2005 Texas Health & Safety Code CHAPTER 255. QUALITY ASSURANCE EARLY WARNING SYSTEM FOR LONG-TERM CARE FACILITIES; RAPID RESPONSE TEAMS

HEALTH & SAFETY CODE

CHAPTER 255. QUALITY ASSURANCE EARLY WARNING SYSTEM FOR LONG-TERM 
CARE FACILITIES;  RAPID RESPONSE TEAMS


	§ 255.001. DEFINITIONS.  In this chapter:                                   
		(1)  "Department" means the Department of Aging and 
Disability Services.    
		(2)  "Long-term care facility" means a nursing 
institution, an assisted living facility, or an intermediate care 
facility for the mentally retarded licensed under Chapter 242, 247, 
or 252, or certified under Chapter 32, Human Resources Code.
		(3)  "Quality-of-care monitor" means a registered 
nurse, pharmacist, or nutritionist who:
			(A)  is employed by the department;                                          
			(B)  is trained and experienced in long-term care 
facility regulation, standards of practice in long-term care, and 
evaluation of patient care;  and
			(C)  functions independently of other divisions 
of the department.         

Added by Acts 2001, 77th Leg., ch. 1284, § 7.03, eff. June 15, 
2001.  Amended by Acts 2005, 79th Leg., ch. 837, § 1, eff. Sept. 
1, 2005.


	§ 255.002. EARLY WARNING SYSTEM.  The department shall 
establish an early warning system to detect conditions that could 
be detrimental to the health, safety, and welfare of residents.  The 
early warning system shall include analysis of financial and 
quality-of-care indicators that would predict the need for the 
department to take action.

Added by Acts 2001, 77th Leg., ch. 1284, § 7.03, eff. June 15, 
2001.     


	§ 255.003. QUALITY-OF-CARE MONITORS.  (a) The department 
shall establish regional offices with one or more quality-of-care 
monitors, based on the number of long-term care facilities in the 
region, to monitor the facilities in the region on a regular, 
aperiodic basis, including nights, evenings, weekends, and 
holidays.  A monitoring visit conducted under this chapter may be 
announced or unannounced.
	(b)  Priority for monitoring visits shall be given to 
long-term care facilities with a history of patient care 
deficiencies.
	(c)  Quality-of-care monitors may not be deployed by the 
department as a part of the regional survey team in the conduct of 
routine, scheduled surveys.
	(d)  A quality-of-care monitor may not interfere with, 
impede, or otherwise adversely affect the performance of the duties 
of a surveyor, inspector, or investigator of the department.
	(e)  Quality-of-care monitors shall assess:                                    
		(1)  the overall quality of life in the long-term care 
facility;  and       
		(2)  specific conditions in the facility directly 
related to patient care.  
	(f)  The quality-of-care monitor shall include in a 
monitoring visit:        
		(1)  observation of the care and services rendered to 
residents;  and       
		(2)  formal and informal interviews with residents, 
family members, facility staff, resident guests, volunteers, other 
regulatory staff, and representatives of a human rights advocacy 
committee.
	(g)  The identity of a resident or a family member of a 
resident interviewed by a quality-of-care monitor as provided by 
Subsection (f)(2) shall remain confidential and may not be 
disclosed to any person under any other provision of this section.
	(h)  The findings of a monitoring visit, both positive and 
negative, shall be provided orally and in writing to the long-term 
care facility administrator or, in the absence of the facility 
administrator, to the administrator on duty or the director of 
nursing.
	(i)  The quality-of-care monitor may recommend to the 
long-term care facility administrator procedural and policy 
changes and staff training to improve the care or quality of life of 
facility residents.
	(j)  Conditions observed by the quality-of-care monitor that 
create an immediate threat to the health or safety of a resident 
shall be reported immediately to the regional office supervisor for 
appropriate action and, as appropriate or as required by law, to law 
enforcement, adult protective services, other divisions of the 
department, or other responsible agencies.

Added by Acts 2001, 77th Leg., ch. 1284, § 7.03, eff. June 15, 
2001.  Amended by Acts 2005, 79th Leg., ch. 837, § 2, eff. Sept. 
1, 2005.


	§ 255.004. RAPID RESPONSE TEAMS.  (a) The department 
shall create rapid response teams composed of health care experts 
that can visit long-term care facilities identified through the 
department's early warning system.
	(b)  Rapid response teams may visit long-term care 
facilities that request the department's assistance.  A visit under 
this subsection may not occur before the 60th day after the date of 
an exit interview following an annual or follow-up survey or 
inspection.
	(c)  The rapid response teams may not be deployed for the 
purpose of helping a long-term care facility prepare for a regular 
inspection or survey conducted under Chapter 242, 247, or 252 or in 
accordance with Chapter 32, Human Resources Code.

Added by Acts 2001, 77th Leg., ch. 1284, § 7.03, eff. June 15, 
2001.     


	§ 255.005. REPORT.  The department shall assess and 
evaluate the effectiveness of the quality assurance early warning 
system and shall report its findings annually to the governor, the 
lieutenant governor, and the speaker of the house of 
representatives.

Added by Acts 2001, 77th Leg., ch. 1284, § 7.03, eff. June 15, 
2001.