| (5) The EMS provider shall, consistent with applicable
law, permit the department to copy or reproduce, or shall provide
photocopies to the department of any requested records or documents.
If it is necessary for the department to remove records or other information
(other than photocopies) from the provider's premises, the department
will provide the EMS provider's governing authority or designee with
a written statement of this fact, describing the information being
removed and when it is expected to be returned. The department will
make a reasonable effort, consistent with the circumstances, to return
the records the same day.
(6) The department will hold an entrance conference
with the EMS provider, governing authority or designee before beginning
the inspection or investigation, to explain, consistent with applicable
law, the nature, scope and estimated time schedule of the inspection
or investigation.
(7) Except for a complaint investigation or a follow-up
visit, an inspection will include an evaluation of compliance with
the Health and Safety Code, Chapter 773 and the rules of this chapter.
During the inspection, the department representative will, unless
otherwise provided for by law, inform the EMS provider's governing
authority or designee of the preliminary findings and give the provider
a reasonable opportunity to submit additional facts or other information
to the department representative in response to those findings.
(8) When the inspection is complete, the department
will hold an exit conference with the provider, unless otherwise provided
for by law, to inform the provider, to the extent permitted by law,
of any preliminary findings of the inspection or investigation and
to give the EMS provider the opportunity to provide additional information
regarding the deficiencies cited. If no deficiencies are identified
at the time of inspection, a statement indicating this fact may be
left with the EMS provider's governing authority or designee. Such
a statement does not constitute a department finding or certification
that the facility is in compliance.
(9) If deficiencies are cited:
(A) the department will provide the EMS provider's
administrator of record and medical director with a written deficiency
report no more than 30 calendar days after the exit conference.
(B) The EMS provider's governing authority, designee,
or person in charge at the time shall sign an acknowledgement of the
inspection and receipt of the written deficiency report and return
it to the department. The signature does not indicate the EMS provider's
agreement with, or admission to the cited deficiencies unless the
agreement or admission is explicitly stated.
(C) No later than 30 calendar days after the EMS provider's
receipt of the deficiency report, the EMS provider shall return a
written plan of correction to the department for each deficiency,
including time frames for implementation, together with any additional
evidence of compliance the EMS provider may have, regarding any cited
deficiency. The department will determine if the written plan of correction
and proposed timeframes for implementation are acceptable. If the
plan is not acceptable, the department will notify the provider in
writing no later than 30 days after receipt and request a modified
plan. The EMS provider shall modify and resubmit the plan of correction
no later than 30 calendar days after the EMS provider's receipt of
the request. The EMS provider shall correct the identified deficiencies
and submit documentation to the department verifying completion of
the corrective action within the timeframes set forth in the plan
of correction accepted by the department, or as otherwise specified
by the department. The provider will be deemed to have received the
deficiency report or other department correspondence mailed under
this subparagraph three days after mailing.
(D) Regardless of the EMS provider's compliance with
this subsection, the department's acceptance of the provider's plan
of correction, or the provider's utilization of an informal compliance
group review under paragraph (10) of this subsection, the department
may, at any time, propose to take action as appropriate under §157.16
of this title (relating to Emergency Suspension, Suspension, Probation,
Revocation, Denial of a Provider License or Administrative Penalties).
(10) The department inspector will inform the provider's
chief executive officer, designee, or person in charge at the time
of the inspection, of the provider's right to an informal compliance
group review, when there is disagreement with deficiencies cited by
the inspector or investigator, that the provider was unable to resolve
through submission of information to the inspector or additional information
bearing on the deficiencies cited.
(11) The department shall refer issues and complaints
relating to the conduct or actions by licensed professionals to their
appropriate licensing boards.
(12) All initial applicants and their medical director
shall be required to have an initial compliance survey by the department
that evaluates all aspects of the applicant's proposed operations
including clinical care components and an inspection of all vehicles
prior to the issuance of a license.
(13) At renewal, randomly, or in response to a complaint,
the department may conduct an unannounced compliance survey that includes
inspection of a provider's vehicles, operations and/or records to
ensure compliance with this title at any time, including nights or
weekends.
(14) If a re-survey/inspection to ensure correction
of a deficiency is conducted, the provider shall pay a nonrefundable
fee of $30 per vehicle needing a re-inspection.
(s) Specialty Care Transports. A Specialty Care Transport
is defined as the interfacility transfer by a department licensed
EMS provider of a critically ill or injured patient requiring specialized
interventions, monitoring and/or staffing. To qualify to function
as a Specialty Care Transport the following minimum criteria shall
be met:
(1) Qualifying Interventions:
(A) patients with one or more of the following IV infusions:
vasopressors; vasoactive compounds; antiarrhythmics; fibrinolytics;
tocolytics; blood or blood products and/or any other parenteral pharmaceutical
unique to the patient's special health care needs; and
(B) one or more of the following special monitors or
procedures: mechanical ventilation; multiple monitors; cardiac balloon
pump; external cardiac support (ventricular assist devices, etc);
any other specialized device, vehicle or procedure unique to the patient's
health care needs.
(2) Equipment. All specialized equipment and supplies
appropriate to the required interventions shall be available at the
time of the transport.
(3) Minimum Required Staffing. One currently certified
EMT-Basic and one currently certified or licensed paramedic with the
additional training as defined in paragraph (4) of this subsection;
or, a currently certified EMT-Basic and a currently certified or licensed
paramedic accompanied by at least one of the following: a Registered
Nurse with special knowledge of the patient's care needs; a certified
Respiratory Therapist; a licensed physician; or, any other licensed
health care professional designated by the transferring physician.
(4) Additional Required Education and Training for
Certified/Licensed Paramedics: Evidence of successful completion of
post-paramedic education, training and appropriate periodic skills
verification in management of patients on ventilators, 12 lead EKG
and/or other critical care monitoring devices, drug infusion pumps,
and cardiac and/or other critical care medications, or any other specialized
procedures or devices determined at the discretion of the EMS provider's
medical director.
(t) For all initial applications and renewal applications,
the department is authorized to collect subscription and convenience
fees, in amounts determined by the Texas Online Authority, to recover
costs associated with the initial application and renewal application
processing through Texas Online.
(u) Complaint Investigations.
(1) Upon request, all licensed EMS Providers shall
make available for a patient or its legal guardian a written statement
supplied by the department, identifying the department as the responsible
agency for conducting EMS provider and EMS personnel complaint investigations.
The statement shall inform persons that they may direct a complaint
to the Department of State Health Services, EMS Compliance Group,
by phone, or by email. The statement shall provide the most current
contact information, including the appropriate department group, address,
local and toll-free telephone number, and email address for filing
a complaint.
(2) The department evaluates all complaints made against
EMS providers and/or EMS personnel. Any complaint submitted to the
department shall be submitted by telephone, electronically, or in
writing, using the department's current contact information for that
purpose, as described in paragraph (1) of this subsection.
Cont'd... |
