Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 509 - FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
Subchapter C - OPERATIONAL REQUIREMENTS
Section 509.46 - Facility Staffing and Training
Universal Citation: 26 TX Admin Code ยง 509.46
Current through Reg. 49, No. 38; September 20, 2024
(a) A facility shall have personnel qualified to operate emergency equipment and to provide emergency care to patients that is on site and available at all times.
(b) A facility shall comply with the following nursing services staffing and training requirements.
(1) There shall be an organized nursing
service under the direction of a qualified registered nurse (RN). The facility
shall be staffed to ensure the nursing needs of all patients are met.
(2) There shall be a written plan of
administrative authority for all nursing services with responsibilities and
duties of each category of nursing personnel delineated and a written job
description for each category. The scope of nursing services shall be limited
to nursing care rendered to patients as authorized by Texas Occupations Code
Chapter 301 (relating to Nurses).
(A) The
responsible individual for nursing services shall be a qualified RN whose
responsibility and authority shall be clearly defined and shall include
supervision of both personnel performance and patient care.
(B) There shall be a written delineation of
functions, qualifications, and patient care responsibilities for all categories
of nursing personnel.
(C) Nursing
services shall be provided in accordance with current recognized standards or
recommended practices.
(3) There shall be an adequate number of RNs
on duty to meet minimum staff requirements, including supervisory and staff
RNs, to ensure the immediate availability of an RN for emergency care or for
any patient when needed.
(4) There
shall be other nursing personnel in sufficient numbers to provide nursing care
not requiring the service of an RN. An RN shall assign the nursing care of each
patient to other nursing personnel in accordance with the patient's needs and
the preparation and qualifications of the nursing staff available.
(5) An RN qualified, at a minimum, with
current certification in advanced cardiac life support and pediatric advanced
life support shall be on duty at the facility at all times whenever patients
are present in the facility.
(6)
All direct care staff members shall maintain current certification and
competency in basic cardiac life support.
(7) The facility shall establish a nursing
peer review committee to conduct nursing peer review, to the extent required by
Texas Occupations Code Chapter 303 (relating to Nursing Peer Review).
(c) In addition to meeting the requirements for nursing staff under subsection (b) of this section, a facility shall comply with the following minimum staffing requirements:
(1) A facility that provides only topical
anesthesia, local anesthesia, or minimal sedation shall have a second
individual, who is trained and currently certified in basic cardiac life
support, on duty at the facility until all patients have been discharged from
the facility.
(2) A facility that
provides moderate sedation or analgesia shall have the following additional
staff:
(A) a second individual, who is trained
and currently certified in basic cardiac life support, on duty at the facility
until all patients have been discharged from the facility; and
(B) an individual trained and currently
certified in advanced cardiac life support and pediatric advanced life support,
until all patients have been discharged.
(3) A facility that provides deep sedation or
analgesia or regional anesthesia shall have the following additional staff:
(A) a second individual, who is trained and
currently certified in basic cardiac life support, on duty at the facility
until all patients have been discharged from the facility; and
(B) an individual who is trained and
currently certified in advanced cardiac life support and pediatric advanced
life support, on duty and sufficiently free of other duties to enable the
individual to respond rapidly to emergency situations, until all patients have
been discharged.
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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