(a) Staff member training shall be in accordance with §301.331 of this title (relating to Competency and Credentialing).      
        (1) A hospital administrator, or administrator's designee, shall:                  (A) ensure that services are provided by staff members who are operating within their scope of their license, credentialing, job description, or contract specification, and in accordance with applicable state law and rule, including 25 TAC Chapter 415, Subchapter F (relating to Interventions in Mental Health Services);                   (B) define competency-based expectations for each hospital staff position and ensure each staff member receives initial training before the staff member assumes responsibilities required by the hospital and annually throughout the staff member's employment with the hospital;                   (C) provide hospital staff live, interactive, instructor-led electronic or face-to-face training competency-based training; and                   (D) require all staff members to demonstrate required competencies delineated in §301.331(a)(3)(A) of this title, including:                      (i) identifying, preventing, and reporting abuse and neglect of patients and unprofessional or unethical conduct in the hospital, as defined by Texas Health and Safety Code §161.131 (relating to Definitions);                       (ii) identifying, preventing, and reporting abuse, neglect, and exploitation as follows, in accordance with Texas Health and Safety Code §161.133 (relating to In-service Training):                          (I) residential staff must receive eight hours of training;                           (II) training must be conducted in person, and not through teleconferencing, web-based video conferencing, or other technology;                           (III) a hospital must ensure all new employees receive training on abuse, neglect, and exploitation; and                           (IV) a hospital may provide abuse, neglect, and exploitation training to staff or may choose to contract with an outside entity to provide the training;                         (iii) preserving and protecting dignity and rights of a patient in accordance with 25 TAC Chapter 404, Subchapter E (relating to Rights of Persons Receiving Mental Health Services); and                       (iv) preserving and protecting confidentiality of a patient's information in accordance with Texas Health and Safety Code Chapter 611 or Chapter 241, Subchapter G, as applicable, 42 CFR Part 2, and 45 CFR Parts 160 and 164.           
        (2) All registered nurses (RNs), licensed vocational nurses (LVNs), and unlicensed assistive personnel (UAP) shall receive training in:                  (A) monitoring for patient safety in accordance with §568.67 of this chapter (relating to Protection of a Patient);                   (B) infection control in accordance with §510.41(d) of this title (relating to Facility Functions and Services); and                   (C) the hospital's mandatory overtime policy required by §568.63(k) of this chapter (relating to Nursing Services).         
        (3) An RN and LVN shall receive training in the process for reporting concerns regarding the adequacy of the staffing plan, as described in §568.63(h) of this chapter.       
        (4) A staff member routinely providing treatment to, working with, or providing consultation about a patient who is younger than 18 years of age shall receive training in the aspects of growth and development (including physical, emotional, cognitive, educational and social) and the treatment needs of patients in the following age groups:                  (A) early childhood (1-5 years of age);                   (B) late childhood (6-13 years of age); and                   (C) adolescent (14-17 years of age).         
        (5) A staff member routinely providing treatment to, working with, or providing consultation about a patient diagnosed with co-occurring psychiatric and substance-related disorders (COPSD) shall receive training in substance-related and addictive disorders.       
        (6) A staff member routinely providing treatment to, working with, or providing consultation about a geriatric patient shall receive training in the social, psychological, and physiological changes associated with aging.       
        (7) In accordance with Texas Health and Safety Code §572.0025(e), a pre-admission screening professional (PASP) shall receive at least eight hours of pre-admission screening and intake training, as described in subsection (c) of this section.       
        (8) In accordance with Texas Health and Safety Code §572.0025(e), a staff member whose responsibilities include conducting the hospital's intake process for a patient shall receive at least eight hours of pre-admission screening and intake training, as described in subsection (c) of this section.       
        (9) A staff member who may initiate an involuntary intervention shall receive training in and demonstrate competency in performing such interventions in accordance with 25 TAC Chapter 415, Subchapter F (relating to Interventions in Mental Health Services) prior to performing such interventions.       
      (b) A staff member providing direct patient care shall maintain certification in a course developed by the American Heart Association, the American Red Cross, or the Health and Safety Institute in recognizing and caring for breathing and cardiac emergencies. The course shall teach the following skills appropriate to the age of the hospital's patients:      
        (1) rescue breathing, with and without devices;       
        (2) airway obstruction;       
        (3) cardiopulmonary resuscitation; and       
        (4) use of an automated external defibrillator.       
      (c) Pre-admission screening and intake training. The pre-admission screening and intake training required by subsections (a)(7) and (8) of this section shall provide instruction to staff members regarding:      
        (1) assessing, interviewing, and diagnosing an individual with a mental illness and an individual diagnosed with COPSD;       
        (2) obtaining relevant information about the patient, including information about finances, insurance benefits and advance directives;       
        (3) explaining, orally and in writing, the patient's rights described in 25 TAC Chapter 404, Subchapter E (relating to Rights of Persons Receiving Mental Health Services);       
        (4) explaining, orally and in writing, the hospital's services and treatment as they relate to the patient;       
        (5) informing the patient in writing of the existence, telephone number, and address of the protection and advocacy system of the state of Texas; and       
        (6) determining whether the patient comprehends the information provided in accordance with paragraphs (3) - (5) of this subsection.       
      (d) Frequency of training. A hospital shall provide the training described in subsection (a) of this section, periodically, as follows.      
        (1) A staff member shall receive the patient rights training required by subsection (a)(1)(D)(iii) of this section:                  (A) before assuming responsibilities at the hospital; and                   (B) annually throughout the staff member's employment or association with the hospital.         
        (2) A staff member shall receive the training in identifying, preventing, and reporting abuse and neglect of patients and unprofessional or unethical conduct required by subsection (a)(1)(D)(i) of this section annually throughout the staff member's employment or association with the hospital, as set forth in Texas Health and Safety Code §161.133.       
        (3) A staff member shall receive the training required by subsections (a)(1)(D) and (a)(2) - (5) of this section:                  (A) before assuming responsibilities at the hospital; and                   (B) annually throughout the staff member's employment or association with the hospital.         
        (4) A staff member shall have the certification required by subsection (b) of this section:                  (A) before assuming responsibilities at the hospital; or                   (B) not later than 30 days after the staff member is hired by the hospital if another staff member who has such certification is physically present and on-duty on the same unit on which the uncertified staff member is on-duty.         
        (5) A pre-admission screening professional (PASP) shall receive the training required by subsection (a)(7) of this section:                  (A) before the PASP conducting a pre-admission screening; and                   (B) annually throughout the PASP's employment or association with the hospital.         
        (6) A staff member shall receive the training required by subsection (a)(8) of this section:                  (A) before conducting the intake process; and                   (B) annually throughout the staff member's employment or association with the hospital.         
        (7) A staff member shall receive the training required by subsection (a)(9) of this section at the intervals described in 25 TAC Chapter 415, Subchapter F .       
      (e) Documentation of training.      
        (1) A hospital shall document that a staff member has successfully completed the training described in subsection (a) of this section including:                  (A) the date of the training;                   (B) the length of the training session; and                   (C) the name of the instructor.         
        (2) A hospital shall maintain certification or other evidence issued by the American Heart Association, the American Red Cross or the Health and Safety Institute that a staff member has successfully completed the training described in subsection (b) of this section.       
      (f) Performance in accordance with training. A staff member shall perform the staff member's responsibilities in accordance with the training and certification required by this section.     
     Source Note:        The provisions of this §568.121 adopted to be effective May 27, 2021, 46 TexReg 3276