A facility must maintain policies and procedures regarding
the following with respect to all clients receiving services provided
by the facility.
(1) The facility must provide a client with written
information about:
(A) the client's rights under Texas law (whether statutory
or as recognized by the courts of the state) to make decisions concerning
medical care, including the right to accept or refuse medical or surgical
treatment and the right to formulate advance directives;
(B) the facility's policies respecting the implementation
of these rights; and
(C) a written list of the client's rights as applicable,
as outlined under Texas Human Resource Code §102.004 (relating
to List of Rights), and as required in §559.52 of this subchapter
(relating to Client Rights).
(2) The facility must document in the client's record
whether the client has executed an advance directive.
(3) The facility must not condition the provision of
care or otherwise discriminate against a client based on whether the
client has executed an advance directive.
(4) The facility must ensure compliance with the requirements
of Texas law, whether statutory or as recognized by the courts of
Texas, respecting advance directives.
(5) The facility must educate the client, family members,
and staff, in a language each understands, on issues concerning advance
directives.
(6) The facility must provide the attending physician
with any information relating to a known existing Directive to Physicians,
Living Will, or Durable Power of Attorney for Health Care and assist
with coordinating prescribing practitioners' orders with any directive.
(7) When a client is in an incapacitated state, and
therefore is unable to receive information or articulate whether he
or she has executed an advance directive, the family, surrogate, or
other concerned person must receive the information concerning advance
directives. The facility must provide this information to the client
in a language he or she understands if he or she is no longer incapacitated.
(8) When the client or a relative, surrogate, or other
concerned or related individual presents the facility with a copy
of the client's advance directive, the facility must comply with the
advance directive including recognition of a durable power of attorney
for health care to the extent allowed under state law. If no one comes
forward with a previously executed advance directive and the client
is incapacitated or otherwise unable to receive information or articulate
whether he has executed an advance directive, the facility must note
that the client was not able to receive information and was unable
to communicate whether an advance directive existed.
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