| (a) A limited services rural hospital (LSRH) shall
adopt, implement, and enforce written policies and procedures regarding
patient visitation rights, including those setting forth any clinically
necessary or reasonable restriction or limitation that the LSRH may
need to place on such rights and the reasons for the clinical restriction
or limitation.
(b) An LSRH shall:
(1) inform each patient (or support person, where appropriate)
of their visitation rights, including any clinical restriction or
limitation on such rights, when they are informed of their other rights
under §511.63 of this subchapter (relating to Patient's Rights);
(2) inform each patient of the LSRH's visitation policy;
(3) inform each patient (or support person, where appropriate)
of the right, subject to their consent, to receive the visitors whom
they designate, including a spouse, a domestic partner (including
a same-sex domestic partner), another family member, or a friend,
and their right to withdraw or deny such consent at any time;
(4) not restrict, limit, or otherwise deny visitation
privileges on the basis of race, color, national origin, religion,
sex, gender identity, sexual orientation, or disability;
(5) ensure all visitors enjoy full and equal visitation
privileges consistent with patient preferences; and
(6) record any clinically justified visitation restrictions
in the patient's medical record.
(c) In accordance with Texas Health and Safety Code
(HSC) §260C.002 (relating to In-Person Visitation with Religious
Counselor), except as provided by subsections (d) and (e) of this
section, an LSRH may not prohibit a patient from receiving in-person
visitation with a religious counselor during a public health emergency
upon the request of the patient or, if the patient is incapacitated,
upon the request of the patient's legally authorized representative,
including a family member of the patient.
(d) An LSRH may prohibit in-person visitation with
a religious counselor during a public health emergency if federal
law or a federal agency requires the LSRH to prohibit in-person visitation
during that period.
(e) To the extent that an LSRH establishes policies
and procedures for in-person religious counselor visitation during
a public health emergency, these policies and procedures shall comply
with the following.
(1) The policies and procedures shall establish minimum
health and safety requirements for in-person visitation with religious
counselors consistent with:
(A) state, local, and federal directives and guidance
regarding the public health emergency;
(B) public health emergency and disaster preparedness
plans; and
(C) other policies adopted by the LSRH, including the
LSRH's general visitation policy and infection control policy.
(2) The policies and procedures shall address considerations
for patients who are receiving end-of-life care.
(3) The policies and procedures may contain reasonable
time, place, and manner restrictions on in-person visitation with
religious counselors to mitigate the spread of a communicable disease
or address a patient's medical condition.
(4) The policies and procedures may condition in-person
visitation with religious counselors on the counselor's compliance
with guidelines, policies, and procedures established under this subsection.
(f) In accordance with HSC §241.012 (relating
to In-Person Hospital Visitation During Period of Disaster), an LSRH
may not, during a qualifying period of disaster prohibit in-person
visitation with a patient receiving care or treatment at the LSRH
unless federal law or a federal agency requires the LSRH to prohibit
in-person visitation during that period.
(g) Notwithstanding subsection (f) of this section,
an LSRH may, during a qualifying period of disaster:
(1) restrict the number of visitors a patient receiving
care or treatment at the LSRH may receive to not fewer than one, except
for religious counselors visiting under subsection (b) of this section;
(2) require a visitor, including a religious counselor
visiting under subsection (c) of this section, to:
(A) complete a health screening before entering the
LSRH; and
(B) wear personal protective equipment at all times
while visiting a patient at the LSRH; and
(3) deny entry to or remove from the LSRH's premises
a visitor, including a religious counselor visiting under subsection
(c) of this section, who fails or refuses to:
(A) submit to or meet the requirements of a health
screening administered by the LSRH; or
(B) wear personal protective equipment that meets the
LSRH's infection control and safety requirements in the manner prescribed
by the LSRH.
(h) A health screening administered by an LSRH under
this section and during a qualifying period of disaster must be conducted
in a manner that, at a minimum, complies with:
(1) LSRH policy; and
(2) if applicable, guidance or directives issued by
the Texas Health and Human Services Commission, the Centers for Medicare &
Medicaid Services, or another agency with regulatory authority over
the LSRH.
(i) This section does not require an LSRH to:
(1) provide a specific type of personal protective
equipment to a visitor, including a religious counselor visiting under
subsection (c) of this section; or
(2) except for a religious counselor visiting under
subsection (c) of this section, allow in-person visitation with a
patient receiving care or treatment at the LSRH if an attending physician
determines and documents in the patient's medical record that in-person
visitation with that patient may lead to the transmission of an infectious
agent that poses a serious community health risk during a qualifying
period of disaster.
(j) A determination made by an attending physician
under subsection (h) of this section is valid for not more than five
days after the date the determination is made unless renewed by an
attending physician.
(k) When a visitor to an LSRH is denied in-person visitation
with a patient receiving care or treatment at a LSRH because of a
determination made by an attending physician under subsection (i)(2)
of this section, the LSRH shall:
(1) provide each day a written or oral update of the
patient's condition to the visitor if the visitor:
(A) is authorized by the patient to receive relevant
health information regarding the patient;
(B) has authority to receive the patient's health information
under an advance directive or medical power of attorney; or
(C) is otherwise the patient's surrogate decision-maker
regarding the patient's health care needs under LSRH policy and other
applicable law; and
(2) notify the person who receives the daily update
required under paragraph (1) of this subsection of the estimated date
and time at which the patient will be discharged from the LSRH.
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