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TITLE 25HEALTH SERVICES
PART 1DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 133HOSPITAL LICENSING
SUBCHAPTER COPERATIONAL REQUIREMENTS
RULE §133.51In-Person Visitation During a Public Health Emergency or Disaster

(a) The following words and terms, when used in this section, have the following meanings, unless the context clearly indicates otherwise.

  (1) Public health emergency--A state of disaster or local disaster declared under Texas Government Code Chapter 418 or a public health disaster as defined by Texas Health and Safety Code (HSC) §81.003.

  (2) Qualifying official disaster order--An order, proclamation, or other instrument issued by the Governor, another official of this state, or the governing body or an official of a political subdivision of this state declaring a disaster that has infectious disease as the basis for the declared disaster.

  (3) Qualifying period of disaster--The period of time the area in which a hospital is located is declared to be a disaster area by a qualifying official disaster order.

  (4) Religious counselor--An individual acting substantially in a pastoral or religious capacity to provide spiritual counsel to other individuals.

(b) In accordance with HSC §260C.002 (relating to In-Person Visitation with Religious Counselor), except as provided by subsections (c) and (d) of this section, a hospital may not prohibit a patient from receiving in-person visitation with a religious counselor during a public health emergency upon the request of the patient or, if the patient is incapacitated, upon the request of the patient's legally authorized representative, including a family member of the patient.

(c) A hospital may prohibit in-person visitation with a religious counselor during a public health emergency if federal law or a federal agency requires the hospital to prohibit in-person visitation during that period.

(d) To the extent that hospital establishes policies and procedures for in-person religious counselor visitation during a public health emergency, these policies and procedures shall comply with the following:

  (1) The policies and procedures shall establish minimum health and safety requirements for in-person visitation with religious counselors consistent with:

    (A) state, local, and federal directives and guidance regarding the public health emergency;

    (B) public health emergency and disaster preparedness plans; and

    (C) other policies adopted by the hospital, including the hospital's general visitation policy and infection control policy.

  (2) The policies and procedures shall address considerations for patients who are receiving end-of-life care.

  (3) The policies and procedures may contain reasonable time, place, and manner restrictions on in-person visitation with religious counselors to mitigate the spread of a communicable disease or address a patient's medical condition.

  (4) The policies and procedures may condition in-person visitation with religious counselors on the counselor's compliance with guidelines, policies, and procedures established under this subsection.

(e) In accordance with HSC §241.012 (relating to In-Person Hospital Visitation During Period of Disaster), a hospital may not, during a qualifying period of disaster prohibit in-person visitation with a patient receiving care or treatment at the hospital unless federal law or a federal agency requires the hospital to prohibit in-person visitation during that period.

(f) Notwithstanding subsection (e) of this section, a hospital may, during a qualifying period of disaster:

  (1) restrict the number of visitors a patient receiving care or treatment at the hospital may receive to not fewer than one, except for religious counselors visiting under subsection (b) of this section;

  (2) require a visitor, including a religious counselor visiting under subsection (b) of this section, to:

    (A) complete a health screening before entering the hospital; and

    (B) wear personal protective equipment at all times while visiting a patient at the hospital; and

  (3) deny entry to or remove from the hospital's premises a visitor, including a religious counselor visiting under subsection (b) of this section, who fails or refuses to:

    (A) submit to or meet the requirements of a health screening administered by the hospital; or

    (B) wear personal protective equipment that meets the hospital's infection control and safety requirements in the manner prescribed by the hospital.

(g) A health screening administered by a hospital under this section must be conducted in a manner that, at a minimum, complies with:

  (1) hospital policy; and

  (2) if applicable, guidance or directives issued by the Texas Health and Human Services Commission, the Centers for Medicare and Medicaid Services, or another agency with regulatory authority over the hospital.

(h) This section does not require a hospital to:

  (1) provide a specific type of personal protective equipment to a visitor, including a religious counselor visiting under subsection (b) of this section; or

  (2) except for a religious counselor visiting under subsection (b) of this section, allow in-person visitation with a patient receiving care or treatment at the hospital if an attending physician determines and documents in the patient's medical record that in-person visitation with that patient may lead to the transmission of an infectious agent that poses a serious community health risk.

(i) A determination made by an attending physician under subsection (h) of this section is valid for not more than five days after the date the determination is made unless renewed by an attending physician.

(j) If a visitor to a hospital is denied in-person visitation with a patient receiving care or treatment at a hospital because of a determination made by an attending physician under subsection (h) of this section, the hospital shall:

  (1) provide each day a written or oral update of the patient's condition to the visitor if the visitor:

    (A) is authorized by the patient to receive relevant health information regarding the patient;

    (B) has authority to receive the patient's health information under an advance directive or medical power of attorney; or

    (C) is otherwise the patient's surrogate decision-maker regarding the patient's health care needs under hospital policy and other applicable law; and

  (2) notify the person who receives the daily update required under paragraph (1) of this subsection of the estimated date and time at which the patient will be discharged from the hospital.


Source Note: The provisions of this §133.51 adopted to be effective September 29, 2022, 47 TexReg 6197

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