| (C) All medical services performed in the facility
shall be evaluated as they relate to appropriateness of diagnosis
and treatment.
(2) Implementation. The facility shall take and document
appropriate remedial action to address deficiencies found through
the QA program. The facility shall document the outcome of the remedial
action.
(3) Discharge planning. The facility shall have an
effective, ongoing discharge planning program that facilitates the
provision of follow-up care.
(A) Discharge planning shall be completed prior to
discharge.
(B) Patients, along with necessary medical information,
shall be transferred or referred to appropriate facilities, agencies,
or outpatient services, as needed for follow-up or ancillary care.
(C) Screening and evaluation before patient discharge
from facility. In accordance with 42 Code of Federal Regulations (CFR),
Part 483, Subpart C (relating to Requirements for Long Term Care Facilities)
and the rules of the Department of Aging and Disability Services (DADS)
set forth in 40 TAC Chapter 17, (relating to Preadmission Screening
and Resident Review (PASRR)), all patients who are being considered
for discharge from the facility to a nursing facility shall be screened,
and if appropriate, evaluated, prior to discharge by the facility
and admission to the nursing facility to determine whether the patient
may have a mental illness, intellectual disability or developmental
disability. If the screening indicates that the patient has a mental
illness, intellectual disability or developmental disability, the
facility shall contact and arrange for the local mental health authority
designated pursuant to Texas Health and Safety Code, §533.035,
to conduct prior to facility discharge an evaluation of the patient
in accordance with the applicable provisions of the PASRR rules.
The purpose of PASRR is:
(i) to ensure that placement of the patient in a nursing
facility is necessary;
(ii) to identify alternate placement options when applicable;
and
(iii) to identify specialized services that may benefit
the person with a diagnosis of mental illness, intellectual disability,
or developmental disability.
(n) Radiology services. When radiology services are
provided, written policies and procedures shall be adopted, implemented
and enforced which describe the radiology services provided in the
facility and how employee and patient safety will be maintained.
(1) Proper safety precautions shall be maintained
against radiation hazards. This includes adequate shielding for patients,
personnel, and facilities.
(2) Inspection of equipment shall be made periodically.
Defective equipment shall be promptly repaired or replaced.
(3) Radiation workers shall be checked, by the use
of exposure meters or badge tests, for amount of radiation exposure.
Exposure reports and documentation shall be available for review.
(4) Radiology services shall be provided only on the
order of individuals with privileges granted by the medical staff
and of other physicians or practitioners authorized by the medical
staff and governing body to order such services.
(5) Personnel.
(A) A qualified full-time, part-time, or consulting
radiologist shall supervise the ionizing radiology services and shall
interpret only those radiology tests that are determined by the medical
staff to require a radiologist's specialized knowledge. For purposes
of this section a radiologist is a physician who is qualified by education
and experience in radiology in accordance with medical staff bylaws.
(B) Only personnel designated as qualified by the medical
staff shall use the radiology equipment and administer procedures.
(6) Records. Records of radiology services shall be
maintained. The radiologist or other individuals who have been granted
privileges to perform radiology services shall sign reports of his
or her interpretations.
(o) Respiratory care services. When respiratory care
services are provided, written policies and procedures shall be adopted,
implemented, and enforced which describe the provision of respiratory
care services in the facility. Personnel qualified to perform specific
procedures and the amount of supervision required for personnel to
carry out specific procedures shall be designated in writing.
(p) Waste and waste disposal.
(1) Special waste and liquid/sewage waste management.
(A) The hospital shall comply with the requirements
set forth by the department in §§1.131 - 1.137 of this title
(relating to Definition, Treatment, and Disposition of Special Waste
from Health Care Related Facilities) and the Texas Commission on
Environmental Quality (TCEQ) requirements in 30 TAC §330.1207
(relating to Generators of Medical Waste).
(B) All sewage and liquid wastes shall be disposed
of in a municipal sewerage system or a septic tank system permitted
by the TCEQ in accordance with 30 TAC Chapter 285 (relating to On-Site
Sewage Facilities).
(2) Waste receptacles.
(A) Waste receptacles shall be conveniently available
in all toilet rooms, patient areas, staff work areas, and waiting
rooms. Receptacles shall be routinely emptied of their contents at
a central location(s) into closed containers.
(B) Waste receptacles shall be properly cleaned with
soap and hot water, followed by treatment of inside surfaces of the
receptacles with a germicidal agent.
(C) All containers for other municipal solid waste
shall be leak-resistant, have tight-fitting covers, and be rodent-proof.
(D) Non-reusable containers shall be of suitable strength
to minimize animal scavenging or rupture during collection operations.
|
| Source Note: The provisions of this §510.41 adopted to be effective January 1, 2004, 28 TexReg 5154; amended to be effective December 9, 2010, 35 TexReg 10746; amended to be effective May 24, 2013, 38 TexReg 3027; amended to be effective February 18, 2018, 43 TexReg 576; transferred effective June 1, 2019, as published in the Texas Register May 17, 2019, 44 TexReg 2469 |
