(a) For purposes of this subchapter, the term, "communicable diseases" has the meaning assigned to it under 25 TAC Chapter 97 (relating to Communicable Diseases).

(b) A facility must:

(1) comply with the requirements for advance directives as outlined under subsection (c) of this section;

(2) comply with the provisions of Chapter 250 of the Health and Safety Code (relating to criminal history checks of employees and applicants for employment in certain facilities serving the elderly or persons with disabilities);

(3) before offering employment, search the employee misconduct registry (EMR) established under §253.007, Health and Safety Code, and the DADS nurse aide registry (NAR) to determine if an individual is designated in either registry as unemployable. Both registries can be accessed on the DADS Internet website. (A) A facility must not employ a person who is listed as unemployable in either registry. (B) A facility must provide information about the EMR to an employee in accordance with §93.3 of this title (relating to Employment and Registry Information). (C) In addition to the initial search of the EMR and NAR, a facility must: (i) conduct a search of the NAR and EMR to determine if the employee is designated in either registry as unemployable as follows: (I) for an employee most recently hired before September 1, 2009, by August 31, 2011 and at least every twelve months thereafter; and (II) for an employee most recently hired on or after September 1, 2009, at least every twelve months; and (ii) keep a copy of the results of the initial and annual searches of the NAR and EMR in the employee's personnel file;

(4) develop policies to comply with standards for universal precautions for HIV/AIDS and related conditions in the workplace;

(5) develop written policies for the control of communicable diseases in employees and clients, which include tuberculosis (TB) screening and provision of a safe and sanitary environment for clients and their families;

(6) comply with all relevant federal and state standards; and

(7) comply with all applicable provisions of the Human Resource Code, Chapter 102.

(c) A facility must maintain policies and procedures regarding the following rules with respect to all adult clients receiving services provided by the facility:

(1) The facility must provide a client with the following written information: (A) the client's rights under Texas law (whether statutory or as recognized by the courts of the state) to make decisions concerning medical care, including the right to accept or refuse medical or surgical treatment and the right to formulate advance directives; (B) the facility's policies respecting the implementation of these rights; and (C) a written list of the client's rights, as outlined under the Human Resource Code §102.004, Rights of the Elderly.

(2) The facility must document in the client's record whether the client has executed an advance directive.

(3) The facility must not condition the provision of care or otherwise discriminate against a client based on whether the client has executed an advance directive.

(4) The facility must ensure compliance with the requirements of Texas law, whether statutory or as recognized by the courts of Texas, respecting advance directives.

(5) The facility must educate the client, family members and staff, in a language they understand, on issues concerning advance directives.

(6) The facility must provide the attending physician with any information relating to a known existing Directive to Physicians or Living Will or Durable Power of Attorney for Health Care, and assist with coordinating physicians' orders with any directive.

(7) When a client is in an incapacitated state, and therefore is unable to receive information or articulate whether he has executed an advance directive, the family, surrogate, or other concerned person must receive the information concerning advance directives. The facility must provide this information to the client in a language he understands, if he is no longer incapacitated.

(8) When the client or a relative, surrogate, or other concerned or related individual presents the facility with a copy of the client's advance directive, the facility must comply with the advance directive including recognition of a durable power of attorney for health care, to the extent allowed under state law. If no one comes forward with a previously executed advance directive and the client is incapacitated or otherwise unable to receive information or articulate whether he has executed an advance directive, the facility must note that the client was not able to receive information and was unable to communicate whether an advance directive existed.

(d) A facility must:

(1) contact DADS at 1-800-458-9858 on learning of alleged abuse or neglect of a client and send a written investigation report to DADS no later than the fifth working day after the oral report;

(2) maintain incident reports;

(3) ensure the confidentiality of individual client records and other information related to clients; and

(4) inform the client orally and in writing of his rights, responsibilities, and grievance procedures in a language he understands.

(e) A facility must prominently and conspicuously post for display in a public area of the facility that is readily available to clients, employees, and visitors:

(1) the license issued under this chapter;

(2) a sign prescribed by DADS that describes complaint procedures and specifies how complaints may be filed with DADS;

(3) a notice in the form prescribed by DADS stating that inspection and related reports are available at the facility for public inspection and providing DADS' toll-free telephone number that may be used to obtain information concerning the facility;

(4) a copy of the most recent inspection report relating to the facility;

(5) a brochure or letter that outlines the facility's hours of operation, holidays, and a description of activities offered; and

(6) emergency telephone numbers, including the abuse hotline telephone number, near all telephones.

Source Note: The provisions of this §559.61 adopted to be effective May 1, 1999, 24 TexReg 3100; amended to be effective November 1, 2000, 25 TexReg 10753; amended to be effective November 19, 2001, 26 TexReg 9414; amended to be effective September 1, 2010, 35 TexReg 6355; transferred effective January 15, 2021, as published in the Texas Register December 18, 2020, 45 TexReg 9249