Facilities offering respite care must meet the requirements of this chapter, except as provided in paragraph (4) of this section.     
       (1) Definitions. The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.                (A) Plan of care--A written description of the medical care or the supervision and nonmedical care needed by an individual during respite care.                 (B) Respite care--The provision by a facility to an individual, for not more than two weeks for each stay in the facility, of room, board, and care at the level ordinarily provided for permanent residents.        
       (2) Plan of care. The facility and the  individual arranging respite  care must agree on the plan of care, and the plan must be filed at the facility before the facility admits the individual.                (A) The plan of care must be signed by:                    (i) a licensed physician if the individual needing care requires medical care or treatment; or                     (ii) the individual arranging the care if medical care or treatment is not required.                   (B) The facility may keep a plan of care for an individual for six months from the date on which it is developed. During that period, the facility may admit the individual as frequently as needed.        
       (3) Notification. A facility must notify the Texas Department of Human Services (DHS) in  writing that it offers respite services.      
       (4) Inspections. During licensing or certification inspections, or at other times DHS determines necessary, DHS inspects a facility's records of respite care services, physical accommodations for respite care, and the plan of care records to ensure that the respite care services comply with the certification requirements of this chapter, with the following exceptions.                (A) The clinical record of each respite care resident must contain:                    (i) general identifying information necessary to care for the individual and maintain his clinical record;                     (ii) resident assessment and care plan according to facility policy;                     (iii) progress notes and/or flow sheets which document care and services;                     (iv) reports of diagnostic  or lab studies;                     (v) physician's orders; and                     (vi) discharge and readmission information as required by facility policy for respite care services.                   (B) Resident assessment requirements of §19.801 of this title (relating to Resident Assessment) apply to respite care services only on the 14th day of care.                 (C) The clinical records requirement found at §19.1912(e) of this title (relating to Additional Clinical Record Service Requirements) does not apply.        
       (5) Suspension. DHS may require an institution to cease  providing respite care if DHS determines that the respite care does not meet the requirement of this chapter and that the facility cannot comply with those requirements in the  respite care it provides. DHS may suspend the license of a facility that continues to provide respite care after receiving a written order from DHS to cease.      
       (6) Licensed capacity. When a facility provides respite care:                (A) the total number of individuals receiving services in the facility must not exceed the number of licensed beds; and                 (B) any required nurse-to-resident ratio must include any individual receiving respite care services regardless of the number of hours that the individual spends in the facility.        
     Source Note:        The provisions of this §554.1916 adopted to be effective May 1, 1995, 20 TexReg 2393; transferred effective January 15, 2021, as published in the Texas Register December 11, 2020, 45 TexReg 8871