Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS
Subchapter E - DISCHARGE
Section 568.81 - Discharge Planning
Universal Citation: 26 TX Admin Code ยง 568.81
Current through Reg. 49, No. 38; September 20, 2024
(a) Involvement of staff, patient, and legally authorized representative (LAR), when applicable, in planning activities.
(1) Following the
admission of a patient to a hospital, the hospital shall conduct discharge
planning with the patient and LAR, as well as the LMHA or LBHA if the patient
is in a psychiatric inpatient bed funded under a contract with HHSC or operated
by or funded under a contract with a LMHA or LBHA.
(2) Discharge planning shall involve the
interdisciplinary treatment team (IDT), which includes the patient and LAR, as
well as the LMHA or LBHA if the patient is in a psychiatric inpatient bed
funded under a contract with HHSC or operated by or funded under a contract
with a LMHA or LBHA.
(3) Discharge
planning shall include, at a minimum, the following activities:
(A) the patient's IDT recommending services
and supports needed by the patient after discharge, including the placement
after discharge;
(B) qualified
staff members arranging for the services and supports recommended by the
patient's IDT;
(C) qualified staff
members counseling the patient, the patient's LAR, when applicable, and as
appropriate, the patient's caregivers, to prepare them for post-discharge care;
and
(D) Preadmission Screening and
Resident Review (PASRR) as required by paragraph (5) of this
subsection.
(4) The
discharge plan shall consist of:
(A) a
description of the individual's living arrangement after discharge that
reflects the individual's preferences, choices, and available community
resources;
(B) arrangements and
referrals for the available and accessible services and supports agreed upon by
the individual or LAR recommended in the individual's discharge plan;
(C) a written description of recommended
clinical and non-clinical services and supports the individual may receive
after discharge. The hospital documents arrangements and referrals for the
services and supports recommended upon discharge in the discharge
plan;
(D) a description of problems
identified at discharge, including any issues that may disrupt the individual's
stability in the community;
(E) the
individual's goals, strengths, interventions, and objectives as stated in the
individual's discharge plan in the hospital;
(F) comments or additional
information;
(G) a final diagnosis
based on the current edition of the Diagnostic and Statistical Manual of Mental
Disorders (DSM) published by the American Psychiatric Association;
(H) the names, contact information, and
addresses of providers to whom the individual will be referred for any services
or supports after discharge; and
(I) in accordance with Texas Health and
Safety Code §
574.081,
a description of:
(i) the types and amount of
medication the individual needs after discharge until the individual is
evaluated by a physician; and
(ii)
the person or entity responsible for providing and paying for the
medication.
(5) Screening and evaluation before patient
discharge from hospital. In accordance with 42 CFR Part 483, Subpart C
(relating to Requirements for Long Term Care Facilities) and the rules set
forth in Chapter 303 of this title (relating to Preadmission Screening and
Resident Review (PASRR)), all patients who are being considered for discharge
from the hospital to a nursing facility shall be screened, and if appropriate,
evaluated, before discharge by the hospital and admission to the nursing
facility to determine whether the patient may have a mental illness,
intellectual disability, or developmental disability. If the screening
indicates that the patient has a mental illness, intellectual disability, or
developmental disability, the hospital shall contact and arrange for the local
mental health authority designated pursuant to Texas Health and Safety Code
§
533.035,
to conduct before hospital discharge an evaluation of the patient in accordance
with the applicable provisions of the PASRR rules. The purpose of PASRR is:
(A) to ensure that placement of the patient
in a nursing facility, is necessary;
(B) to identify alternate placement options,
when applicable; and
(C) to
identify specialized services that may benefit the person with a diagnosis of
mental illness, intellectual disability, or developmental disability.
(b) Discharge summary. The patient's treating physician shall prepare a written discharge summary that includes:
(1) a description of the patient's
treatment at the hospital and the response to that treatment;
(2) a description of the patient's condition
at discharge;
(3) a description of
the patient's placement after discharge;
(4) a description of the services and
supports the patient will receive after discharge;
(5) a final diagnosis based on the
DSM;
(6) a description of the
amount of medication the patient will need until the patient is evaluated by a
physician; and
(7) in accordance
with Texas Health and Safety Code §
574.081(c)
and (h), for involuntary patients admitted
under an order described in § 568.24(a)(2) of this chapter (related to
Admission of an Individual under an Order of Protective Custody, for
Court-ordered Inpatient Mental Health Services, or Under Order for Commitment
or Order for Placement), the name of the individual or entity responsible for
providing and paying for the medication referenced in paragraph (6) of this
subsection, which is not required to be the hospital.
(c) Documentation of refusal. If it is not feasible for any of the activities listed in subsection (a)(3) of this section to be performed because the patient, the patient's LAR, when applicable, or the patient's caregivers refuse to participate in the discharge planning, the circumstances of the refusal shall be documented in the patient's medical record.
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.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
