| (a) The facility must inform the resident, both orally
and in writing, in a language that the resident understands, of the
resident's rights and all rules and regulations governing resident
conduct and responsibilities during the stay in the facility. This
notification must be made prior to or upon admission and during the
resident's stay if changed.
(b) The facility must also inform the resident, upon
admission and during the stay, in a language the resident understands,
of the following:
(1) facility admission policies;
(2) a description of the protection of personal funds
as described in §554.404 of this subchapter (relating to Protection
of Resident Funds);
(3) the Texas Human Resources Code, Title 6, Chapter
102; or a written list of the rights and responsibilities contained
in the Texas Human Resources Code, Title 6, Chapter 102;
(4) a written description of the services available
through the Ombudsman Program. This information must be made available
to each facility by the ombudsman program. Facilities are responsible
for reproducing this information and making it available to residents,
their families, and resident representatives;
(5) a written statement to the resident, the resident's
next of kin, or guardian describing the facility's policy for:
(A) the drug testing of employees who have direct contact
with residents; and
(B) the criminal history checks of employees and applicants
for employment;
(6) HHSC rules and the facility's policies related
to the use of restraint and involuntary seclusion. This information
must also be given to the resident's legally authorized representative,
if the resident has one; and
(7) facility essential caregiver policies and procedures
during a public health emergency or disaster, and this information
must also be given to the resident’s legally authorized representative,
if the resident has one.
(c) Upon admission of a resident, a facility must:
(1) provide written information to the resident's family
representative, in a language the representative understands, of the
right to form a family council; or
(2) inform the resident's family representative, in
writing, if a family council exists, of the council's meeting time,
date, location and contact person.
(d) Receipt of information in subsections (b) - (d)
of this section, and any amendments to it, must be acknowledged in
writing by all parties receiving the information.
(e) The facility must post a copy of the documents
specified in subsections (a) and (b) of this section in a conspicuous
location.
(f) The resident or the resident's legal representative
has the following rights:
(1) upon an oral or written request to the facility,
to access all records pertaining to the resident, including clinical
records, within 24 hours (excluding weekends and holidays); and
(2) to purchase photocopies of all or any portion of
the records upon request and two workdays advance notice to the facility.
(g) The resident has the right to be fully informed
in language the resident understands of the resident's total health
status, including the resident's medical condition.
(h) The resident has the right to refuse treatment,
to formulate an advance directive (as specified in §554.419 of
this subchapter (relating to Advance Directives), and to refuse to
participate in experimental research.
(1) If the resident refuses treatment, the resident
must be informed of the possible consequences.
(2) If the resident chooses to participate in experimental
research, the resident must be fully notified of the research and
possible effects of the research. The research may be carried on only
with the full written consent of the resident's physician, and the
resident.
(3) Experimental research must comply with Federal
Drug Administration regulations on human research as found in 45 CFR,
Part 46.
(i) The facility must inform a resident before, or
at the time of admission, and periodically during the resident's stay
(if there are any changes), of services available in the facility
and of charges for those services, including any charges for services
not covered under Medicare or by the facility's per diem rate.
(j) The facility must provide a written description
of a resident's legal rights, which includes:
(1) a description of the manner of protecting personal
funds, described in §554.404 of this subchapter;
(2) a posting of names, addresses, and telephone numbers
of all pertinent state client advocacy groups such as HHSC, the Ombudsman
Program, the protection and advocacy network, and, in Medicaid-certified
facilities, the Medicaid fraud control unit; and
(3) a statement that the resident may file a complaint
with HHSC concerning resident abuse, neglect, and misappropriation
of resident property in the facility.
(k) The facility must inform a resident of the name,
specialty, and way of contacting the physician responsible for the
resident's care.
(l) Notification of changes.
(1) A facility must immediately inform the resident;
consult with the resident's physician; and notify, consistent with
the representative's authority, the resident representative when there
is:
(A) an accident involving the resident that results
in injury and has the potential for requiring physician intervention;
(B) a significant change in the resident's physical,
mental, or psychosocial status (that is, a deterioration in health,
mental, or psychosocial status in either life-threatening conditions
or clinical complications);
(C) a need to alter treatment significantly (that is,
a need to discontinue an existing form of treatment due to adverse
consequences, or to commence a new form of treatment); or
(D) a decision to transfer or discharge the resident
from the facility.
(2) The facility also must promptly notify the resident
and the resident representative, if any, when there is:
(A) a change in room or roommate assignment with the
reason for the change provided in writing; or
(B) a change in resident rights under federal or state
law or regulations as described in subsection (b) of this section.
(3) The facility must record and periodically update
the address and phone number of the resident.
(m) Additional requirements for Medicaid-certified
facilities. Medicaid-certified facilities must:
(1) provide the resident with the state-developed notice
of rights under §1919(e)(6) of the Social Security Act (42 U.S.C. §1396r(e)(6));
(2) inform a resident who is entitled to Medicaid benefits,
in writing, at the time of admission to the nursing facility or, when
the resident becomes eligible for Medicaid of:
(A) the items and services that are included in nursing
facility services provided under the State Plan and for which the
resident may not be charged;
(B) those other items and services that the facility
offers and for which the resident may be charged, and the amount of
charges for those services;
(3) inform each resident when changes are made to the
items and services specified in paragraph (2)(A) and (B) of this subsection;
(4) provide a written description of the requirements
and procedures for establishing eligibility for Medicaid, including
the right to request an assessment under §1924(c) of the Social
Security Act (42 U.S.C. §1396r-5(c)), which:
(A) is used to determine the extent of a couple's nonexempt
resources at the time of institutionalization; and
(B) attributes to the community spouse an equitable
share of resources that cannot be considered available for payment
toward the cost of the institutionalized spouse's medical care in
the process of spending down to Medicaid eligibility levels; and
(5) prominently display in the facility written information,
and provide to residents and potential residents oral and written
information about how to apply for and use Medicare and Medicaid benefits,
and how to receive refunds for previous payments covered by such benefits.
(n) Additional requirements for certain facilities
related to memory care and Alzheimer’s disease and related disorders.
Facilities must provide the following HHSC forms:
(1) for a facility that advertises, markets, or otherwise
promotes that it provides memory care services to residents, the Memory
Care Disclosure Statement for Nursing Facilities, to each resident,
disclosing as required by the Texas Health and Safety Code §242.0405
whether the facility is certified to provide specialized care and
treatment for a resident with Alzheimer's disease and related disorders,
to:
Cont'd... |
