| (a) At the time an individual is admitted, a CSU nursing
supervisor or designee must implement the level of monitoring ordered
by the physician, or physician-delegated PA or APRN, based on the
individual's needs and in accordance with this section, 25 TAC §415.260
(relating to Initiation of Restraint or Seclusion in a Behavioral
Emergency), and §415.266 (relating to Observation, Monitoring,
and Care of the Individual in Restraint or Seclusion Initiated in
Response to a Behavioral Emergency).
(b) All CSU staff must contribute to the protection
of individuals by:
(1) modifying the CSU environment based on the individual's
needs, including:
(A) providing furnishings that do not present safety
hazards to the individual;
(B) securing or removing objects that are hazardous
to the individual;
(C) installing any necessary safety devices; and
(D) making roommate assignments and other decisions
affecting the interaction of the individual with other individuals,
based on individual needs and vulnerabilities;
(2) monitoring the individual in accordance with the
physician's, or physician-delegated PA's or APRN's, order and CSU
written policies and procedures; and
(3) documenting the individual's level of monitoring
ordered by the physician, or physician-delegated PA or APRN, in the
individual's medical record.
(c) A CSU medical director must ensure:
(1) each level of monitoring is defined in the CSU's
policies and procedures, including a description of the responsibilities
of staff members for each level of monitoring identified; and
(2) implementation of the level of monitoring ordered
by the physician, or physician-delegated PA or APRN, based on the
individual's needs.
(d) In accordance with Texas Health and Safety Code §321.002,
a CSU administrator or administrator's designee, must keep children
and adolescents separate from adults.
(e) All CSU staff must maintain an individual's confidential
information in accordance with the Health Insurance Portability and
Accountability Act rules and 1 TAC Chapter 390, Subchapter A (relating
to Standards Relating to the Electronic Exchange of Health Information).
CSU staff must:
(1) be knowledgeable of and obey all current state
and federal laws and regulations relating to confidential information
regarding the provision of services; and
(2) not disclose confidential information without the
express written consent of the individual, and individual's LAR or
adult caregiver, if applicable, except as permitted by the Health
Insurance Portability and Accountability Act or other law.
(f) Qualified CSU staff must adhere to transportation
requirements provided in accordance with 25 TAC §404.156 (relating
to Additional Rights of Persons Receiving Residential Mental Health
Services at Department Facilities) and Texas Health and Safety Code §574.045
and §574.0455 if the CSU provides transportation.
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