| (iv) identification and reporting of abuse, neglect,
or exploitation.
(2) Ongoing training.
(A) A facility must provide at least three hours of
ongoing training to direct service staff quarterly. The facility must
ensure that direct delivery staff maintain current certification in
CPR.
(B) A facility must practice evacuation procedures
with staff and individuals at least once a month. The facility must
document evacuation results in the facility records.
(3) Policy for individuals with Alzheimer's disease
or a related disorder. A facility must adopt, implement, and enforce
a written policy that:
(A) requires a facility employee who provides direct
care at the facility to an individual with Alzheimer's disease or
a related disorder to successfully complete training in the provision
of care to individuals with Alzheimer's disease or related disorders;
and
(B) ensures the care and services provided by a facility
employee to an individual with Alzheimer's disease or a related disorder
meet the specific identified needs of the individual relating to the
diagnosis of Alzheimer's disease or a related disorder.
(C) The training required for facility employees under
paragraph (3)(A) of this subsection must include information about:
(i) symptoms and treatment of dementia;
(ii) stages of Alzheimer's disease;
(iii) person-centered behavioral interventions; and
(iv) communication with an individual with Alzheimer's
disease or a related disorder.
(f) Medications.
(1) Administration.
(A) A facility must ensure that a person who holds
a current license under state law that authorizes the licensee to
administer medications to individuals who choose not to or cannot
self-administer their medications.
(B) A facility must ensure that all medication prescribed
to an individual that is administered at the facility is dispensed
through a pharmacy or by the individual's treating physician or dentist.
(C) A facility may administer physician sample medications
at the facility if the medication has specific dosage instructions
for the individual.
(D) A facility must record an individual's medications
on the individual's medication profile record. The recorded information
must be obtained from the prescription label and must include the
medication name, strength, dosage, amount received, directions for
use, route of administration, prescription number, pharmacy name,
and the date each medication was issued by the pharmacy.
(2) Assistance with self-administration. A nurse may
assist with self-administration of an individual's medication if
the individual is unable to administer the medication without assistance.
Assistance with self-administration of medication is limited to the
following activities:
(A) reminding an individual to take medications at
the prescribed time;
(B) opening and closing containers or packages;
(C) pouring prescribed dosage according to the individual's
medication profile record;
(D) returning medications to the proper locked areas;
(E) obtaining medications from a pharmacy; and
(F) listing on an individual's medication profile record
the medication name, strength, dosage, amount received, directions
for use, route of administration, prescription number, pharmacy name,
and the date each medication was issued by the pharmacy.
(3) Self-administration.
(A) A nurse must counsel an individual who self-administers
medication or treatment at least once per month to ascertain if the
individual continues to be able to self-administer the medication
or treatment. The facility must keep a written record of the counseling.
(B) A facility may permit an individual who chooses
to keep the individual's medication locked in the facility's central
medication storage area to enter or have access to the area for the
purpose of self-administering medication or treatment. A facility
staff member must remain in or at the storage area the entire time
the individual is present.
(4) General.
(A) A facility director, an activities director, or
a facility nurse must immediately report to an individual's physician
and responsible party any unusual reactions to a medication or treatment.
(B) When a facility supervises or administers medications,
the facility must document in writing if an individual does not receive
or take the medication and treatment as prescribed. The documentation
must include the date and time the dose should have been taken, and
the name and strength of medication missed.
(5) Storage.
(A) A facility must provide a locked area for all medications,
which may include:
(i) a central storage area; and
(ii) a medication cart.
(B) A facility must store an individual's medication
separately from other individuals' medications within the storage
area.
(C) A facility must store medication requiring refrigeration
in a locked refrigerator that is used only for medication storage
or in a separate, permanently attached, locked medication storage
box in a refrigerator.
(D) A facility must store poisonous substances and
medications labeled for "external use only" separately within the
locked area.
(E) A facility must store drugs covered by Schedule
II of the Controlled Substances Act of 1970 in a locked, permanently
attached cabinet, box, or drawer that is separate from the locked
storage area for other medications.
(6) Disposal.
(A) A facility must keep medication that is no longer
being used by an individual for the following reasons separate from
current medications and ensure the medication is disposed of by a
registered pharmacist licensed in the State of Texas:
(i) the medication has been discontinued by order of
the physician;
(ii) the individual is deceased; or
(iii) the expiration date of the medications has passed.
(B) A facility must dispose of needles and hypodermic
syringes with needles attached as required by 25 TAC, Chapter 1,
Subchapter K (relating to the Definition, Treatment, and Disposition
of Special Waste from Health Care-Related Facilities).
(C) A facility must obtain a signed receipt from an
individual or the individual's responsible party if the facility releases
medication to the individual or responsible party.
(g) Accident, injury, or acute illness.
(1) A facility must stock and maintain in a single
location first aid supplies to treat burns, cuts, and poisoning.
(2) In the event of accident or injury to an individual
requiring emergency medical, dental, or nursing care, or in the event
of death of an individual, a facility must:
(A) make arrangements for emergency care or transfer
to an appropriate place for treatment, including:
(i) a physician's office;
(ii) a clinic; or
(iii) a hospital;
(B) immediately notify an individual's physician and
responsible party, or agency who admitted the individual to the facility;
and
(C) describe and document the accident, injury, or
illness on a separate report. The report must contain a statement
of final disposition and be maintained on file.
(h) Menus.
(1) A facility must plan, date, and post a menu at
least two weeks in advance and maintain a copy of the menu. A facility
must serve meals according to approved menus.
(2) A facility must ensure that a special diet meal
ordered by an individual's physician and developed by the dietician
consultant is labeled with the individual's name and type of diet.
|
| Source Note: The provisions of this §559.62 adopted to be effective May 1, 1999, 24 TexReg 3100; amended to be effective November 1, 2000, 25 TexReg 10753; amended to be effective December 1, 2016, 41 TexReg 9327; amended to be effective October 28, 2018, 43 TexReg 7210; transferred effective January 15, 2021, as published in the Texas Register December 18, 2020, 45 TexReg 9249 |
