26 Tex. Admin. Code § 550.607 - Initial and Updated Plan of Care
(a) A
center must develop an individualized written plan of care for a minor. The
plan of care must include:
(1) the minor's and
the minor's parent's goals and interventions based on the issues identified in
the pre-admission conference and the initial and updated comprehensive
assessments; and
(2) measurable
goals with interventions based on the minor's care needs and means of achieving
each goal and must address, as appropriate, rehabilitative and restorative
measures, preventive intervention and training, and teaching of personal care
by the minor's parent.
(b) An RN must address in the written
interdisciplinary plan of care:
(1) the
services needed to address the medical, nursing, psychosocial, therapeutic,
dietary, functional, educational, and developmental needs of the minor and the
training needs of the minor's parent;
(2) the minor's functional
assessment;
(3) the specific goals
of care;
(4) the time frame for
achieving the goals and the schedule for evaluation of progress;
(5) the orders for treatment, services,
medications, medical equipment, diet, and restraints, if applicable;
(6) specific criteria for transitioning from
or discontinuing participation at the center; and
(7) the minor's scheduled days of
attendance.
(c) In
collaboration with the interdisciplinary team, an RN, a minor's parent, the
minor, and an individual requested by the adult minor or the minor's parent
must develop a plan of care based on the comprehensive assessment.
(d) The RN, an adult minor, and a minor's
parent must sign the plan of care within five days after initiation of the
plan.
(e) A minor's prescribing
physician must review and sign the plan of care within 30 days after initiation
of the plan.
(f) The center must
incorporate the plan of care into a minor's medical record no later than 10
days after receiving the signed plan from a minor's prescribing
physician.
(g) Copies of the plan
of care must be given, in a language and format the recipient understands, to a
minor's parent, an adult minor, the minor's prescribing physician, the center's
staff, and other health care providers and providers of basic services as
appropriate.
(h) The center's IDT
and an RN must review and update a minor's plan of care at least every 180
days, or more often, if there is a change in the minor's medical condition or
changes in the minor's needs.
(i) A
minor's parent and an adult minor must review and sign the updated plan of care
within five days before changes to the plan of care are implemented.
(j) A minor's prescribing physician must
review and sign the updated plan of care within 30 days after initiation of the
updated plan.
(k) The center must
incorporate the updated plan of care into a minor's medical record no later
than 10 days after receiving the signed plan from the minor's prescribing
physician.
(l) The center must
adopt and enforce written policies and procedures regarding the communication
and coordination of a minor's care with the minor's prescribing physician in
accordance with the plan of care.
(m) The policy described in subsection (l) of
this section must ensure the communication between the center's staff and a
minor's prescribing physician is conveyed to the minor's parent and the minor
in a language and format that the adult minor and minor's parent
understand.
(n) The center's
nursing director or designee must:
(1)
document communication with a minor's prescribing physician;
(2) maintain the documentation in the minor's
medical record; and
(3) ensure that
the communication is conveyed to the minor's parent and the adult minor in a
language and format the adult minor and minor's parent understand.
(o) The center staff must ensure
the provision of services and treatments in accordance with the plan of care
and as ordered by a minor's prescribing physician.
Notes
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