(a) Definitions. The following words and terms, when used in this section, have the following meanings, unless the context clearly indicates otherwise.
  (1) Aftercare--Assistance provided by a designated caregiver to a person after that person's discharge from a hospital, as described by Health and Safety Code, chapter 317, and this section.
  (2) Designated caregiver--An individual designated by a patient, including a relative, partner, friend, or neighbor, who:
    (A) is at least 18 years of age;
    (B) has a significant relationship with the patient; and
    (C) will provide aftercare to the patient.
  (3) Surrogate decision-maker--An individual with decision-making capacity who is identified as the person who has authority to consent to medical treatment on behalf of an incapacitated patient in need of medical treatment.
(b) The hospital shall provide a patient who is at least 18 years of age, a patient who is younger than 18 years of age who has had the disabilities of minority removed, the patient's legal guardian, or the patient's surrogate decision-maker the opportunity to designate a caregiver for receipt of aftercare instructions.
(c) The hospital shall provide the opportunity to designate a caregiver on admission of the patient or before the patient is discharged or transferred to another facility.
(d) If the patient, the patient's legal guardian, or the patient's surrogate decision-maker declines to designate a caregiver, the hospital shall note the fact in the patient's medical record.
(e) If the patient, the patient's legal guardian, or the patient's surrogate decision-maker designates a caregiver, the hospital shall:
  (1) document in the patient's medical record the designated caregiver's name, telephone number, address, and relationship to the patient; and
  (2) request written authorization to disclose health care information to the designated caregiver.
(f) If written authorization to disclose health care information to the designated caregiver is obtained, the hospital shall:
  (1) as soon as possible before the patient's discharge or transfer, notify the designated caregiver of this fact;
  (2) if the hospital is unable to contact the designated caregiver before the patient's discharge or transfer, note this in the patient's medical record;
  (3) before the patient's discharge, provide the designated caregiver a written discharge plan that describes the patient's aftercare needs that includes:
    (A) the designated caregiver's name, contact information, and relationship to the patient;
    (B) a description of the aftercare tasks that the patient requires, written in a culturally competent manner; and
    (C) the contact information for any health care resources necessary to meet the patient's aftercare needs;
  (4) before the patient's discharge to any setting in which health care services are not regularly provided to others, provide the designated caregiver instruction and training as necessary for the caregiver to perform aftercare tasks, including the opportunity to ask follow-up questions.
(g) The patient, the patient's legal guardian, or the patient's surrogate decision-maker may change the designated caregiver at any time and the hospital shall note the change in the patient's medical record.
(h) This section may not be construed to interfere with, delay, or otherwise affect any medical care provided to the patient or the discharge or transfer of the patient.

Source Note: The provisions of this §133.50 adopted to be effective July 23, 2019, 44 TexReg 3635