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RULE §568.62Medical Services

(a) Medical services in treatment plan. A hospital shall provide medical services to a patient in accordance with a treatment plan developed in accordance with §568.61 of this subchapter (relating to Inpatient Mental Health Treatment and Treatment Planning).

(b) Director of psychiatric services. A hospital shall have a director of psychiatric services who directs, monitors, and evaluates the psychiatric services provided.

(c) Qualifications of director of psychiatric services. In accordance with Texas Health and Safety Code §577.008, the director of psychiatric services shall be a physician who:

  (1) is certified in psychiatry by the American Board of Psychiatry and Neurology or by the American Osteopathic Board of Psychiatry and Neurology; or

  (2) has three years of experience as a physician in psychiatry in a "mental hospital" as defined in Texas Health and Safety Code §571.003.

(d) Treating physician. A hospital shall assign a treating physician to a patient and document such assignment in the patient's medical record at the time the patient is admitted.

(e) Physical examination.

  (1) A physician shall:

    (A) review written findings of a physical examination of the patient conducted by another physician no more than seven days before the patient's admission; or

    (B) conduct a physical examination of the patient.

  (2) The physical examinations described in paragraph (1) of this subsection shall include a neurological screening and, if indicated, a comprehensive neurological examination.

(f) Psychiatric evaluation. A physician shall conduct an initial psychiatric evaluation of a patient. The results of the initial evaluation shall include:

  (1) a description of the patient's medical history;

  (2) a determination of the patient's mental status;

  (3) a description of the onset of the patient's mental illness, any substance-related or addictive disorder, and the circumstances leading to admission;

  (4) an estimation of the patient's intellectual functioning, memory functioning, and orientation;

  (5) a description of the patient's strengths and limitations; and

  (6) the diagnoses of the patient's mental illness and, if applicable, any substance-related and addictive disorders.

(g) Re-evaluation. A physician shall re-evaluate a patient:

  (1) once a day for five of the first seven days after the initial psychiatric evaluation described in subsection (f) of this section is conducted and once a week thereafter; and

  (2) as clinically indicated.

(h) Provision of medical services. A hospital shall provide:

  (1) medical services to a patient in response to an emergency medical condition in accordance with the plan required by §568.41 of this chapter (relating to Responding to an Emergency Medical Condition); and

  (2) other medical services, as needed by the patient, or transfer the patient to a health care entity that can provide the medical services in accordance with the following, as applicable:

    (A) §510.43 of this title (relating to Patient Transfer Policy), or a transfer agreement made in accordance with §510.61 of this title (relating to Patient Transfer Agreements); or

    (B) 25 TAC §133.44 (relating to Hospital Patient Transfer Policy), or a transfer agreement made in accordance with 25 TAC §133.61 (relating to Hospital Patient Transfer Agreements).

(i) Availability of physicians. At least one physician shall always:

  (1) be physically present at the hospital to provide medical services to a patient; or

  (2) be available to staff members by telephone, radio, or audiovisual telecommunication to provide medical consultation.

Source Note: The provisions of this §568.62 adopted to be effective May 27, 2021, 46 TexReg 3276

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