| (A) obstructs the resident's airway, including a procedure
that places anything in, on, or over the resident's mouth or nose;
(B) impairs the resident's breathing by putting pressure
on the resident's torso;
(C) interferes with the resident's ability to communicate;
or
(D) places the resident in a prone or supine position.
(5) If a facility uses a restraint hold in a circumstance
described in paragraph (2) of this subsection, the facility must use
an acceptable restraint hold.
(A) An acceptable restraint hold is a hold in which
the individual's limbs are held close to the body to limit or prevent
movement and that does not violate the provisions of paragraph (4)
of this subsection.
(B) After the use of restraint, the facility must:
(i) with the resident's consent, make an appointment
with the resident's physician no later than the end of the first working
day after the use of restraint and document in the resident's record
that the appointment was made; or
(ii) if the resident refuses to see the physician,
document the refusal in the resident's record.
(C) As soon as possible but no later than 24 hours
after the use of restraint, the facility must notify one of the following
persons, if there is such a person, that the resident has been restrained:
(i) the resident's legally authorized representative;
or
(ii) an individual actively involved in the resident's
care, unless the release of this information would violate other law.
(D) If, under the Health Insurance Portability and
Accountability Act, the facility is a "covered entity," as defined
in 45 Code of Federal Regulations (CFR) §160.103, any notification
provided under subparagraph (C)(ii) of this paragraph must be to a
person to whom the facility is allowed to release information under
45 CFR §164.510.
(6) In order to decrease the frequency of the use of
restraint, facility staff must be aware of and adhere to the findings
of the resident assessment required in subsection (c) of this section
for each resident.
(7) A facility may adopt policies that allow less use
of restraint than allowed by the rules of this chapter.
(8) A facility must not discharge or otherwise retaliate
against:
(A) an employee, resident, or other person because
the employee, resident, or other person files a complaint, presents
a grievance, or otherwise provides in good faith information relating
to the misuse of restraint or seclusion at the facility; or
(B) a resident because someone on behalf of the resident
files a complaint, presents a grievance, or otherwise provides in
good faith information relating to the misuse of restraint or seclusion
at the facility.
(q) Accreditation status. If a license holder uses
an on-site accreditation survey by an accreditation commission instead
of a licensing survey by DADS, as provided in §92.11(c)(2) and
§92.15(j) of this chapter (relating to Criteria for Licensing;
and Renewal Procedures and Qualifications), the license holder must
provide written notification to DADS within five working days after
the license holder receives a notice of change in accreditation status
from the accreditation commission. The license holder must include
a copy of the notice of change with its written notification to DADS.
(r) Vaccine Preventable Diseases.
(1) Effective September 1, 2012, a facility must develop
and implement a policy to protect a resident from vaccine preventable
diseases in accordance with Texas Health and Safety Code, Chapter
224.
(2) The policy must:
(A) require an employee or a contractor providing direct
care to a resident to receive vaccines for the vaccine preventable
diseases specified by the facility based on the level of risk the
employee or contractor presents to residents by the employee's or
contractor's routine and direct exposure to residents;
(B) specify the vaccines an employee or contractor
is required to receive in accordance with paragraph (1) of this subsection;
(C) include procedures for the facility to verify that
an employee or contractor has complied with the policy;
(D) include procedures for the facility to exempt an
employee or contractor from the required vaccines for the medical
conditions identified as contraindications or precautions by the Centers
for Disease Control and Prevention;
(E) for an employee or contractor who is exempt from
the required vaccines, include procedures the employee or contractor
must follow to protect residents from exposure to disease, such as
the use of protective equipment, such as gloves and masks, based on
the level of risk the employee or contractor presents to residents
by the employee's or contractor's routine and direct exposure to residents;
(F) prohibit discrimination or retaliatory action
against an employee or contractor who is exempt from the required
vaccines for the medical conditions identified as contraindications
or precautions by the Centers for Disease Control and Prevention,
except that required use of protective medical equipment, such as
gloves and masks, may not be considered retaliatory action;
(G) require the facility to maintain a written or electronic
record of each employee's or contractor's compliance with or exemption
from the policy;
(H) include disciplinary actions the facility may take
against an employee or contractor who fails to comply with the policy.
(3) The policy may:
(A) include procedures for an employee or contractor
to be exempt from the required vaccines based on reasons of conscience,
including religious beliefs; and
(B) prohibit an employee or contractor who is exempt
from the required vaccines from having contact with residents during
a public health disaster, as defined in Texas Health and Safety Code,
§81.003 (relating to Communicable Diseases).
(s) A DADS employee must not retaliate against an assisted
living facility, an employee of an assisted living facility, or a
person in control of an assisted living facility for:
(1) complaining about the conduct of a DADS employee;
(2) disagreeing with a DADS employee about the existence
of a violation of this chapter or a rule adopted under this chapter;
or
(3) asserting a right under state or federal law.
|
| Source Note: The provisions of this §553.41 adopted to be effective August 1, 2000, 25 TexReg 6361; amended to be effective May 1, 2001, 26 TexReg 2047; amended to be effective September 1, 2002, 27 TexReg 6329 ; amended to be effective September 1, 2003, 28 TexReg 3830; amended to be effective August 1, 2004, 29 TexReg 6354; amended to be effective June 1, 2006, 31 TexReg 4470; amended to be effective April 1, 2007, 32 TexReg 1582; amended to be effective September 1, 2010, 35 TexReg 7877; amended to be effective June 1, 2012, 37 TexReg 3876; amended to be effective January 6, 2014, 39TexReg 90; amended to be effective July 21, 2016, 41 TexReg 5214; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1886 |
