| (a) A center must develop an individualized written
plan of care for a minor. The plan of care must include:
(1) the minor's and the minor's parent's goals and
interventions based on the issues identified in the pre-admission
conference and the initial and updated comprehensive assessments;
and
(2) measurable goals with interventions based on the
minor's care needs and means of achieving each goal and must address,
as appropriate, rehabilitative and restorative measures, preventive
intervention and training, and teaching of personal care by the minor's
parent.
(b) An RN must address in the written interdisciplinary
plan of care:
(1) the services needed to address the medical, nursing,
psychosocial, therapeutic, dietary, functional, educational, and developmental
needs of the minor and the training needs of the minor's parent;
(2) the minor's functional assessment;
(3) the specific goals of care;
(4) the time frame for achieving the goals and the
schedule for evaluation of progress;
(5) the orders for treatment, services, medications,
medical equipment, diet, and restraints, if applicable;
(6) specific criteria for transitioning from or discontinuing
participation at the center; and
(7) the minor's scheduled days of attendance.
(c) In collaboration with the interdisciplinary team,
an RN, a minor's parent, the minor, and an individual requested by
the adult minor or the minor's parent must develop a plan of care
based on the comprehensive assessment.
(d) The RN, a minor's parent and the minor, if the
minor is an adult minor, must sign the plan of care within five days
after initiation of the plan.
(e) A minor's prescribing physician must review and
sign the plan of care within 30 days after initiation of the plan.
(f) The center must incorporate the plan of care into
a minor's medical record no later than 10 days after receiving the
signed plan from a minor's prescribing physician.
(g) Copies of the plan of care must be given, in a
language and format the recipient understands, to a minor's parent,
an adult minor, the minor's prescribing physician, the center's staff
and other health care providers and providers of basic services as
appropriate.
(h) The center's IDT and an RN must review and update
a minor's plan of care at least every 180 days, or more often, if
there is a change in a minor's medical condition or changes in a minor's
needs.
(i) A minor's parent and the minor, if the minor is
an adult minor, must review and sign the updated plan of care within
five days before changes to the plan of care are implemented.
(j) A minor's prescribing physician must review and
sign the updated plan of care within 30 days after initiation of
the updated plan.
(k) The center must incorporate the updated plan of
care into a minor's medical record no later than 10 days after receiving
the signed plan from a minor's prescribing physician.
(l) The center must adopt and enforce written policies
and procedures regarding the communication and coordination of a minor's
care with a minor's prescribing physician in accordance with the plan
of care.
(m) The policy described in subsection (l) of this
section must ensure the communication between the center's staff and
the minor's prescribing physician is conveyed to the minor's parent
and the minor in a language and format that an adult minor and minor's
parent understand.
(n) The center's nursing director or designee must:
(1) document communication with the minor's prescribing
physician;
(2) maintain the documentation in the minor's medical
record; and
(3) ensure that the communication is conveyed to the
minor's parent and the adult minor in a language and format the adult
minor and minor's parent understand.
(o) The center staff must ensure the provision of services
and treatments in accordance with the plan of care and as ordered
by the minor's prescribing physician.
|
| Source Note: The provisions of this §550.607 adopted to be effective September 1, 2014, 39 TexReg 6569; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1875 |
