|(a) Residents' Bill of Rights.
(1) A facility must:
(A) provide a copy of the Residents' Bill of Rights
to each resident; and
(B) post the Residents' Bill of Rights, as provided
by HHSC, in a prominent place in the facility and written in the primary
language of each resident.
(2) A resident has all the rights, benefits, responsibilities,
and privileges granted by the constitution and laws of this state
and the United States, except where lawfully restricted. The resident
has the right to be free of interference, coercion, discrimination,
and reprisal in exercising these civil rights.
(3) Each resident in the facility has the right to:
(A) be free from physical and mental abuse, including
corporal punishment or physical and chemical restraints that are administered
for the purpose of discipline or convenience and not required to treat
the resident's medical symptoms;
(i) A provider may use physical or chemical restraints
only if the use is authorized in writing by a physician or if the
use is necessary in an emergency to protect the resident or others
(ii) A physician's written authorization for the use
of restraints must specify the circumstances under which the restraints
may be used and the duration for which the restraints may be used.
(iii) Except in an emergency, restraints may only be
administered by qualified medical personnel.
(B) participate in activities of social, religious,
or community groups unless the participation interferes with the rights
(C) practice the religion of the resident's choice.
(D) if intellectually disabled, with a court-appointed
guardian of the person, participate in a behavior modification program
involving use of restraints, consistent with subparagraph (A) of this
paragraph, or adverse stimuli only with the informed consent of the
(E) be treated with respect, consideration, and recognition
of his or her dignity and individuality, without regard to race, religion,
national origin, sex, age, disability, marital status, or source of
payment. This means that the resident:
(i) has the right to make his or her own choices regarding
personal affairs, care, benefits, and services;
(ii) has the right to be free from abuse, neglect,
and exploitation; and
(iii) if protective measures are required, has the
right to designate a guardian or representative to ensure the right
to quality stewardship of his or her affairs.
(F) a safe and decent living environment.
(G) not be prohibited from communicating in his or
her native language with other residents or employees for the purpose
of acquiring or providing any type of treatment, care, or services.
(H) complain about the resident's care or treatment.
The complaint may be made anonymously or communicated by a person
designated by the resident. The provider must promptly respond to
resolve the complaint. The provider must not discriminate or take
other punitive action against a resident who makes a complaint.
(I) receive and send unopened mail, and the provider
must ensure that the resident's mail is sent and delivered promptly.
(J) unrestricted communication, including personal
visitation with any person of the resident's choice, including family
members and representatives of advocacy groups and community service
organizations, at any reasonable hour.
(K) make contacts with the community and to achieve
the highest level of independence, autonomy, and interaction with
the community of which the resident is capable.
(L) manage his or her financial affairs.
(i) The resident may authorize in writing another person
to manage his or her money.
(ii) The resident may choose the manner in which his
or her money is managed, including a money management program, a representative
payee program, a financial power of attorney, a trust, or a similar
method, and the resident may choose the least restrictive of these
(iii) The resident must be given, upon request of the
resident or the resident's representative, but at least quarterly,
an accounting of financial transactions made on his or her behalf
by the facility should the facility accept his or her written delegation
of this responsibility to the facility in conformance with state law.
(M) access the resident's records, which are confidential
and may not be released without the resident's consent, except:
(i) to another provider, if the resident transfers
(ii) if the release is required by another law.
(N) choose and retain a personal physician and to be
fully informed in advance about treatment or care that may affect
the resident's well-being.
(O) participate in developing his or her individual
service plan that describes the resident's medical, nursing, and psychological
needs and how the needs will be met.
(P) be given the opportunity to refuse medical treatment
or services after the resident:
(i) is advised by the person providing services of
the possible consequences of refusing treatment or services; and
(ii) acknowledges that he or she understands the consequences
of refusing treatment or services.
(Q) unaccompanied access to a telephone at a reasonable
hour or in case of an emergency or personal crisis.
(R) privacy, while attending to personal needs and
a private place for receiving visitors or associating with other residents,
unless providing privacy would infringe on the rights of other residents.
(i) This right applies to medical treatment, written
communications, telephone conversations, meeting with family, and
access to resident councils.
(ii) If a resident is married and the spouse is receiving
similar services, the couple may share a room.
(S) retain and use personal possessions, including
clothing and furnishings, as space permits, and may be limited for
the health and safety of other residents.
(T) determine his or her dress, hair style, or other
personal effects according to individual preference, except the resident
has the responsibility to maintain personal hygiene.
(U) retain and use personal property in his or her
immediate living quarters and to have an individual locked area (cabinet,
closet, drawer, footlocker, etc.) in which to keep personal property.
(V) refuse to perform services for the facility, except
as contracted for by the resident and operator.
(W) be informed by the provider no later than the 30th
day after admission:
(i) whether the resident is entitled to benefits under
Medicare or Medicaid; and
(ii) which items and services are covered by these
benefits, including items or services for which the resident may not
(X) not be transferred or discharged unless:
(i) the transfer is for the resident's welfare, and
the resident's needs cannot be met by the facility;
(ii) the resident's health is improved sufficiently
so that services are no longer needed;
(iii) the resident's health and safety or the health
and safety of another resident would be endangered if the transfer
or discharge was not made;
(iv) the provider ceases to operate or to participate
in the program that reimburses for the resident's treatment or care;
(v) the resident fails, after reasonable and appropriate
notice, to pay for services.
(Y) not be transferred or discharged, except in an
emergency, until the 30th day after the date the facility provides
written notice to the resident, the resident's legal representative,
or a member of the resident's family, stating:
(i) that the facility intends to transfer or discharge
(ii) the reason for the transfer or discharge;
(iii) the effective date of the transfer or discharge;
(iv) if the resident is to be transferred, the location
to which the resident will be transferred; and
(v) any appeal rights available to the resident.
(Z) leave the facility temporarily or permanently,
subject to contractual or financial obligations.
(AA) have access to the State Ombudsman and a certified
(BB) execute an advance directive, under Texas Health
and Safety Code, Chapter 166, or designate a guardian in advance of
need to make decisions regarding the resident's health care should
the resident become incapacitated.
(b) Providers' Bill of Rights.
(1) A facility must post a Providers' Bill of Rights
in a prominent place in the facility.
(2) The Providers' Bill of Rights must provide that
a provider of assisted living services has the right to:
(A) be shown consideration and respect that recognizes
the dignity and individuality of the provider and the facility;
(B) terminate a resident's contract for just cause
after a written 30-day notice;
(C) terminate a contract immediately, after notice
to HHSC, if the provider finds that a resident creates a serious or
immediate threat to the health, safety, or welfare of other residents
of the facility, except during evening hours and on weekends or holidays,
notice to HHSC must be made to 1-800-458-9858;
(D) present grievances, file complaints, or provide
information to state agencies or other persons without threat of reprisal
(E) refuse to perform services for the resident or
the resident's family other than those contracted for by the resident
and the provider;
(F) contract with the community to achieve the highest
level of independence, autonomy, interaction, and services to residents;
(G) access patient information concerning a client
referred to the facility, which must remain confidential as provided
(H) refuse a person referred to the facility if the
referral is inappropriate;
(I) maintain an environment free of weapons and drugs;
(J) be made aware of a resident's problems, including
self-abuse, violent behavior, alcoholism, or drug abuse.
(c) Access to residents. The facility must allow an
employee of HHSC or an employee of a local authority into the facility
as necessary to provide services to a resident.
(d) Authorized electronic monitoring (AEM).
(1) A facility must permit a resident, or the resident's
guardian or legal representative, to monitor the resident's room through
the use of electronic monitoring devices.
(2) A facility may not refuse to admit an individual
and may not discharge a resident because of a request to conduct authorized
(3) HHSC Information Regarding Authorized Electronic
Monitoring form must be signed by or on behalf of all new residents
upon admission. The form must be completed and signed by or on behalf
of all current residents. A copy of the form must be maintained in
the active portion of the resident's clinical record.
(4) A resident, or the resident's guardian or legal
representative, who wishes to conduct AEM must request AEM by giving
a completed, signed, and dated HHSC Request for Authorized Electronic
Monitoring form to the manager or designee. A copy of the form must
be maintained in the active portion of the resident's clinical record.
(A) If a resident has the capacity to request AEM and
has not been judicially declared to lack the required capacity, only
the resident may request AEM, notwithstanding the terms of any durable
power of attorney or similar instrument.
(B) If a resident has been judicially declared to lack
the capacity required to request AEM, only the guardian of the resident
may request AEM.
(C) If a resident does not have the capacity to request
AEM and has not been judicially declared to lack the required capacity,
only the legal representative of the resident may request AEM.
(i) A resident's physician makes the determination
regarding the capacity to request AEM. Documentation of the determination
must be made in the resident's clinical record.
(ii) When a resident's physician determines the resident
lacks the capacity to request AEM, a person from the following list,
in order of priority, may act as the resident's legal representative
for the limited purpose of requesting AEM:
(I) a person named in the resident's medical power
of attorney or other advance directive;
(II) the resident's spouse;
(III) an adult child of the resident who has the waiver
and consent of all other qualified adult children of the resident
to act as the sole decision-maker;
(IV) a majority of the resident's reasonably available
(V) the resident's parents; or