| (2) a nursing task will be performed by the program
provider's unlicensed service provider and a physician has delegated
the task as a medical act under Texas Occupations Code, Chapter 157,
as documented by the physician.
(r) If an individual or LAR refuses a nursing assessment
described in §9.555(c)(10)(A) of this subchapter, the program
provider must not:
(1) provide nursing services to the individual; or
(2) provide community support, day habilitation, employment
assistance, supported employment, respite, or CFC PAS/HAB to the individual
unless:
(A) an unlicensed service provider does not perform
nursing tasks in the provision of the service; and
(B) the program provider determines that it can ensure
the individual's health, safety, and welfare in the provision of the
service.
(s) If an individual or LAR refuses a nursing assessment
and the program provider determines that the program provider cannot
ensure the individual's health, safety, and welfare in the provision
of a service as described in subsection (r) of this section, the
program provider must:
(1) immediately notify the individual or LAR and the
individual's service coordinator, in writing, of the determination;
and
(2) include in the notification required by paragraph
(1) of this subsection the reasons for the determination and the services
affected by the determination.
(t) If notified by the service coordinator that the
individual or LAR refuses the nursing assessment after the discussion
with the service coordinator as described in §9.583(j)(6) of
this subchapter (relating to TxHmL Program Principles for LIDDAs),
the program provider must immediately send the written notification
described in subsection (s) of this section to DADS.
(u) The program provider must, if a physician delegates
a medical act to an unlicensed service provider in accordance with
Texas Occupations Code, Chapter 157, and the program provider has
concerns about the health or safety of the individual in performance
of the medical act, communicate the concern to the delegating physician
and take additional steps as necessary to ensure the health and safety
of the individual.
(v) The program provider must:
(1) for an applicant 21 years of age or older residing
in a nursing facility who is enrolling in the TxHmL Program:
(A) participate as a member of the service planning
team, which includes attending service planning team meetings scheduled
by the service coordinator;
(B) assist in the implementation of the applicant's
transition plan as described in the plan; and
(C) be physically present for the pre-move site review
and assist the service coordinator during the review as requested;
and
(2) for 365 calendar days after an individual 21 years
of age or older has enrolled in the TxHmL Program from a nursing facility
or has enrolled in the TxHmL Program as a diversion from admission
to a nursing facility:
(A) be physically present for each post-move monitoring
visit and assist the service coordinator during the visit as requested;
(B) assist in the implementation of the individual's
transition plan as described in the plan;
(C) participate as a member of the service planning
team, which includes attending service planning team meetings scheduled
by the service coordinator; and
(D) within one calendar day after becoming aware of
an event or condition that may put the individual at risk of admission
or readmission to a nursing facility, notify the service planning
team of the event or condition.
(w) A program provider must ensure that CFC PAS/HAB
is provided in accordance with the individual's PDP, IPC, and implementation
plan.
(x) CFC ERS must be provided in accordance with this
subsection.
(1) A program provider must ensure that CFC ERS is
provided only to an individual who:
(A) lives alone, who is alone for significant parts
of the day, or has no regular caregiver for extended periods of time;
and
(B) would otherwise require extensive routine supervision.
(2) A program provider must ensure that CFC ERS is
provided in accordance with the individual's PDP, IPC, and implementation
plan.
(3) A program provider must ensure that CFC ERS equipment
is installed within 14 business days after one of the following dates,
whichever is later:
(A) the date DADS authorizes the proposed IPC that
includes CFC ERS; or
(B) the effective date of the individual's IPC as determined
by the service planning team.
(4) At the time CFC ERS equipment is installed, a program
provider must ensure that:
(A) the equipment is installed in accordance with the
manufacturer's installation instructions;
(B) an initial test of the equipment is made;
(C) the equipment has an alternate power source in
the event of a power failure;
(D) the individual is trained on the use of the equipment,
including:
(i) demonstrating how the equipment works; and
(ii) having the individual activate an alarm call;
(E) an explanation is given to the individual that
the individual must:
(i) participate in a system check each month; and
(ii) contact the CFC ERS provider if:
(I) the individual's telephone number or address changes;
or
(II) one or more of the individual's responders change;
and
(F) the individual is informed that a responder, in
response to an alarm call, may forcibly enter the individual's home
if necessary.
(5) A program provider must ensure that the date and
time of the CFC ERS equipment installation and compliance with the
requirements in paragraphs (4) and (5) of this subsection are documented
in the individual's record.
(6) A program provider must ensure that, on or before
the date CFC ERS equipment is installed:
(A) an attempt is made to obtain from an individual,
the names and telephone numbers of at least two responders, such as
a relative or neighbor;
(B) public emergency personnel:
(i) is designated as a second responder if the individual
provides the name of only one responder; or
(ii) is designated as the sole responder if the individual
does not provide the names of any responders; and
(C) the name and telephone number of each responder
is documented in the individual's record.
(7) At least once during each calendar month a program
provider must ensure that a system check is conducted on a date and
time agreed to by the individual.
(8) A program provider must ensure that the date, time,
and result of the system check is documented in the individual's record.
(9) If, as a result of the system check:
(A) the equipment is working properly but the individual
is unable to successfully activate an alarm call, the program provider
must ensure that a request is made of the service coordinator to convene
a service planning team meeting to determine if CFC ERS meets the
individual's needs; or
(B) the equipment is not working properly, the program
provider must ensure that, within three calendar days of the system
check, the equipment is repaired or replaced.
(10) If a system check is not conducted in accordance
with paragraph (7) of this subsection, the program provider must ensure
that:
(A) the failure to comply is because of good cause;
and
(B) the good cause is documented in the individual's
record.
(11) A program provider must ensure that an alarm call
is responded to 24 hours a day, seven days a week.
(12) A program provider must ensure that, if an alarm
call is made, the CFC ERS provider:
(A) within 60 seconds of the alarm call, attempts to
contact the individual to determine if an emergency exists;
(B) immediately contacts a responder, if as a result
of attempting to contact the individual:
(i) the CFC ERS provider confirms there is an emergency;
or
(ii) the CFC ERS provider is unable to communicate
with the individual; and
(C) documents the following information in the individual's
record when the information becomes available:
(i) the name of the individual;
(ii) the date and time of the alarm call, recorded
in hours, minutes, and seconds;
(iii) the response time, recorded in seconds;
Cont'd... |
