Current through Reg. 49, No. 38; September 20, 2024
(a) Medical
services in treatment plan. A hospital shall provide medical services to a
patient in accordance with a treatment plan developed in accordance with §
568.61 of this subchapter (relating to Inpatient Mental Health Treatment and
Treatment Planning).
(b) Director
of psychiatric services. A hospital shall have a director of psychiatric
services who directs, monitors, and evaluates the psychiatric services
provided.
(c) Qualifications of
director of psychiatric services. In accordance with Texas Health and Safety
Code §
577.008,
the director of psychiatric services shall be a physician who:
(1) is certified in psychiatry by the
American Board of Psychiatry and Neurology or by the American Osteopathic Board
of Psychiatry and Neurology; or
(2) has three years of experience as a
physician in psychiatry in a "mental hospital" as defined in Texas Health and
Safety Code §
571.003.
(d) Treating physician. A hospital
shall assign a treating physician to a patient and document such assignment in
the patient's medical record at the time the patient is admitted.
(e) Physical examination.
(1) A physician shall:
(A) review written findings of a physical
examination of the patient conducted by another physician no more than seven
days before the patient's admission; or
(B) conduct a physical examination of the
patient.
(2) The
physical examinations described in paragraph (1) of this subsection shall
include a neurological screening and, if indicated, a comprehensive
neurological examination.
(f) Psychiatric evaluation. A physician shall
conduct an initial psychiatric evaluation of a patient. The results of the
initial evaluation shall include:
(1) a
description of the patient's medical history;
(2) a determination of the patient's mental
status;
(3) a description of the
onset of the patient's mental illness, any substance-related or addictive
disorder, and the circumstances leading to admission;
(4) an estimation of the patient's
intellectual functioning, memory functioning, and orientation;
(5) a description of the patient's strengths
and limitations; and
(6) the
diagnoses of the patient's mental illness and, if applicable, any
substance-related and addictive disorders.
(g) Re-evaluation. A physician shall
re-evaluate a patient:
(1) once a day for
five of the first seven days after the initial psychiatric evaluation described
in subsection (f) of this section is conducted and once a week thereafter; and
(2) as clinically indicated.
(h) Provision of
medical services. A hospital shall provide:
(1) medical services to a patient in response
to an emergency medical condition in accordance with the plan required by
§ 568.41 of this chapter (relating to Responding to an Emergency Medical
Condition); and
(2) other medical
services, as needed by the patient, or transfer the patient to a health care
entity that can provide the medical services in accordance with the following,
as applicable:
(A)
§
510.43 of
this title (relating to Patient Transfer Policy), or a transfer agreement made
in accordance with §
510.61
of this title (relating to Patient Transfer Agreements); or
(B) 25 TAC §
133.44(relating
to Hospital Patient Transfer Policy), or a transfer agreement made in
accordance with 25 TAC §
133.61(relating
to Hospital Patient Transfer Agreements).
(i) Availability of physicians. At least one
physician shall always:
(1) be physically
present at the hospital to provide medical services to a patient; or
(2) be available to staff members by
telephone, radio, or audiovisual telecommunication to provide medical
consultation.
