Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.44 - Emergency Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  limited services rural hospital (LSRH) shall provide the emergency care
				  necessary to meet the needs of its patients in accordance with acceptable
				  standards of practice.
(b) An LSRH
				  shall provide to each patient, without regard to the individual's ability to
				  pay, an appropriate medical screening, examination, and stabilization within
				  the facility's capability, including ancillary services routinely available to
				  the hospital, to determine whether an emergency medical condition exists and
				  shall provide any necessary stabilizing treatment.
(c) An LSRH shall have an emergency suite
				  that complies with §
										511.163(e) of
				  this chapter (relating to Spatial Requirements).
(d) The organization of the LSRH's emergency
				  services must be appropriate to the scope of the services offered.
(e) Emergency services must be organized
				  under the direction of a qualified physician member of the LSRH's medical staff
				  who is the medical director or clinical director.
(f) Emergency services must be integrated
				  with other LSRH departments.
(g)
				  The LSRH must maintain patient medical records for all emergency patients. The
				  medical records shall contain patient identification, the reason for the visit,
				  name of physician, name of nurse, time admitted to the emergency suite,
				  treatment, time discharged, and disposition.
(h) The policies and procedures governing
				  medical care provided in the emergency suite must be established by and must be
				  a continued responsibility of the medical staff.
(i) There must be adequate medical and
				  nursing personnel qualified in emergency care to meet the written emergency
				  procedures and needs anticipated by the LSRH.
(j) There must be on-duty and on-site 24
				  hours a day, seven days a week at least one person qualified, as determined by
				  the medical staff, to initiate immediate appropriate lifesaving measures and at
				  least one nurse with current advanced cardiac life support and pediatric
				  advanced life support certification. This individual or individuals must be
				  able to receive patients and activate the appropriate medical resources to meet
				  the care needed by the patient.
(k)
				  Qualified personnel must be physically present in the emergency treatment area
				  at all times.
(l) An LSRH must
				  maintain schedules, names, and phone numbers of all physicians and others on
				  emergency call duty, including alternates. The LSRH must maintain the schedules
				  for at least one year.
(m) In
				  accordance with Code of Federal Regulations Title 42 (42 CFR)
				  §485.516(c)(4), there must be a physician, a physician assistant, or an
				  advanced practice registered nurse, with training or experience in emergency
				  care, on call and immediately available by telephone or radio contact, and
				  available on-site at the LSRH within 30 minutes, on a 24-hour a day basis, if
				  the LSRH is located in an area other than an area described in
				  42 CFR §
											485.618(d)(1)(ii).
(n) Emergency services must be available
				  24-hours per day.
(o) An LSRH shall
				  keep adequate age-appropriate equipment, supplies, and medication used in
				  treating emergency cases and make this equipment, supplies, and medication
				  readily available for treating emergency cases.
(p) The age-appropriate emergency equipment
				  and supplies available at the LSRH shall include at least the following:
(1) emergency call system;
(2) oxygen;
(3) mechanical ventilatory assistance
				  equipment, including airways, manual breathing bag, endotracheal tubes, ambu
				  bag/valve/mask;
(4) cardiac
				  defibrillator;
(5) cardiac
				  monitoring equipment;
(6)
				  laryngoscopes and endotracheal tubes;
(7) suction equipment;
(8) stabilization devices for cervical
				  injuries;
(9) blood pressure
				  monitoring equipment;
(10) pulse
				  oximeter or similar medical device to measure blood oxygenation;
(11) tourniquets;
(12) immobilization devices;
(13) nasogastric tubes;
(14) splints;
(15) Intravenous (IV) therapy
				  supplies;
(16) suction
				  machine;
(17) chest
				  tubes;
(18) indwelling urinary
				  catheters; and
(19) drugs and
				  biologicals commonly used in life-saving procedures as specified by the medical
				  staff, which shall include:
(A)
				  analgesics,
(B) local
				  anesthetics,
(C)
				  antibiotics,
(D)
				  anticonvulsants,
(E) antidotes and
				  emetics,
(F) serums and
				  toxoids,
(G)
				  antiarrhythmics,
(H) cardiac
				  glycosides,
(I)
				  antihypertensives,
(J) diuretics,
				  and
(K) electrolytes and
				  replacement solutions.