| (iv) a detailed emergency plan that explains how the
facility will meet the evacuation needs of the resident, including:
(I) the specific staff positions that will be on duty
to assist with evacuation and their shift times;
(II) specific staff positions that will be on duty
and awake at night; and
(III) specific staff training that relates to resident
evacuation;
(v) a copy of an accurate facility floor plan, to scale,
that labels all rooms by use and indicates the specific resident's
room;
(vi) a copy of the facility's emergency evacuation
plan;
(vii) a copy of the facility fire drill records for
the last 12 months;
(viii) a copy of a completed Fire Marshal/State Fire
Marshal Notification, Form 1127, signed by the fire authority having
jurisdiction (either the local Fire Marshal or State Fire Marshal)
as an acknowledgement that the fire authority has been notified that
the resident's evacuation capability has changed;
(ix) a copy of a completed Fire Suppression Authority
Notification, Form 1129, signed by the local fire suppression authority
as an acknowledgement that the fire suppression authority has been
notified that the resident's evacuation capability has changed;
(x) a copy of the resident's most recent comprehensive
assessment that addresses the areas required by subsection (c) of
this section and that was completed within 60 days, based on the
date stated on the evacuation waiver form submitted to DADS;
(xi) the resident's service plan that addresses all
aspects of the resident's care, particularly those areas identified
by DADS, including:
(I) the resident's medical condition and related nursing
needs;
(II) hospitalizations within 60 days, based on the
date stated on the evacuation waiver form submitted to DADS;
(III) any significant change in condition in the last
60 days, based on the date stated on the evacuation waiver form submitted
to DADS;
(IV) specific staffing needs; and
(V) services that are provided by an outside provider;
(xii) any other information that relates to the required
fire safety features of the facility that will ensure the evacuation
capability of any resident; and
(xiii) service plans of other residents, if requested
by DADS.
(D) A facility must meet the following criteria to
receive a waiver from DADS:
(i) The emergency plan submitted in accordance with
subparagraph (C)(iv) of this paragraph must ensure that:
(I) staff is adequately trained;
(II) a sufficient number of staff is on all shifts
to move all residents to a place of safety;
(III) residents will be moved to appropriate locations,
given health and safety issues;
(IV) all possible locations of fire origin areas and
the necessity for full evacuation of the building are addressed;
(V) the fire alarm signal is adequate;
(VI) there is an effective method for warning residents
and staff during a malfunction of the building fire alarm system;
(VII) there is a method to effectively communicate
the actual location of the fire; and
(VIII) the plan satisfies any other safety concerns
that could have an effect on the residents' safety in the event of
a fire; and
(ii) the emergency plan will not have an adverse effect
on other residents of the facility who have waivers of evacuation
or who have special needs that require staff assistance.
(E) DADS reviews the documentation submitted under
this subsection and notifies the facility in writing of its determination
to grant or deny the waiver within 10 working days after the date
the request is received in the DADS regional office.
(F) Upon notification that DADS has granted the evacuation
waiver, the facility must immediately initiate all provisions of the
proposed emergency plan. If the facility does not follow the emergency
plan, and there are health and safety concerns that are not addressed,
DADS may determine that there is an immediate threat to the health
or safety of a resident.
(G) DADS reviews a waiver of evacuation during the
facility's annual renewal licensing inspection.
(3) If a DADS surveyor determines that a resident is
inappropriately placed at a facility and the facility either agrees
with the determination or fails to obtain the written statements or
waiver required in this subsection, the facility must discharge the
resident.
(A) The resident is allowed 30 days after the date
of notice of discharge to move from the facility.
(B) A discharge required under this subsection must
be made notwithstanding:
(i) any other law, including any law relating to the
rights of residents and any obligations imposed under the Property
Code; and
(ii) the terms of any contract.
(4) If a facility is required to discharge the resident
because the facility has not submitted the written statements required
by paragraph (1) of this subsection to the DADS regional office, or
DADS denies the waiver as described in paragraph (2) of this subsection,
DADS may:
(A) assess an administrative penalty if DADS determines
the facility has intentionally or repeatedly disregarded the waiver
process because the resident is still residing in the facility when
DADS conducts a future onsite visit; or
(B) seek other sanctions, including an emergency suspension
or closing order, against the facility under Texas Health and Safety
Code Chapter 247, Subchapter C (relating to General Enforcement),
if DADS determines there is a significant risk and immediate threat
to the health and safety of a resident of the facility.
(5) The facility's disclosure statement must notify
the resident and resident's legally authorized representative of the
waiver process described in this section and the facility's policies
and procedures for aging in place.
(6) After the first year of employment and no later
than the anniversary date of the facility manager's hire date, the
manager must show evidence of annual completion of DADS training on
aging in place and retaliation.
(g) Advance directives.
(1) The facility must maintain written policies regarding
the implementation of advance directives. The policies must include
a clear and precise statement of any procedure the facility is unwilling
or unable to provide or withhold in accordance with an advance directive.
(2) The facility must provide written notice of these
policies to residents at the time they are admitted to receive services
from the facility.
(A) If, at the time notice is to be provided, the resident
is incompetent or otherwise incapacitated and unable to receive the
notice, the facility must provide the written notice, in the following
order of preference, to:
(i) the resident's legal guardian;
(ii) a person responsible for the resident's health
care decisions;
(iii) the resident's spouse;
(iv) the resident's adult child;
(v) the resident's parents; or
(vi) the person admitting the resident.
(B) If the facility is unable, after diligent search,
to locate an individual listed under subparagraph (A) of this paragraph,
the facility is not required to give notice.
(3) If a resident who was incompetent or otherwise
incapacitated and unable to receive notice regarding the facility's
advance directives policies later becomes able to receive the notice,
the facility must provide the written notice at the time the resident
becomes able to receive the notice.
(4) Failure to inform the resident of facility policies
regarding the implementation of advance directives will result in
an administrative penalty of $500.
(A) Facilities will receive written notice of the recommendation
for an administrative penalty.
(B) Within 20 days after the date on which written
notice is sent to a facility, the facility must give written consent
to the penalty or make written request for a hearing to the Texas
Health and Human Services Commission.
(C) Hearings will be held in accordance with the formal
hearing procedures at 1 TAC Chapter 357, Subchapter I (relating to
Hearings Under the Administrative Procedures Act).
(h) Resident records.
(1) Records that pertain to residents must be treated
as confidential and properly safeguarded from unauthorized use, loss,
or destruction.
(2) Resident records must contain:
(A) information contained in the facility's standard
and customary admission form;
Cont'd... |
