Current through Reg. 49, No. 38; September 20, 2024
(a) A limited
services rural hospital (LSRH) shall adopt, implement, and enforce written
policies and procedures regarding patient visitation rights, including those
setting forth any clinically necessary or reasonable restriction or limitation
that the LSRH may need to place on such rights and the reasons for the clinical
restriction or limitation.
(b) An
LSRH shall:
(1) inform each patient (or
support person, where appropriate) of their visitation rights, including any
clinical restriction or limitation on such rights, when they are informed of
their other rights under §
511.63 of this subchapter
(relating to Patient's Rights);
(2)
inform each patient of the LSRH's visitation policy;
(3) inform each patient (or support person,
where appropriate) of the right, subject to their consent, to receive the
visitors whom they designate, including a spouse, a domestic partner (including
a same-sex domestic partner), another family member, or a friend, and their
right to withdraw or deny such consent at any time;
(4) not restrict, limit, or otherwise deny
visitation privileges on the basis of race, color, national origin, religion,
sex, gender identity, sexual orientation, or disability;
(5) ensure all visitors enjoy full and equal
visitation privileges consistent with patient preferences; and
(6) record any clinically justified
visitation restrictions in the patient's medical record.
(c) In accordance with Texas Health and
Safety Code (HSC) §260C.002 (relating to In-Person Visitation with
Religious Counselor), except as provided by subsections (d) and (e) of this
section, an LSRH may not prohibit a patient from receiving in-person visitation
with a religious counselor during a public health emergency upon the request of
the patient or, if the patient is incapacitated, upon the request of the
patient's legally authorized representative, including a family member of the
patient.
(d) An LSRH may prohibit
in-person visitation with a religious counselor during a public health
emergency if federal law or a federal agency requires the LSRH to prohibit
in-person visitation during that period.
(e) To the extent that an LSRH establishes
policies and procedures for in-person religious counselor visitation during a
public health emergency, these policies and procedures shall comply with the
following.
(1) The policies and procedures
shall establish minimum health and safety requirements for in-person visitation
with religious counselors consistent with:
(A)
state, local, and federal directives and guidance regarding the public health
emergency;
(B) public health
emergency and disaster preparedness plans; and
(C) other policies adopted by the LSRH,
including the LSRH's general visitation policy and infection control
policy.
(2) The policies
and procedures shall address considerations for patients who are receiving
end-of-life care.
(3) The policies
and procedures may contain reasonable time, place, and manner restrictions on
in-person visitation with religious counselors to mitigate the spread of a
communicable disease or address a patient's medical condition.
(4) The policies and procedures may condition
in-person visitation with religious counselors on the counselor's compliance
with guidelines, policies, and procedures established under this
subsection.
(f) In
accordance with HSC §241.012 (relating to In-Person Hospital Visitation
During Period of Disaster), an LSRH may not, during a qualifying period of
disaster prohibit in-person visitation with a patient receiving care or
treatment at the LSRH unless federal law or a federal agency requires the LSRH
to prohibit in-person visitation during that period.
(g) Notwithstanding subsection (f) of this
section, an LSRH may, during a qualifying period of disaster:
(1) restrict the number of visitors a patient
receiving care or treatment at the LSRH may receive to not fewer than one,
except for religious counselors visiting under subsection (b) of this
section;
(2) require a visitor,
including a religious counselor visiting under subsection (c) of this section,
to:
(A) complete a health screening before
entering the LSRH; and
(B) wear
personal protective equipment at all times while visiting a patient at the
LSRH; and
(3) deny entry
to or remove from the LSRH's premises a visitor, including a religious
counselor visiting under subsection (c) of this section, who fails or refuses
to:
(A) submit to or meet the requirements of
a health screening administered by the LSRH; or
(B) wear personal protective equipment that
meets the LSRH's infection control and safety requirements in the manner
prescribed by the LSRH.
(h) A health screening administered by an
LSRH under this section and during a qualifying period of disaster must be
conducted in a manner that, at a minimum, complies with:
(1) LSRH policy; and
(2) if applicable, guidance or directives
issued by the Texas Health and Human Services Commission, the Centers for
Medicare & Medicaid Services, or another agency with regulatory authority
over the LSRH.
(i) This
section does not require an LSRH to:
(1)
provide a specific type of personal protective equipment to a visitor,
including a religious counselor visiting under subsection (c) of this section;
or
(2) except for a religious
counselor visiting under subsection (c) of this section, allow in-person
visitation with a patient receiving care or treatment at the LSRH if an
attending physician determines and documents in the patient's medical record
that in-person visitation with that patient may lead to the transmission of an
infectious agent that poses a serious community health risk during a qualifying
period of disaster.
(j) A
determination made by an attending physician under subsection (h) of this
section is valid for not more than five days after the date the determination
is made unless renewed by an attending physician.
(k) When a visitor to an LSRH is denied
in-person visitation with a patient receiving care or treatment at a LSRH
because of a determination made by an attending physician under subsection
(i)(2) of this section, the LSRH shall:
(1)
provide each day a written or oral update of the patient's condition to the
visitor if the visitor:
(A) is authorized by
the patient to receive relevant health information regarding the
patient;
(B) has authority to
receive the patient's health information under an advance directive or medical
power of attorney; or
(C) is
otherwise the patient's surrogate decision-maker regarding the patient's health
care needs under LSRH policy and other applicable law; and
(2) notify the person who receives the daily
update required under paragraph (1) of this subsection of the estimated date
and time at which the patient will be discharged from the LSRH.
