Current through Reg. 50, No. 13; March 28, 2025
(a) A limited
services rural hospital (LSRH) shall protect and promote each patient's
rights.
(b) An LSRH shall adopt,
implement, and enforce a policy to ensure patients' rights are upheld within
the limits of law. The LSRH's written patient's rights policy shall include the
following:
(1) the right to participate in the
development and implementation of their plan of care;
(2) the right to make informed decisions
regarding their care, including being informed of their health status, and
being able to request or refuse treatment;
(3) the right to formulate advance directives
and to have LSRH staff and practitioners who provide care in the LSRH comply
with these directives, in accordance with Code of Federal Regulations Title 42
(42 CFR) §§489.100 (relating to Definitions), 489.102 (relating to
Requirement for Providers), and 489.104 (relating to Effective Dates) and Texas
Health and Safety Code Chapter 166 (relating to Advance Directives);
(4) the right to have personal
privacy;
(5) the right to receive
medical standard of care in a safe setting;
(6) the right to be free from all forms of
abuse, neglect, exploitation, and harassment;
(7) the right to have confidentiality of
their medical records;
(8) the
right to the LSRH's reasonable response to the patient's requests and needs for
treatment or service, within the LSRH's capacity, stated mission, and
applicable law and regulation;
(9)
the right to considerate and respectful care, which includes:
(A) the care of the patient includes
consideration of the psychosocial, spiritual, and cultural variables that
influence perceptions of illness; and
(B) the care of a dying patient optimizes the
comfort and dignity of the patient through;
(i) treating primary and secondary symptoms
that respond to treatment as desired by the patient or surrogate decision
maker;
(ii) effectively managing
pain; and
(iii) acknowledging the
psychosocial and spiritual concerns of the patient and the family regarding
dying and the expression of grief by the patient and family;
(10) the right of the
patient or their legally authorized representative (LAR) to, in collaboration
with the patient's physician, make decisions involving their health care,
including:
(A) the right to accept medical
care or to refuse treatment to the extent permitted by law and to be informed
of the medical consequences of such refusal; and
(B) the right to formulate advance directives
and to appoint a surrogate to make health care decisions on their behalf to the
extent permitted by law;
(11) a mechanism to ascertain the existence
of, and, as appropriate, assist in the development of advance directives at the
time of the patient's admission;
(12) the right to not have the provision of
care conditioned on the existence of an advance directive;
(13) the right of a patient to the
information necessary to enable them to make treatment decisions reflecting
their wishes;
(14) the right of a
patient to receive at the time of admission information about the LSRH's
patient rights policy or policies and the mechanism for the initiation, review,
and, when possible, resolution of patient complaints concerning the quality of
care;
(15) the right to receive
information about the patient's rights in advance of receiving or discontinuing
patient care whenever possible;
(16) the right of the patient or the
patient's legally authorized representative to participate in the consideration
of ethical issues that arise in the care of a patient;
(17) a mechanism for the consideration of
ethical issues arising in the care of patients and to provide education to care
givers and patients on ethical issues in health care;
(18) the right of the patient to be informed
of and consent to any human experimentation or other research or educational
projects affecting their care or treatment;
(19) the right of the patient or the
patient's legally authorized representative to access the information contained
in the patient's medical record, on oral or written request; and
(20) the right of the patient's guardian,
next of kin, or LAR to exercise, to the extent permitted by law, the rights
delineated on behalf of the patient if the patient:
(A) has been adjudicated incompetent in
accordance with the law;
(B) is
found by their physician to be medically incapable of understanding the
proposed treatment or procedure;
(C) is unable to communicate their wishes
regarding treatment; or
(c) An
LSRH must post the patient bill of rights prominently and conspicuously for
display in a public area of the LSRH that is readily available to patients,
residents, employees, and visitors.
(1) In
addition to these patient bill of rights requirements, an LSRH that provides
chemical dependency services shall comply with this section and Texas
Administrative Code Title 25 (25 TAC) §448.701 (relating to Client Bill of
Rights) applicable to patients who receive such services.
(2) In addition to these patient bill of
rights requirements, an LSRH that provides mental health services shall comply
with this section and 25 TAC Chapter 404, Subchapter E (relating to Rights of
Persons Receiving Mental Health Services) applicable to patients who receive
such services.
(3) The patient bill
of rights posted for display shall be in English and in a second language
appropriate to the demographic makeup of the community served.
(d) An LSRH's medical staff and
governing body shall adopt, implement, and enforce a policy on informed
decision making that is consistent with any legal requirements.
(e) An LSRH shall establish a process for
prompt resolution of patient complaints and inform each patient whom to contact
to file a complaint. The LSRH's governing body or responsible individual shall
approve and be responsible for the effective operation of the complaint process
and shall review and resolve complaints, unless it delegates the
responsibility, in writing, to a complaint committee. The complaint process
shall include a mechanism for timely referral of patient concerns regarding
quality of care or premature discharge to the appropriate Utilization and
Quality Control Quality Improvement Organization.
(1) The LSRH shall establish a clearly
explained procedure for the submission of a patient's written or verbal
complaint to the LSRH.
(2) The
complaint process shall specify timeframes for review of the complaint and the
provision of a response.
(3) In its
resolution of the complaint, the LSRH shall provide the patient with written
notice of its decision that contains the name of the LSRH contact person, the
steps taken on behalf of the patient to investigate the complaint, the results
of the complaint process, and the date of completion.
(f) Notwithstanding subsection (b) of this
section, an LSRH may deny treatment or services deemed medically unnecessary or
inappropriate.
