Due to the fact that we are providing care to seniors, it is imperative to assure you are up to speed on the status of their advanced directives. There are so many important factors to consider when a resident has a health emergency and can no longer make decisions for themselves, so having a plan for the inevitable is key to keeping yourself out of trouble with HSSC and keeping the family happy.
RULE 553.41 Standards for Type A and Type B Assisted Living Facilities
(g) Advance directives.
(1) The facility must maintain written policies regarding the implementation of advance directives. The policies must include a clear and precise statement of any procedure the facility is unwilling or unable to provide or withhold in accordance with an advance directive.
(2) The facility must provide written notice of these policies to residents at the time they are admitted to receive services from the facility.
(A) If, at the time notice is to be provided, the resident is incompetent or otherwise incapacitated and unable to receive the notice, the facility must provide the written notice, in the following order of preference, to:
(i) the resident’s legal guardian;
(ii) a person responsible for the resident’s health care decisions;
(iii) the resident’s spouse;
(iv) the resident’s adult child;
(v) the resident’s parents; or
(vi) the person admitting the resident.
(B) If the facility is unable, after diligent search, to locate an individual listed under subparagraph (A) of this paragraph, the facility is not required to give notice.
(3) If a resident who was incompetent or otherwise incapacitated and unable to receive notice regarding the facility’s advance directives policies later becomes able to receive the notice, the facility must provide the written notice at the time the resident becomes able to receive the notice.
(4) Failure to inform the resident of facility policies regarding the implementation of advance directives will result in an administrative penalty of $500.
(A) Facilities will receive written notice of the recommendation for an administrative penalty.
(B) Within 20 days after the date on which written notice is sent to a facility, the facility must give written consent to the penalty or make a written request for a hearing to the Texas Health and Human Services Commission.
(C) Hearings will be held in accordance with the formal hearing procedures at 1 TAC Chapter 357, Subchapter I (relating to Hearings Under the Administrative Procedures Act).
(h) Resident records.
(1) Records that pertain to residents must be treated as confidential and properly safeguarded from unauthorized use, loss, or destruction.
(2) Resident records must contain:
(A) information contained in the facility’s standard and customary admission form;
(B) a record of the resident’s assessments;
(C) the resident’s service plan
(D) physician’s orders, if any;
(E) any advance directives;
(F) documentation of a health examination by a physician performed within 30 days before admission or 14 days after admission, unless a transferring hospital or facility has a physical examination in the medical record. Christian Scientists are excluded from this requirement;
(G) documentation by health care professionals of any services delivered in accordance with the licensing, certification, or other regulatory standards applicable to the health care professional under the law; and
(H) a copy of the most recent court order appointing a guardian of a resident or a resident’s estate and letters of guardianship that the facility received in response to the request made in accordance with §92.42 of this subchapter (relating to Guardianship Record Requirements).
(3) Records must be available to residents, their legal representatives, and DADS staff.