) The plan must:
(A) be consistent with §558.295 of this
					 division (relating to Client Transfer or Discharge Notification
					 Requirements);
(B) include
					 procedures for:
(i) notifying the client of
					 the agency's dissolution;
(ii)
					 documenting the notification;
(iii)
					 carrying out the notification; and
(C) comply with § 558.217(a)(2) of this
					 subchapter (relating to Agency Closure Procedures and Voluntary Suspension of
					 Operations).
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.292 - Agency and Client Agreement and Disclosure

Current through Reg. 49, No. 28; July 12, 2024
(a) The agency must provide the client or the
					 client's family with a written agreement for services. The agency must comply
					 with the terms of the agreement. The agreement must include at a minimum the
					 following:
(1) notification of client
					 rights;
(2) documentation
					 concerning notification to the client of the availability of medical power of
					 attorney for health care, advance directive or "Do Not Resuscitate" orders in
					 accordance with the applicable law;
(3) services to be provided;
(4) supervision by the agency of services
					 provided;
(5) agency charges for
					 services rendered if the charges will be paid in full or in part by the client
					 or the client's family, or on request;
(6) a written statement containing procedures
					 for filing a complaint in accordance with §558.282(d) of this division
					 (relating to Client Conduct and Responsibility and Client Rights);
					 and
(7) a client agreement to and
					 acknowledgement of services by home health medication aides, if home health
					 medication aides are used.
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.293 - Client List and Services

Current through Reg. 49, No. 28; July 12, 2024
An agency must maintain a current list of clients for
						each category of service licensed.
(1)
					 The list must include all services being delivered by the agency and services
					 being delivered under contract.
(2)
					 The client list must include the client's name, identification or clinical
					 record number, start of care date or admission date, certification period (if
					 applicable), diagnosis(es) or functional assessment (as appropriate), and the
					 disciplines that are providing 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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.294 - Time Frame(s) for the Initiation of Care or Services

Current through Reg. 49, No. 28; July 12, 2024
An agency must adopt and enforce a written policy
						establishing time frame(s) for the initiation of care or
						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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.295 - Client Transfer or Discharge Notification Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) Except as provided in subsection (e) of
					 this section, an agency intending to transfer or discharge a client must:
(1) provide written notification to the
					 client or the client's parent, family, spouse, significant other, or legal
					 representative; and
(2) notify the
					 client's attending physician or practitioner if he is involved in the agency's
					 care 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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.296 - Physician Delegation and Performance of Physician-Delegated Tasks

Current through Reg. 49, No. 28; July 12, 2024
(a) An agency must adopt and enforce a
					 written policy that states whether physician delegation will be honored by the
					 agency. If an agency accepts physician delegation, the agency must comply with
					 Texas Occupations Code Chapter 157, concerning physician delegation.
(b) An agency may accept delegation from a
					 physician only if the agency receives the following from the physician:
(1) the name of the client;
(2) the name of the delegating
					 physician;
(3) the task(s) to be
					 performed;
(4) the name of the
					 individual(s) to perform the task(s);
(5) the time frame for the delegation order;
					 and
(6) if the task is medication
					 administration, the medication to be given, route, dose, and
					 frequency.
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.297 - Receipt of Physician Orders

Current through Reg. 49, No. 28; July 12, 2024
An agency must adopt and enforce a written policy
						describing protocols and procedures agency staff must follow when receiving
						physician orders.
(1) The policy must
					 address the time frame for countersignature of physician verbal
					 orders.
(2) Signed physician orders
					 may be submitted via fax machine. The agency is not required to have the
					 original signatures on file. However, the agency must be able to obtain
					 original signatures if an issue surfaces that would require verification of an
					 original signature. The policy must include protocols to follow when accepting
					 physician orders via fax. If physician orders are accepted via fax, the policy
					 must:
(A) outline safeguards to assure that
					 transmitted information is sent to the appropriate individual; and
(B) outline the procedures to be followed in
					 the case of misdirected transmission.
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.298 - Delegation of Nursing Tasks by Registered Professional Nurses to Unlicensed Personnel and Tasks Not Requiring Delegation

Current through Reg. 49, No. 28; July 12, 2024
(a) An agency must adopt and enforce a
					 written policy to ensure compliance with the following rules adopted by the
					 Texas Board of Nursing:
(1) 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
(2) 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).
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.299 - Nursing Education, Licensure and Practice

Current through Reg. 49, No. 28; July 12, 2024
If providing nursing services, an agency must adopt and
						enforce a written policy to ensure compliance with the rules of the Texas Board
						of Nursing adopted in 22 TAC Chapters 211 - 226 (relating to Nursing Continuing
						Education, Licensure, and Practice in the State of Texas).
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.300 - Medication Administration

Current through Reg. 49, No. 28; July 12, 2024
(a) This
					 section applies only to clients to whom agency staff administer
					 medications.
(b) An agency must
					 adopt and enforce a written policy for maintaining a current medication list
					 and a current medication administration record.
(1) A client's practitioner must order
					 administration of medication.
(2)
					 An agency may incorporate a current medication list and medication
					 administration record into one document.
(A)
					 An agency must use the medication list to identify possible ineffective drug
					 therapy or adverse reactions, significant side effects, drug allergies, and
					 contraindications.
(B) An agency
					 must document in the medication administration record or clinical notes any
					 medication that is not administered and the reason it was not
					 administered.
(3) An
					 individual delivering care must report any adverse reaction to a supervisor and
					 document this in the client's record on the day of occurrence. If the adverse
					 reaction occurs after regular business hours, the individual delivering care
					 must report the adverse reaction as soon as it is disclosed.
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.302 - Pronouncement of Death

Current through Reg. 49, No. 28; July 12, 2024
An agency must adopt and enforce a written policy on
						pronouncement of death, if that function is carried out by an agency RN. The
						policy must comply with Texas Health and Safety Code §
											671.001
						(relating to Standard Used in Determining Death ).
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 4 - PROVISION AND COORDINATION OF TREATMENT SERVICES › Section 558.303 - Standards for Possession of Sterile Water or Saline, Certain Vaccines or Tuberculin, and Certain Dangerous Drugs

Current through Reg. 49, No. 28; July 12, 2024
An agency that possesses sterile water or saline, certain
						vaccines or tuberculin, or certain dangerous drugs, as specified by this
						section, must comply with the provisions of this section.
(1) Possession of sterile water or saline. An
					 agency or its employees, who are RNs or LVNs, may purchase, store, or transport
					 for the purpose of administering to their home health or hospice clients under
					 physician's orders:
(A) sterile water for
					 injection and irrigation; and
(B)
					 sterile saline for injection and irrigation.
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 5 - BRANCH OFFICES AND ALTERNATE DELIVERY SITES › Section 558.321 - Standards for Branch Offices

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 branch office operates as a part of the parent agency and must comply with the
					 same regulations as the parent agency. The parent agency is responsible for
					 ensuring that its branches comply with licensing standards.
(b) A branch office providing licensed and
					 certified home health services must comply with the standards for certified
					 agencies in § 558.402 of this chapter (relating to Standards Specific to
					 Licensed and Certified Home Health Services).
(c) The service area of a branch office must
					 be located within the parent agency's service area.
(1) A branch office must not provide services
					 outside its licensed service area.
(2) A branch office must maintain adequate
					 staff to provide services and to supervise the provision of services within the
					 service area.
(3) A branch office
					 may expand its service area at any time during the licensure period.
(A) Unless exempted under subparagraph (B) of
					 the paragraph, a branch office must submit to HHSC a written notice to expand
					 its service area at least 30 days before the expansion. The notice must
					 include:
(i) revised boundaries of the branch
					 office's original service area;
(ii) the effective date of the expansion;
					 and
(iii) an updated list of
					 management and supervisory personnel (including names), if changes are
					 made.
(B) An agency is
					 exempt from the 30-day written notice requirement under subparagraph (A) of
					 this paragraph if HHSC determines an emergency exists that would impact client
					 health and safety. An agency must notify HHSC immediately of a possible
					 emergency. HHSC determines if an exemption can be granted.
(4) A branch office may reduce its service
					 area at any time during the licensure period by sending HHSC written
					 notification of the reduction, revised boundaries of the branch office's
					 original service area, and the effective date of the reduction.
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 C - MINIMUM STANDARDS FOR ALL HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Division 5 - BRANCH OFFICES AND ALTERNATE DELIVERY SITES › Section 558.322 - Standards for Alternate Delivery Sites

Current through Reg. 49, No. 28; July 12, 2024
(a) An ADS must comply with the Statute and
					 this chapter, including the additional standards in Subchapter H of this
					 chapter (relating to Standards Specific to Agencies Licensed to Provide Hospice
					 Services).
(b) If certified by CMS,
					 an ADS must comply with the applicable federal rules and regulations for
					 hospice agencies in 42 CFR Part 418.
(c) A parent agency and an ADS must meet the
					 following requirements:
(1) The parent agency
					 administrator or alternate administrator, or supervising nurse or alternate
					 supervising nurse, must conduct an on-site supervisory visit to the ADS at
					 least monthly. The parent agency may visit the ADS more frequently considering
					 the size of the service area provided by the parent agency. The supervisory
					 visits must be documented and include the date of the visit, the content of the
					 consultation, the individuals in attendance, and the recommendations of the
					 staff.
(2) The parent agency must
					 approve all ADS policies and procedures. This approval must be documented and
					 filed in the parent agency and ADS.
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 D - ADDITIONAL STANDARDS SPECIFIC TO LICENSE CATEGORY AND SPECIFIC TO SPECIAL SERVICES › Section 558.402 - Standards Specific to Licensed and Certified Home Health Services

Current through Reg. 49, No. 28; July 12, 2024
(a) In addition to the standards in
				  Subchapter C of this chapter (relating to Minimum Standards for All Home and
				  Community Support Services Agencies), an agency providing licensed and
				  certified home health services must comply with applicable requirements of 42
				  United States Code Chapter 7, Subchapter XVII and the regulations in 42 CFR
				  Part 484.
(b) An agency providing
				  licensed and certified home health services that plans to implement a home
				  health aide training and competency evaluation program must meet the
				  requirements in § 558.701(d)-(f) of this chapter (relating to Home Health
				  Aides).
(c) An agency providing
				  licensed and certified home health services that plans to implement a
				  competency evaluation program must comply with § 558.701(f) of this
				  chapter .
(d) An agency providing
				  licensed and certified home health services may not use an individual as a home
				  health aide unless:
(1) the individual has
				  met the federal requirements under subsection (a) of this section;
(2) the individual qualifies as a home health
				  aide based on a:
(A) training and competency
				  evaluation program, and the program meets the requirements of subsection (b) of
				  this section; or
(B) competency
				  evaluation program, and the program meets the requirements of subsection (c) of
				  this section; or
(3) the
				  individual is a licensed health care provider.
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 D - ADDITIONAL STANDARDS SPECIFIC TO LICENSE CATEGORY AND SPECIFIC TO SPECIAL SERVICES › Section 558.404 - Standards Specific to Agencies Licensed to Provide Personal Assistance Services

Current through Reg. 49, No. 28; July 12, 2024
(a) In addition to
				  meeting the standards in Subchapter C of this chapter (relating to Minimum
				  Standards for All Home and Community Support Services Agencies), an agency
				  holding a license with the category of personal assistance services must meet
				  the standards of this section.
(b)
				  A person who is not licensed to provide personal assistance services under this
				  chapter may not indicate or imply that the person is licensed to provide
				  personal assistance services by using the words "personal assistance services"
				  or in any other manner.
(c)
				  Personal assistance services, as defined in § 558.2 of this chapter
				  (relating to Definitions), may be performed by an unlicensed person who is at
				  least 18 years of age and has demonstrated competency, when competency cannot
				  be determined through education and experience, to perform the tasks assigned
				  by the supervisor. An unlicensed person who is under 18 years of age, is a high
				  school graduate or is enrolled in a vocational educational program, and has
				  demonstrated competency to perform the tasks assigned by the supervisor, may
				  perform personal assistance services.
(d) The following tasks may be performed
				  under a personal assistance services category:
(1) personal care as defined in § 558.2
				  of this chapter;
(2) health-related
				  tasks provided by unlicensed personnel that may be delegated by an RN, or that
				  an RN determines do not require delegation, in accordance with the agency's
				  written policy adopted, implemented, and enforced to ensure compliance with the
				  rules adopted by the Texas Board of Nursing in 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);
(3) health-related
				  tasks that are not the practice of professional nursing under the memorandum of
				  understanding between HHSC and the Texas Board of Nursing; and
(4) health-related tasks that are delegated
				  by a physician under the Texas Occupations Code Chapter 157.
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 D - ADDITIONAL STANDARDS SPECIFIC TO LICENSE CATEGORY AND SPECIFIC TO SPECIAL SERVICES › Section 558.405 - Standards Specific to Agencies Licensed to Provide Home Dialysis Services

Current through Reg. 49, No. 28; July 12, 2024
(a) License designation. An agency may not
				  provide peritoneal dialysis or hemodialysis services in a client's residence,
				  independent living environment, or other appropriate location unless the agency
				  holds a license to provide licensed home health or licensed and certified home
				  health services and designated to provide home dialysis services. In order to
				  receive a home dialysis designation, the agency must meet the licensing
				  standards specified in this section and the standards for home health services
				  in accordance with Subchapter C of this chapter (relating to Minimum Standards
				  for All Home and Community Support Services Agencies) and § 558.401 of
				  this subchapter (relating to Standards Specific to Licensed Home Health
				  Services), except for § 558.401(b)(2)(A) and (B) of this subchapter. If
				  there is a conflict between the standards specified in this section and those
				  specified in Subchapter C of this chapter and § 558.401 of this
				  subchapter, the standards specified in this section will apply to the home
				  dialysis services.
(b) Governing
				  body. An agency must have a governing body. The governing body must appoint a
				  medical director and the physicians who are on the agency's medical staff. The
				  governing body must annually approve the medical staff policies and procedures.
				  The governing body on a biannual basis must review and consider for approval
				  continuing privileges of the agency's medical staff. The minutes from the
				  governing body of the agency must be on file in the agency office.
(c) Qualifications and responsibilities of
				  the medical director.
(1) Qualifications. The
				  medical director must be a physician licensed in the State of Texas who:
(A) is eligible for certification or is
				  certified in nephrology or pediatric nephrology by a professional board;
				  or
(B) during the five-year period
				  prior to September 1, 1996, served at least 12 months as director of a dialysis
				  facility or 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 D - ADDITIONAL STANDARDS SPECIFIC TO LICENSE CATEGORY AND SPECIFIC TO SPECIAL SERVICES › Section 558.406 - Standards for Agencies Providing Psychoactive Services

Current through Reg. 49, No. 28; July 12, 2024
An agency that provides skilled nursing psychoactive
					 treatments must comply with the requirements of this section.
(1) An agency must adopt and enforce a
				  written policy relating to the provision of psychoactive treatments consistent
				  with this section.
(2) Skilled
				  nursing psychoactive treatments must be under the direction of a physician.
				  Psychoactive treatments may only be provided by a physician or an RN
				  .
(3) An RN providing skilled
				  nursing psychoactive treatments must have one of the following qualifications:
(A) a master's degree in psychiatric or
				  mental health nursing;
(B) a
				  bachelor's degree in nursing with one year of full-time experience in an active
				  treatment unit in a mental health facility or outpatient clinic;
(C) a diploma or associate degree with two
				  years of full-time experience in an active treatment unit in a mental health
				  facility or outpatient clinic; or
(D) for an RN for Medicare certified
				  agencies, as allowed by the fiscal intermediary for Texas contracting with the
				  United States Department of Health and Human Services (USDHHS) CMS.
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 D - ADDITIONAL STANDARDS SPECIFIC TO LICENSE CATEGORY AND SPECIFIC TO SPECIAL SERVICES › Section 558.407 - Standards for Agencies Providing Home Intravenous Therapy

Current through Reg. 49, No. 28; July 12, 2024
An agency furnishing intravenous therapy directly or under
					 arrangement must comply with the following standards of care.
(1) A physician's order must be written
				  specifically for intravenous therapy.
(2) Intravenous therapy must be provided by a
				  licensed nurse.
(3) To ensure that
				  prescribed care is administered safely, a licensed nurse must have the
				  knowledge and documented competency to interpret and implement the written
				  order.
(4) Written policies and
				  procedures regarding the agency's provision of intravenous therapy must
				  include, but are not limited to, addressing initiation, medication
				  administration, monitoring, and discontinuation. Responsibilities of the
				  licensed nurse must be clearly delineated in written policies and
				  procedures.
(5) An RN must be
				  available 24 hours a day.
(6) The
				  client and caregiver must be assessed for the ability to safely administer the
				  prescribed intravenous therapy, as per agency written criteria.
(7) If the client or caregiver is willing and
				  able to safely administer the prescribed intravenous therapy, the agency must
				  offer to teach the client or caregiver such administration. The teaching
				  process is based on the client and caregiver needs and may include written
				  instructions, verbal explanations, demonstrations, evaluation and documentation
				  of competency, proficiency in performing intravenous therapy, scope of physical
				  activities, and safe disposal of equipment.
(8) Actions must be implemented prior to and
				  during all intravenous therapy to minimize the risk of anaphylaxis or other
				  adverse reactions, as stated in the agency's written policy.
(9) An ongoing assessment of client and
				  caregiver compliance in performing intravenous therapy related procedures must
				  be done at periodic intervals.
(10)
				  Care coordination must be provided to ensure continuity of care.
(11) The client and caregiver must be
				  provided with 24-hour access to appropriate health care professionals employed
				  by or having a contract with 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 E - LICENSURE SURVEYS › Division 1 - GENERAL › Section 558.501 - Survey and Investigation Frequency

Current through Reg. 49, No. 28; July 12, 2024
(a) At a minimum, HHSC conducts a survey:
(1) after an agency submits a written request
					 for an initial survey in accordance with § 558.521 of this subchapter
					 (relating to Requirements for an Initial Survey); and
(2) within 18 months after conducting an
					 initial survey and at least every 36 months thereafter.
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 1 - GENERAL › Section 558.503 - Exemption From a Survey

Current through Reg. 49, No. 28; July 12, 2024
Except for the investigation of complaints, an agency is
						exempt from additional surveys by HHSC if the agency maintains accreditation
						status for the services for which the agency seeks exemption and applicable to
						the agency's category of license from an accreditation organization with
						current HHSC approval. As of the effective date of this rule, accreditation
						organizations with current HHSC approval on its HCSSA licensure website are the
						Joint Commission, Community Health Accreditation Partner, and Accreditation
						Commission for Health Care, Inc.
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 1 - GENERAL › Section 558.505 - Notice of a Survey

Current through Reg. 49, No. 28; July 12, 2024
HHSC does not announce or give prior notice of a survey
						to an 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 E - LICENSURE SURVEYS › Division 1 - GENERAL › Section 558.507 - Agency Cooperation with a Survey

Current through Reg. 49, No. 28; July 12, 2024
(a) By applying for or holding a license, an
					 agency consents to entry and survey by a HHSC representative to verify
					 compliance with the Statute or this chapter.
(b) An agency must provide the surveyor
					 access to all agency records required by HHSC to be maintained by or on behalf
					 of the agency.
(c) If a surveyor
					 requests an agency record that is stored at a location other than the survey
					 site, the agency must provide the record to the surveyor within eight working
					 hours after the request.
(d) An
					 agency must provide the surveyor with copies of agency records upon
					 request.
(e) During a survey,
					 agency staff must not:
(1) make a false
					 statement of a material fact about a matter under investigation by HHSC that a
					 person knows, or should know, is false;
(2) willfully interfere with the work of a
					 HHSC representative;
(3) willfully
					 interfere with a HHSC representative in preserving evidence of a violation;
					 or
(4) refuse to allow a HHSC
					 representative to inspect a book, record, or file required to be maintained by
					 or on behalf of an 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 E - LICENSURE SURVEYS › Division 1 - GENERAL › Section 558.509 - Survey of a Branch Office, Alternate Delivery Site, and Services Provided

Current through Reg. 49, No. 28; July 12, 2024
(a) If an agency is applying for or renewing
					 a branch office or alternate delivery site license, a survey covers all
					 locations.
(b) If an agency is
					 applying for a license to provide more than one category of service, a survey
					 covers all provided services of 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 E - LICENSURE SURVEYS › Division 2 - THE SURVEY PROCESS › Section 558.521 - Requirements for an Initial Survey

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 No later than six months after the effective date of an agency's initial
					 license, an agency must:
(1) admit and
					 provide services to clients as described in subsection (b) of this section;
					 and
(2) except as provided in
					 subsection (f) of this section, submit a written request for an initial
					 licensure survey to the designated survey office, as described in subsection
					 (c) of this section.