|(a) For purposes of this subchapter, the term, "communicable
diseases" has the meaning assigned to it under 25 TAC Chapter 97 (relating
to Communicable Diseases).
(b) A facility must:
(1) comply with the requirements for advance directives
as outlined under subsection (c) of this section;
(2) comply with the provisions of Chapter 250 of the
Health and Safety Code (relating to criminal history checks of employees
and applicants for employment in certain facilities serving the elderly
or persons with disabilities);
(3) before offering employment, search the employee
misconduct registry (EMR) established under §253.007, Health
and Safety Code, and the DADS nurse aide registry (NAR) to determine
if an individual is designated in either registry as unemployable.
Both registries can be accessed on the DADS Internet website.
(A) A facility must not employ a person who is listed
as unemployable in either registry.
(B) A facility must provide information about the EMR
to an employee in accordance with §93.3 of this title (relating
to Employment and Registry Information).
(C) In addition to the initial search of the EMR and
NAR, a facility must:
(i) conduct a search of the NAR and EMR to determine
if the employee is designated in either registry as unemployable as
(I) for an employee most recently hired before September
1, 2009, by August 31, 2011 and at least every twelve months thereafter;
(II) for an employee most recently hired on or after
September 1, 2009, at least every twelve months; and
(ii) keep a copy of the results of the initial and
annual searches of the NAR and EMR in the employee's personnel file;
(4) develop policies to comply with standards for universal
precautions for HIV/AIDS and related conditions in the workplace;
(5) develop written policies for the control of communicable
diseases in employees and clients, which include tuberculosis (TB)
screening and provision of a safe and sanitary environment for clients
and their families;
(6) comply with all relevant federal and state standards;
(7) comply with all applicable provisions of the Human
Resource Code, Chapter 102.
(c) A facility must maintain policies and procedures
regarding the following rules with respect to all adult clients receiving
services provided by the facility:
(1) The facility must provide a client with the following
(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 outlined
under the Human Resource Code §102.004, Rights of the Elderly.
(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 they understand, on issues concerning advance
(6) The facility must provide the attending physician
with any information relating to a known existing Directive to Physicians
or Living Will or Durable Power of Attorney for Health Care, and assist
with coordinating physicians' orders with any directive.
(7) When a client is in an incapacitated state, and
therefore is unable to receive information or articulate whether he
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 understands, if he 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.
(d) A facility must:
(1) contact DADS at 1-800-458-9858 on learning of alleged
abuse or neglect of a client and send a written investigation report
to DADS no later than the fifth working day after the oral report;
(2) maintain incident reports;
(3) ensure the confidentiality of individual client
records and other information related to clients; and
(4) inform the client orally and in writing of his
rights, responsibilities, and grievance procedures in a language he
(e) A facility must prominently and conspicuously post
for display in a public area of the facility that is readily available
to clients, employees, and visitors:
(1) the license issued under this chapter;
(2) a sign prescribed by DADS that describes complaint
procedures and specifies how complaints may be filed with DADS;
(3) a notice in the form prescribed by DADS stating
that inspection and related reports are available at the facility
for public inspection and providing DADS' toll-free telephone number
that may be used to obtain information concerning the facility;
(4) a copy of the most recent inspection report relating
to the facility;
(5) a brochure or letter that outlines the facility's
hours of operation, holidays, and a description of activities offered;
(6) emergency telephone numbers, including the abuse
hotline telephone number, near all telephones.
|Source Note: The provisions of this §559.61 adopted to be effective May 1, 1999, 24 TexReg 3100; amended to be effective November 1, 2000, 25 TexReg 10753; amended to be effective November 19, 2001, 26 TexReg 9414; amended to be effective September 1, 2010, 35 TexReg 6355; transferred effective January 15, 2021, as published in the Texas Register December 18, 2020, 45 TexReg 9249