| (a) A limited services rural hospital (LSRH) shall
report to the Texas Health and Human Services Commission (HHSC) incidents
of abuse, neglect, exploitation, or illegal, unethical, or unprofessional
conduct as those terms are defined in subsection (b) of this section.
(b) The following definitions apply only to this subsection.
(1) Abuse of a child--includes the following acts or
omissions by any person:
(A) mental or emotional injury to a child that results
in an observable and material impairment in the child's growth, development,
or psychological functioning;
(B) causing or permitting the child to be in a situation
in which the child sustains a mental or emotional injury that results
in an observable and material impairment in the child's growth, development,
or psychological functioning;
(C) physical injury that results in substantial harm
to the child, or the genuine threat of substantial harm from physical
injury to the child, including an injury that is at variance with
the history or explanation given and excluding an accident (an unforeseen
event that causes or threatens physical injury despite prudent efforts
to avoid the risk of injury) or reasonable discipline (correction
of behavior that does not result in or risk substantial harm from
physical injury) by a parent, guardian, or managing or possessory
conservator that does not expose the child to a substantial risk of
harm;
(D) failure to make a reasonable effort to prevent
an action (effort that an ordinary and prudent person would take to
stop an action from occurring) by another person that results in physical
injury that results in substantial harm to the child;
(E) sexual conduct harmful to a child's mental, emotional,
or physical welfare;
(F) failure to make a reasonable effort to prevent
sexual conduct harmful to a child;
(G) compelling or encouraging the child to engage in
sexual conduct as defined by the Texas Penal Code §43.01 (this
is met whether the child actually engages in sexual conduct or simply
faces a substantial risk of doing so);
(H) causing, permitting, encouraging, engaging in,
or allowing the photographing, filming, or depicting of the child
if the person knew or should have known that the resulting photograph,
film, or depiction of the child is obscene (as defined by the Texas
Penal Code) or pornographic (this is met whether or not the child
voluntarily participates);
(I) the current use by a person of a controlled substance
as defined by the Texas Health and Safety Code (HSC) Chapter 481,
in a manner or to the extent that the use results in physical, mental,
or emotional injury to a child; or
(J) causing, expressly permitting, or encouraging a
child to use a controlled substance as defined by HSC Chapter 481.
(2) Abuse of an elderly or disabled person--means:
(A) the negligent or willful infliction of injury,
unreasonable confinement, intimidation, or cruel punishment with resulting
physical or emotional harm or pain by the person's caretaker, family
member, or other individual who has an ongoing relationship with the
person; or
(B) sexual abuse by the persons, caretaker, family
member, or other individual who has an ongoing relationship with the
person, but does not include:
(i) the proper use of restraints or seclusion in accordance
with federal or state laws or regulations or court order;
(ii) other actions taken in accordance with federal
or state laws or regulations or court order;
(iii) actions an employee may reasonably believe to
be immediately necessary to avoid imminent harm to self, patients
or clients, or other individuals if such actions are limited only
to those actions reasonably believed to be necessary under the existing
circumstances. Such actions do not include acts of unnecessary force
or the inappropriate use of restraints or seclusion; or
(iv) complaints related to the daily administrative
operations of a facility (e.g., staffing ratios).
(3) Abuse of an individual with mental illness--Has
the following meanings:
(A) In accordance with 42 United States Code (USC) §10802(1)
(relating to Definitions), any act or failure to act by an employee
of a facility rendering care or treatment that was performed, or that
was failed to be performed, knowingly, recklessly, or intentionally,
and that caused, or may have caused, injury or death to an individual
with mental illness, and includes acts such as:
(i) the rape or sexual assault of an individual with
mental illness;
(ii) the striking of an individual with mental illness;
(iii) the use of excessive force when placing an individual
with mental illness in bodily restraints; and
(iv) the use of bodily or chemical restraints on an
individual with mental illness that is not in compliance with federal
and state laws and regulations.
(B) In accordance with HSC §161.132(j) (relating
to Reports of Abuse and Neglect or of Illegal, Unprofessional, or
Unethical Conduct), abuse also includes coercive or restrictive actions
that are illegal or not justified by the patient's condition and that
are in response to the patient's request for discharge or refusal
of medication, therapy, or treatment.
(4) Exploitation of an elderly or disabled person--means
the illegal or improper act or process of a caretaker, family member,
or other individual who has an ongoing relationship with the elderly
or disabled person using the resources of an elderly or disabled person
for monetary or personal benefit, profit, or gain without the informed
consent of the elderly or disabled person.
(5) Illegal conduct--Conduct prohibited by law.
(6) Neglect of a child--includes:
(A) the leaving of a child in a situation where the
child would be exposed to a substantial risk of physical or mental
harm, without arranging for necessary care for the child, and a demonstration
of an intent not to return by a parent, guardian, or managing or possessory
conservator of a child;
(B) the following acts or omissions by any person:
(i) placing the child in or failing to remove the child
from a situation that a reasonable person would realize requires judgment
or actions beyond the child's level of maturity, physical condition,
or mental abilities and that results in bodily injury or a substantial
risk of immediate harm to the child;
(ii) the failure to seek, obtain, or follow through
with medical care for the child, with the failure resulting in or
presenting a substantial risk of death, disfigurement, or bodily injury
or with the failure resulting in an observable and material impairment
to the growth, development, or functioning of the child;
(iii) the failure to provide the child with food, clothing,
or shelter necessary to sustain the life or health of the child (if
the failure results in an observable and material impairment to the
child's growth, development, or functioning or in a substantial risk
of such an observable or material impairment), excluding failure caused
primarily by financial inability unless relief services had been offered
and refused; or
(iv) placing a child in or failing to remove the child
from a situation in which the child would be exposed to a substantial
risk of sexual conduct harmful to the child; or
(C) the failure by the person responsible for a child's
care, custody, or welfare to permit the child to return to the child's
home without arranging for the necessary care for the child after
the child has been absent from the home for any reason, including
having been in residential placement or having run away.
(7) Neglect of an elderly or disabled person--means
the failure to provide for one's self the goods or services, including
medical services, which are necessary to avoid physical or emotional
harm or pain or the failure of a caretaker to provide such goods or
services.
(8) Neglect of an individual with mental illness--In
accordance with 42 USC §10802(5), a negligent act or omission
by any individual responsible for providing services in a facility
rendering care or treatment that:
(A) caused or may have caused injury or death to an
individual with mental illness, or
(B) placed an individual with mental illness at risk
of injury or death, and includes an act or omission such as the failure
to:
(i) establish or carry out an appropriate individual
program plan or treatment plan for an individual with mental illness,
(ii) provide adequate nutrition, clothing, or health
care to an individual with mental illness, or
Cont'd... |
