(a) A resident or the resident's legally authorized representative (LAR), if the resident is unable, has the right to designate at least one essential caregiver.
(b) A nursing facility (NF) must permit essential caregiver visits except as provided by subsection (j) of this section.
(c) A NF must allow essential caregiver visits to occur outdoors, in the resident's bedroom when possible, or in another area upon request by a resident or resident's LAR.
(d) A NF must develop a visitation policy that permits an essential caregiver to visit the resident for at least two hours each day.
(e) A NF must have procedures in place to enable physical contact between the resident and the essential caregiver, if the resident chooses to have physical contact.
(f) A NF must develop safety protocols for essential caregiver visits. The safety protocols may not be more stringent for essential caregivers than safety protocols for staff.
(g) A NF must obtain the signature of the essential caregiver certifying that the essential caregiver will follow the NF's safety protocols for essential caregiver visits.
(h) A NF may revoke an essential caregiver designation if the caregiver violates the NF's safety protocols or rules adopted under this chapter.
(i) If A NF revokes a person's designation as an essential caregiver under subsection (h) of this section:
  (1) the resident or the resident's LAR has the right to immediately designate another person as the essential caregiver;
  (2) within 24 hours after the revocation, the facility must inform the resident or the resident's LAR, in writing, of the right to appeal the revocation and the procedures for filing an appeal with the Texas Health and Human Services Commission (HHSC) Appeals Division by:
    (A) email at OCC_Appeals_ContestedCases@hhs.texas.gov; or
    (B) mail at HHSC Appeals Division, P.O. Box 149030, MC W-613, Austin, TX 78714-9030; and
  (3) the NF must comply with a hearing officer's decision regarding an appeal of an essential caregiver revocation.
(j) A NF may petition HHSC to suspend in-person essential caregiver visits for no more than seven consecutive calendar days if in-person visitation poses a serious community health risk. A NF may request an extension from HHSC to suspend in-person essential caregiver visitation beyond the NF's original request, but HHSC may not approve an extension for a period that exceeds seven days and a NF must separately request each extension. HHSC may deny the NF's original request to suspend in-person essential caregiver visitation or the NF's extension request if HHSC determines that in-person visitation does not pose a serious community health risk.
(k) A NF may not suspend in-person essential caregiver visits in a calendar year for a time period that:
  (1) is more than 14 consecutive days; or
  (2) is more than a total of 45 days.

Source Note: The provisions of this §570.514 adopted to be effective June 1, 2022, 47 TexReg 3143