|(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
(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;
(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
(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
(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);
(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
(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.