(a) The facility director:
  (1) manages the DAHS program and the facility;
  (2) trains and supervises facility staff, contractors, and volunteers;
  (3) monitors the facility building and grounds to ensure compliance;
  (4) maintains all financial and client records;
  (5) develops relationships with community groups and agencies for identification and referral of clients;
  (6) maintains communication with clients' family members or responsible parties;
  (7) ensures development and maintenance of the clients' plans of care; and
  (8) ensures that, if the facility director also serves as the RN consultant, the facility director fulfills the responsibility as director.
(b) The facility nurse:
  (1) assesses clients' nursing and medical needs;
  (2) develops clients' plans of care;
  (3) obtains prescribing practitioner's orders for medication and treatments to be administered;
  (4) determines whether self-administered medications have been appropriately taken, applied, or used;
  (5) enters, dates, and signs monthly progress notes on medical care provided;
  (6) administers medication and treatments;
  (7) provides health education;
  (8) maintains medical records; and
  (9) oversees implementation of the facility's infection prevention and control policies.
(c) The activities director:
  (1) plans and directs the daily program of activities, including physical fitness exercises or other recreational activities;
  (2) records client's social histories;
  (3) assists clients' related support needs;
  (4) ensures that the identified related support services are included in clients' plans of care;
  (5) signs and dates monthly progress notes about social and related support services activities provided; and
  (6) ensures clients have a choice in whether to participate in activities.
(d) An attendant:
  (1) provides personal care services to assist with activities of daily living;
  (2) assists the activities director with recreational activities; and
  (3) provides protective supervision through observation and monitoring.
(e) Food service personnel:
  (1) prepare meals and snacks; and
  (2) maintain the kitchen area and utensils in a safe and sanitary condition.
(f) A facility must obtain consultation at least four hours per month from a dietitian consultant.
  (1) The dietitian consultant plans and reviews menus and must:
    (A) approve and sign snack and lunch menus;
    (B) review menus monthly to ensure that substitutions were appropriate; and
    (C) develop a special diet for clients if ordered by a prescribing practitioner.
  (2) A facility must obtain consultation from a dietitian consultant even if the facility has meals delivered from another facility with a dietitian consultant or the facility contracts for the preparation and delivery of meals with a contractor that employs a registered dietician. A consultant who provides consultation to several facilities must provide at least four hours of consultation per month to each facility.
(g) If a facility employs an LVN as the facility nurse, the facility must ensure that an RN consultant provides consultation at the facility at least four hours per week. The RN consultant must document the consultation provided. The RN consultant must provide the consultation when clients are present in the facility. The RN consultant may provide the following types of assistance:
  (1) review plans of care and suggest changes, if appropriate;
  (2) assess clients' health conditions;
  (3) consult with the LVN in solving problems involving care and service planning;
  (4) counsel clients on health needs;
  (5) train, consult, and assist the LVN to maintain proper medical records; and
  (6) provide in-service training for direct service staff.

Source Note: The provisions of this §559.65 adopted to be effective July 10, 2024, 49 TexReg 4909