| (a) Each community center shall develop and implement
procedures consistent with this subchapter for the timely reporting
and review of deaths.
(b) Deaths subject to a clinical death review will
be reviewed by a medical review committee pursuant to the statutes
that authorize peer review activities in the State of Texas, consisting
of the previously appointed investigating officer and at least two
other medical/nursing professionals (M.D., D.O., or R.N.), one of
which should be a medical professional whom is neither an employee
of the community center nor was the deceased's attending physician
(if such medical professional is not available, then the effort to
obtain external membership must be documented in the information sent
to the administrative death review committee). Of these three committee
members, all must be either medical doctors or registered nurses.
The community center CEO shall appoint one of the three medical/nursing
professionals as chair of the clinical death review committee. For
the purposes of this subchapter the term employee does not refer to
consultants or contractors. Additionally, the membership of the clinical
death review committee may include the community center CEO and/or
the director of clinical quality assurance, designee, or the person
who is responsible for clinical quality assurance functions.
(1) Upon determination of the need for a clinical death
review, the investigating officer shall provide to the clinical death
review committee:
(A) the individual's medical record;
(B) a copy of the death certificate, bearing a valid
diagnosis, if available;
(C) a copy of the preliminary or full autopsy report,
if available;
(D) the probable final diagnosis, including contributory
causes, and reasons for variance from the death certificate, if any;
and
(E) a briefing of possible issues involving clinically
related community center operational policies and procedures and quality
of medical care.
(2) Within 14 calendar days (or 45 days in which an
autopsy is performed, or for deaths occurring at medical facilities
to which the individual was transferred before death) of the determination
of the need for a clinical death review, the clinical death review
committee shall meet to review the information the investigating officer
has provided as described in subsection (b)(1) of this subsection.
On the basis of the review, the committee shall evaluate the quality
of medical and nursing care given before death and shall formulate
written recommendations, if appropriate, for changes in policy and
procedures, professional education, operations, or patient care. Suspected
abuse or neglect must be reported in accordance with the rules of
the Texas Department of Family and Protective Services.
(c) Within 21 calendar days of the determination of
the need for a clinical death review (or 52 days in cases in which
an autopsy is performed, or for deaths occurring at medical facilities
to which the individual was transferred before death), the clinical
death review committee shall submit to the administrative death review
committee the following:
(1) the clinical death review committee's recommendations;
(2) a copy of the death/discharge summary, if available;
(3) a copy of the death certificate, bearing a valid
diagnosis, if available;
(4) the probable final diagnosis, including contributory
causes, and reasons for variance from the death certificate, if any;
and
(5) documentation of the effort to obtain an external
medical professional, if no such person was available.
(d) To maintain the effectiveness of the death review
process, HHSC may conduct reviews of the community center's clinical
death review process.
(e) The community center CEO is authorized to grant
variances from the timelines by this section on a case-by-case basis.
Reasons for timeline variances must be justified and documented.
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