Current through Reg. 49, No. 38; September 20, 2024
(a) The facility
must inform the resident, both orally and in writing, in a language that the
resident understands, of the resident's rights and all rules and regulations
governing resident conduct and responsibilities during the stay in the
facility. This notification must be made prior to or upon admission and during
the resident's stay if changed.
(b)
The facility must also inform the resident, upon admission and during the stay,
in a language the resident understands, of the following:
(1) facility admission policies;
(2) a description of the protection of
personal funds as described in § 554.404 of this subchapter (relating to
Protection of Resident Funds);
(3)
the Texas Human Resources Code, Title 6, Chapter 102; or a written list of the
rights and responsibilities contained in the Texas Human Resources Code, Title
6, Chapter 102;
(4) a written
description of the services available through the Ombudsman Program. This
information must be made available to each facility by the ombudsman program.
Facilities are responsible for reproducing this information and making it
available to residents, their families, and resident representatives;
(5) a written statement to the resident, the
resident's next of kin, or guardian describing the facility's policy for:
(A) the drug testing of employees who have
direct contact with residents; and
(B) the criminal history checks of employees
and applicants for employment;
(6) HHSC rules and the facility's policies
related to the use of restraint and involuntary seclusion. This information
must also be given to the resident's legally authorized representative, if the
resident has one; and
(7) facility
essential caregiver policies and procedures during a public health emergency or
disaster, and this information must also be given to the resident's
legally authorized representative, if the resident has one.
(c) Upon admission of a resident,
a facility must:
(1) provide written
information to the resident's family representative, in a language the
representative understands, of the right to form a family council; or
(2) inform the resident's family
representative, in writing, if a family council exists, of the council's
meeting time, date, location and contact person.
(d) Receipt of information in subsections (b)
- (d) of this section, and any amendments to it, must be acknowledged in
writing by all parties receiving the information.
(e) The facility must post a copy of the
documents specified in subsections (a) and (b) of this section in a conspicuous
location.
(f) The resident or the
resident's legal representative has the following rights:
(1) upon an oral or written request to the
facility, to access all records pertaining to the resident, including clinical
records, within 24 hours (excluding weekends and holidays); and
(2) to purchase photocopies of all or any
portion of the records upon request and two workdays advance notice to the
facility.
(g) The
resident has the right to be fully informed in language the resident
understands of the resident's total health status, including the resident's
medical condition.
(h) The resident
has the right to refuse treatment, to formulate an advance directive (as
specified in § 554.419 of this subchapter (relating to Advance
Directives), and to refuse to participate in experimental research.
(1) If the resident refuses treatment, the
resident must be informed of the possible consequences.
(2) If the resident chooses to participate in
experimental research, the resident must be fully notified of the research and
possible effects of the research. The research may be carried on only with the
full written consent of the resident's physician, and the resident.
(3) Experimental research must comply with
Federal Drug Administration regulations on human research as found in 45 CFR,
Part 46.
(i) The
facility must inform a resident before, or at the time of admission, and
periodically during the resident's stay (if there are any changes), of services
available in the facility and of charges for those services, including any
charges for services not covered under Medicare or by the facility's per diem
rate.
(j) The facility must provide
a written description of a resident's legal rights, which includes:
(1) a description of the manner of protecting
personal funds, described in § 554.404 of this subchapter;
(2) a posting of names, addresses, and
telephone numbers of all pertinent state client advocacy groups such as HHSC,
the Ombudsman Program, the protection and advocacy network, and, in
Medicaid-certified facilities, the Medicaid fraud control unit; and
(3) a statement that the resident may file a
complaint with HHSC concerning resident abuse, neglect, and misappropriation of
resident property in the facility.
(k) The facility must inform a resident of
the name, specialty, and way of contacting the physician responsible for the
resident's care.
(l) Notification
of changes.
(1) A facility must immediately
inform the resident; consult with the resident's physician; and notify,
consistent with the representative's authority, the resident representative
when there is:
(A) an accident involving the
resident that results in injury and has the potential for requiring physician
intervention;
(B) a significant
change in the resident's physical, mental, or psychosocial status (that is, a
deterioration in health, mental, or psychosocial status in either
life-threatening conditions or clinical complications);
(C) a need to alter treatment significantly
(that is, a need to discontinue an existing form of treatment due to adverse
consequences, or to commence a new form of treatment); or
(D) a decision to transfer or discharge the
resident from the facility.
(2) The facility also must promptly notify
the resident and the resident representative, if any, when there is:
(A) a change in room or roommate assignment
with the reason for the change provided in writing; or
(B) a change in resident rights under federal
or state law or regulations as described in subsection (b) of this
section.
(3) The
facility must record and periodically update the address and phone number of
the resident.
(m)
Additional requirements for Medicaid-certified facilities. Medicaid-certified
facilities must:
(1) provide the resident
with the state-developed notice of rights under §1919(e)(6) of the Social
Security Act (42 U.S.C. §
1396r(e)(6));
(2) inform a resident who is entitled to
Medicaid benefits, in writing, at the time of admission to the nursing facility
or, when the resident becomes eligible for Medicaid of:
(A) the items and services that are included
in nursing facility services provided under the State Plan and for which the
resident may not be charged;
(B)
those other items and services that the facility offers and for which the
resident may be charged, and the amount of charges for those
services;
(3) inform
each resident when changes are made to the items and services specified in
paragraph (2)(A) and (B) of this subsection;
(4) provide a written description of the
requirements and procedures for establishing eligibility for Medicaid,
including the right to request an assessment under §1924(c) of the Social
Security Act (42
U.S.C. §
1396r-5(c)),
which:
(A) is used to determine the extent of
a couple's nonexempt resources at the time of institutionalization;
and
(B) attributes to the community
spouse an equitable share of resources that cannot be considered available for
payment toward the cost of the institutionalized spouse's medical care in the
process of spending down to Medicaid eligibility levels; and
(5) prominently display in the
facility written information, and provide to residents and potential residents
oral and written information about how to apply for and use Medicare and
Medicaid benefits, and how to receive refunds for previous payments covered by
such benefits.
(n)
Additional requirements for certain facilities related to memory care and
Alzheimer's disease and related disorders. Facilities must provide the
following HHSC forms:
(1) for a facility that
advertises, markets, or otherwise promotes that it provides memory care
services to residents, the Memory Care Disclosure Statement for Nursing
Facilities, to each resident, disclosing as required by the Texas Health and
Safety Code § 242.0405 whether the facility is certified to provide
specialized care and treatment for a resident with Alzheimer's disease and
related disorders, to:
(A) each resident or
resident representative; and
(B)
each person seeking information about the facility's care and treatment of
residents with Alzheimer's disease or related disorders or dementia;
or
(2) for a facility
that advertises, markets, or otherwise promotes that it provides services to
residents with Alzheimer's disease and related disorders, HHSC Form 3641-A,
Alzheimer's Disclosure Statement for Nursing Facilities, disclosing as required
by the Texas Health and Safety Code §
242.202
whether the facility is certified to provide specialized care and treatment for
a resident with Alzheimer's disease and related disorders to:
(A) each resident or resident
representative;
(B) each person
seeking to become a resident of the facility or that person's
representative; and
(C) a person
seeking information about the facility's care and treatment of residents with
Alzheimer's disease and related disorders.
(o) Amended disclosure statement. A facility
must provide an amended disclosure statement required by subsection (n)(1) and
(2) of this section, to a resident, responsible party, or legal guardian at
least 30 days before the change in the operation of the facility reflected in
the amended disclosure statement is effective.
