(a) At the time an individual is admitted, a CSU nursing supervisor or designee must implement the level of monitoring ordered by the physician, or physician-delegated PA or APRN, based on the individual's needs and in accordance with this section, 25 TAC §415.260 (relating to Initiation of Restraint or Seclusion in a Behavioral Emergency), and §415.266 (relating to Observation, Monitoring, and Care of the Individual in Restraint or Seclusion Initiated in Response to a Behavioral Emergency).
(b) All CSU staff must contribute to the protection of individuals by:
  (1) modifying the CSU environment based on the individual's needs, including:
    (A) providing furnishings that do not present safety hazards to the individual;
    (B) securing or removing objects that are hazardous to the individual;
    (C) installing any necessary safety devices; and
    (D) making roommate assignments and other decisions affecting the interaction of the individual with other individuals, based on individual needs and vulnerabilities;
  (2) monitoring the individual in accordance with the physician's, or physician-delegated PA's or APRN's, order and CSU written policies and procedures; and
  (3) documenting the individual's level of monitoring ordered by the physician, or physician-delegated PA or APRN, in the individual's medical record.
(c) A CSU medical director must ensure:
  (1) each level of monitoring is defined in the CSU's policies and procedures, including a description of the responsibilities of staff members for each level of monitoring identified; and
  (2) implementation of the level of monitoring ordered by the physician, or physician-delegated PA or APRN, based on the individual's needs.
(d) In accordance with Texas Health and Safety Code §321.002, a CSU administrator or administrator's designee, must keep children and adolescents separate from adults.
(e) All CSU staff must maintain an individual's confidential information in accordance with the Health Insurance Portability and Accountability Act rules and 1 TAC Chapter 390, Subchapter A (relating to Standards Relating to the Electronic Exchange of Health Information). CSU staff must:
  (1) be knowledgeable of and obey all current state and federal laws and regulations relating to confidential information regarding the provision of services; and
  (2) not disclose confidential information without the express written consent of the individual, and individual's LAR or adult caregiver, if applicable, except as permitted by the Health Insurance Portability and Accountability Act or other law.
(f) Qualified CSU staff must adhere to transportation requirements provided in accordance with 25 TAC §404.156 (relating to Additional Rights of Persons Receiving Residential Mental Health Services at Department Facilities) and Texas Health and Safety Code §574.045 and §574.0455 if the CSU provides transportation.

Source Note: The provisions of this §306.87 adopted to be effective May 27, 2021, 46 TexReg 3257