Texas Administrative Code
Title 25 - HEALTH SERVICES
Part 1 - DEPARTMENT OF STATE HEALTH SERVICES
Chapter 139 - ABORTION FACILITY REPORTING AND LICENSING
Subchapter D - MINIMUM STANDARDS FOR LICENSED ABORTION FACILITIES
Section 139.53 - Medical and Clinical Services
Universal Citation: 25 TX Admin Code ยง 139.53
Current through Reg. 49, No. 38; September 20, 2024
(a) Surgical abortion.
(1) The medical consultant shall be
responsible for implementing and supervising the medical and clinical policies
of the facility.
(2) All medical
and clinical services of the facility, with the exception of the abortion
procedure, shall be provided under the direction of a physician or registered
nurse who assumes responsibility for the clinical employees' performance in the
facility.
(3) A licensed abortion
facility shall ensure that a surgical consent form is signed by the patient
prior to the procedure being started, that the patient is informed of the risks
and the benefits of the procedure, and that the patient recognizes the
alternatives to abortion. Informed consent shall be in accordance with rules
adopted by the Texas Medical Disclosure Panel under §
601.2
of this title (relating to Procedures Requiring Full Disclosure of Specific
Risks and Hazards--List A), §
601.4
of this title (relating to Disclosure and Consent Form), and Health and Safety
Code §
171.011
(relating to Informed Consent Required), and §171.012 (relating to
Voluntary Informed Consent).
(4) A
licensed abortion facility shall ensure that the attending physician, advanced
practice registered nurse, or physician assistant has obtained and documented a
preoperative history, physical exam, and laboratory studies, including
verification of pregnancy.
(5) A
licensed abortion facility shall ensure that:
(A) the attending physician examines each
patient immediately prior to surgery to evaluate the risk to the procedure;
and
(B) the person administering
the anesthetic agent(s) examines the patient immediately prior to surgery to
evaluate the risk of anesthesia.
(6) The administration of anesthesia shall be
in accordance with §
139.59 of
this subchapter (relating to Anesthesia Services).
(7) A surgical abortion shall be performed
only by a physician.
(8) A
physician, advanced practice registered nurse, physician assistant, registered
nurse, or licensed vocational nurse shall be in the facility whenever there is
a patient in the procedure room or recovery room. While a patient is in the
procedure room or recovery room she shall not be left unattended.
(9) The recovery room(s) at the facility
shall be supervised by a physician, advanced practice registered nurse,
physician assistant, or registered nurse. This supervisor shall be available
for recovery room staff within a recommended 10 minutes with a maximum required
15 minutes while any patient is in the recovery room.
(10) A physician shall be available for the
facility while any patient is in the recovery room within a recommended 10
minutes and a maximum required 15 minutes.
(11) The facility shall ensure that a patient
is fully reactive and her vital signs are stable before discharging the patient
from the facility upon written order by the attending physician.
(12) All fetal tissue shall be examined
grossly at the time of the procedure. In the absence of visible fetal parts or
placenta, the tissue may be examined by magnification for the detection of
villi. If this examination is inconclusive, the tissue shall be sent to a
pathology lab. The results of the tissue examination shall be recorded in the
patient's clinical record.
(13) A
facility shall meet the requirements set forth by the department in
§§
1.131-
1.137 of
this title (relating to Definition, Treatment, and Disposition of Special Waste
from Health Care-Related Facilities).
(b) Medical abortion.
(1) The medical consultant shall be
responsible for implementing and supervising the medical and clinical policies
of the facility.
(2) All medical
and clinical services of the facility, with the exception of the abortion
procedure, shall be provided under the direction of a physician or registered
nurse who assumes responsibility for the clinical employees' performance in the
facility.
(3) A licensed abortion
facility shall ensure:
(A) the physician(s)
providing medical abortion is able to accurately date a pregnancy;
(B) the physician(s) is able to determine
that the pregnancy is not an ectopic gestation;
(C) the physician(s) is able to provide
surgical intervention or provide for the patient to receive a surgical abortion
if necessary; and
(D) patients have
access to medical facilities equipped to provide blood transfusion and patient
resuscitation, if necessary.
(4) A licensed abortion facility shall ensure
follow-up examination and services are provided to patients requesting medical
abortion.
(5) A licensed abortion
facility shall ensure that the attending physician, advanced practice
registered nurse, or physician assistant has obtained and documented a
pre-procedure history, physical exam, and laboratory studies, including
verification of pregnancy.
(6) A
licensed abortion facility shall ensure:
(A)
written consent is obtained from the patient prior to the commencement of the
abortion procedure in accordance with §
139.50 of
this chapter (relating to Disclosure Requirements);
(B) the patient is informed of the risks and
benefits of the procedure;
(C) the
patient is informed of the possibility that a surgical abortion may be
required;
(D) the patient is
informed of the alternatives to abortion; and
(E) informed consent is in accordance with
rules adopted by the Texas Medical Disclosure Panel under §
601.2
of this title, §
601.4
of this title, and Health and Safety Code §
171.011
and §
171.012.
(7) A licensed abortion facility
shall provide the patient with written discharge instructions including a
direct referral to a physician who shall accept the patient for surgical
abortion.
(8) A medical abortion
shall be performed only by a physician.
(c) Requirements of a physician. A physician performing or inducing an abortion must, on the date the abortion is performed or induced, have active admitting privileges at a hospital that:
(1) is located not further than 30 miles from
the location at which the abortion is performed or induced; and
(2) provides obstetrical or gynecological
health care services.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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