| (a) A limited services rural hospital (LSRH) shall
protect and promote each patient's rights.
(b) An LSRH shall adopt, implement, and enforce a policy
to ensure patients' rights are upheld within the limits of law. The
LSRH's written patient's rights policy shall include the following:
(1) the right to participate in the development and
implementation of their plan of care;
(2) the right to make informed decisions regarding
their care, including being informed of their health status, and being
able to request or refuse treatment;
(3) the right to formulate advance directives and to
have LSRH staff and practitioners who provide care in the LSRH comply
with these directives, in accordance with Code of Federal Regulations
Title 42 (42 CFR) §§489.100 (relating to Definitions), 489.102
(relating to Requirement for Providers), and 489.104 (relating to
Effective Dates) and Texas Health and Safety Code Chapter 166 (relating
to Advance Directives);
(4) the right to have personal privacy;
(5) the right to receive medical standard of care in
a safe setting;
(6) the right to be free from all forms of abuse, neglect,
exploitation, and harassment;
(7) the right to have confidentiality of their medical
records;
(8) the right to the LSRH's reasonable response to
the patient's requests and needs for treatment or service, within
the LSRH's capacity, stated mission, and applicable law and regulation;
(9) the right to considerate and respectful care, which
includes:
(A) the care of the patient includes consideration
of the psychosocial, spiritual, and cultural variables that influence
perceptions of illness; and
(B) the care of a dying patient optimizes the comfort
and dignity of the patient through;
(i) treating primary and secondary symptoms that respond
to treatment as desired by the patient or surrogate decision maker;
(ii) effectively managing pain; and
(iii) acknowledging the psychosocial and spiritual
concerns of the patient and the family regarding dying and the expression
of grief by the patient and family;
(10) the right of the patient or their legally authorized
representative (LAR) to, in collaboration with the patient's physician,
make decisions involving their health care, including:
(A) the right to accept medical care or to refuse treatment
to the extent permitted by law and to be informed of the medical consequences
of such refusal; and
(B) the right to formulate advance directives and to
appoint a surrogate to make health care decisions on their behalf
to the extent permitted by law;
(11) a mechanism to ascertain the existence of, and,
as appropriate, assist in the development of advance directives at
the time of the patient's admission;
(12) the right to not have the provision of care conditioned
on the existence of an advance directive;
(13) the right of a patient to the information necessary
to enable them to make treatment decisions reflecting their wishes;
(14) the right of a patient to receive at the time
of admission information about the LSRH's patient rights policy or
policies and the mechanism for the initiation, review, and, when possible,
resolution of patient complaints concerning the quality of care;
(15) the right to receive information about the patient's
rights in advance of receiving or discontinuing patient care whenever
possible;
(16) the right of the patient or the patient's legally
authorized representative to participate in the consideration of ethical
issues that arise in the care of a patient;
(17) a mechanism for the consideration of ethical issues
arising in the care of patients and to provide education to care givers
and patients on ethical issues in health care;
(18) the right of the patient to be informed of and
consent to any human experimentation or other research or educational
projects affecting their care or treatment;
(19) the right of the patient or the patient's legally
authorized representative to access the information contained in the
patient's medical record, on oral or written request; and
(20) the right of the patient's guardian, next of kin,
or LAR to exercise, to the extent permitted by law, the rights delineated
on behalf of the patient if the patient:
(A) has been adjudicated incompetent in accordance
with the law;
(B) is found by their physician to be medically incapable
of understanding the proposed treatment or procedure;
(C) is unable to communicate their wishes regarding
treatment; or
(D) is a minor.
(c) An LSRH must post the patient bill of rights prominently
and conspicuously for display in a public area of the LSRH that is
readily available to patients, residents, employees, and visitors.
(1) In addition to these patient bill of rights requirements,
an LSRH that provides chemical dependency services shall comply with
this section and Texas Administrative Code Title 25 (25 TAC) §448.701
(relating to Client Bill of Rights) applicable to patients who receive
such services.
(2) In addition to these patient bill of rights requirements,
an LSRH that provides mental health services shall comply with this
section and 25 TAC Chapter 404, Subchapter E (relating to Rights of
Persons Receiving Mental Health Services) applicable to patients who
receive such services.
(3) The patient bill of rights posted for display shall
be in English and in a second language appropriate to the demographic
makeup of the community served.
(d) An LSRH's medical staff and governing body shall
adopt, implement, and enforce a policy on informed decision making
that is consistent with any legal requirements.
(e) An LSRH shall establish a process for prompt resolution
of patient complaints and inform each patient whom to contact to file
a complaint. The LSRH's governing body or responsible individual shall
approve and be responsible for the effective operation of the complaint
process and shall review and resolve complaints, unless it delegates
the responsibility, in writing, to a complaint committee. The complaint
process shall include a mechanism for timely referral of patient concerns
regarding quality of care or premature discharge to the appropriate
Utilization and Quality Control Quality Improvement Organization.
(1) The LSRH shall establish a clearly explained procedure
for the submission of a patient's written or verbal complaint to the
LSRH.
(2) The complaint process shall specify timeframes
for review of the complaint and the provision of a response.
(3) In its resolution of the complaint, the LSRH shall
provide the patient with written notice of its decision that contains
the name of the LSRH contact person, the steps taken on behalf of
the patient to investigate the complaint, the results of the complaint
process, and the date of completion.
(f) Notwithstanding subsection (b) of this section,
an LSRH may deny treatment or services deemed medically unnecessary
or inappropriate.
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