(a) Director. A facility must employ a director.
  (1) The director must:
    (A) have graduated from an accredited four-year college or university and have no less than one year of experience in working with people in a human service or medically related program, or have an associate degree or 60 semester hours from an accredited college or university with three years of experience working with people in a human service or medically related program;
    (B) be an RN with one year of experience in a human service or medically related program;
    (C) meet the training and experience requirements for a license as a nursing facility administrator under Chapter 555 of this title (relating to Nursing Facility Administrators); or
    (D) have met the qualifications for a director required on July 16, 1989, and served continuously in the capacity of director since that date.
  (2) The director must show evidence of 12 hours of annual continuing education in at least two of the following areas:
    (A) client and provider rights and responsibilities, abuse, neglect, exploitation, and confidentiality;
    (B) basic principles of supervision;
    (C) skills for working with individuals, families, and other professional service providers;
    (D) individual characteristics and needs;
    (E) community resources;
    (F) basic infection prevention and control measures;
    (G) emergency preparedness and response;
    (H) basic emergency first aid, such as cardiopulmonary resuscitation or choking; or
    (I) federal laws, such as Americans with Disabilities Act, Civil Rights Act of 1991, Rehabilitation Act of 1993, and Family and Medical Leave Act of 1993.
  (3) The activities director may fulfill the function of director if the activities director meets the qualifications for facility director.
  (4) One person may not serve as facility nurse, activities director, and director.
  (5) The facility must have a policy regarding the delegation of responsibility in the director's absence from the facility.
  (6) The facility must notify HHSC Regulatory Services Regional Office for the region in which the facility is located if the director is absent from the facility for more than 10 working days.
(b) Nurse. A facility must employ a nurse.
  (1) An RN must have a license from the Texas Board of Nursing and practice in compliance with the Nurse Practice Act and rules and regulations of the Texas Board of Nursing.
  (2) An LVN must have a license from the Texas Board of Nursing and practice in compliance with the Nurse Practice Act and rules and regulations of the Texas Board of Nursing.
  (3) If a nurse serving as director leaves the facility to perform other duties related to the DAHS program, an LVN or another RN must fulfill the duties of the facility nurse.
  (4) A facility that does not have a DAHS contract, but that has a Special Services to Persons with Disabilities contract, is not required to have an RN on duty if the clients receiving services have no medical needs and are able to self-administer medication.
(c) Activities director. A facility must employ an activities director.
  (1) Except as provided in paragraph (2) of this subsection, an activities director must have graduated from high school or have a certificate recognized by a state of the United States as the equivalent of a high-school diploma and have:
    (A) a bachelor's degree from an accredited college or university and one year of full-time experience working with elderly people or people with disabilities in a human service or medically related program;
    (B) 60 semester hours from an accredited college or university and two years of full-time experience working with elderly people or people with disabilities in a human service or medically related program; or
    (C) completed an activities director's course and two years of full-time experience working with elderly people or people with disabilities in a human service or medically related program.
  (2) An activities director hired before May 1, 1999, with four years of full-time experience working with elderly people or people with disabilities in a human service or medically related program is not subject to the requirements of paragraph (1) of this subsection.
(d) Attendants. An attendant must be at least 18 years of age and may be employed as a driver, aide, food service worker, janitor, housekeeper, or laundry services worker.
  (1) If a facility employs a driver, the driver must have a current operator's license, issued by the Texas Department of Public Safety, that is appropriate for the class of vehicle used to transport clients.
  (2) If an attendant handles food in the facility, the attendant must meet the requirements of the Texas Department of State Health Services (DSHS) rules on food service sanitation as described in 25 TAC Chapter 228 (relating to Retail Food Establishments).
(e) Food service personnel. If a facility prepares meals on site, the facility must have sufficient food service personnel to prepare meals and snacks. Food service personnel must meet the requirements of the DSHS rules on food service sanitation as described in 25 TAC Chapter 228.

Source Note: The provisions of this §559.59 adopted to be effective July 10, 2024, 49 TexReg 4909