Each facility shall adopt, implement, and enforce policies and procedures appropriate to the patient population served which ensure each patient is:     
       (1) treated with respect, dignity, and full recognition of the patient's individuality and personal needs;      
       (2) provided privacy and confidentiality, for the patient and the clinical record;      
       (3) provided a safe, sanitary, and comfortable treatment environment;      
       (4) provided information in a manner to facilitate understanding by the patient and the patient's legal representative, family member, or significant other. Written patient information materials shall be available, with materials in languages other than English. In lieu of written materials in the patient's primary language, an interpreter, interpreter service, visual and hearing impaired assistance shall be provided. Staff shall document in the patient's clinical record how consent forms for treatment requiring a signature were explained, and the patient's consent obtained, and how patient rights and responsibilities were explained to the patient;      
       (5) informed by a physician of the patient's medical status;      
       (6) informed of and receive education regarding all treatment modalities and settings, including self-care and transplant for the treatment of end stage renal disease on an annual basis;      
       (7) informed about and participates in, if desired, all aspects of care, including the right to refuse treatment, and informed of the medical consequences of such refusal;      
       (8) aware of all services available in the facility and the charges for services provided;      
       (9) informed about the facility's reuse of dialysis supplies, including hemodialyzers. If printed materials such as brochures are used to describe a facility and its services, the brochures shall contain a statement with respect to reuse;      
       (10) assured of a reasonable response by the facility to the patient's requests and needs for treatment or service, within the facility's capacity, the facility's stated mission, and applicable law and regulation;      
       (11) provided hours of dialysis that are scheduled for patient convenience whenever feasible or possible. Consideration shall be given to a patient's work or school schedule;      
       (12) transferred or discharged only for medical reasons, for the patient's welfare or that of other patients or staff members, or for nonpayment of fees. A patient shall be given 30 calendar days advance notice to ensure orderly transfer or discharge, except in cases where the patient presents an immediate risk to others;      
       (13) given an opportunity and assistance to improve problematic behavior prior to dismissal from the facility. A facility shall establish, implement, and enforce a policy whereby a disruptive patient or family member or noncompliant patient is given an opportunity and assistance to improve the problematic behavior prior to dismissal from the facility. The policy shall include the requirements at §117.45(a)(8) of this title (relating to Provision and Coordination of Treatment and Services);      
       (14) provided protection from abuse, neglect, or exploitation as those terms are defined in §1.204 of this title (relating to Investigations of Abuse, Neglect, or Exploitation of Children or Elderly or Disabled Persons);      
       (15) provided information regarding advance directives and allowed to formulate such directives to the extent permitted by law. This includes documents executed under the Health and Safety Code, Chapter 166, Advance Directives Act;      
       (16) aware of the mechanisms and agencies to express a complaint against the facility without fear of reprisal or denial of services. A facility shall provide to each individual who is admitted to the facility a written statement that informs the individual that a complaint against the facility may be directed to the department. The statement shall be provided at the time of admission and shall advise the patient that registration of complaints may be filed with the Department of State Health Services, Health Facility Compliance Group, Mail Code 2835, P.O. Box 149347, Austin, TX 78714-9347, (888) 973-0022. Correctional institutions shall not be required to include the 888 number in information provided to patients in these facilities;      
       (17) fully informed of the rights listed in this section, the responsibilities established by the facility, and all rules and regulations governing patient conduct and responsibilities. A written copy of the patient's rights and responsibilities shall be provided to each patient or the patient's legal representative upon admission, and a copy shall be posted with the facility license certificate; and      
       (18) fully informed of the patient plan of care process, including but not limited to the necessary services outlined in the patient plan of care.      
     Source Note:        The provisions of this §117.42 adopted to be effective July 6, 2010, 35 TexReg 5835