26 Tex. Admin. Code § 554.420 - Documentation for the Delegation of Long-Term Care Resident's Rights
(a) The delegation of resident rights may
occur in three cases:
(1) when a competent
individual chooses to allow another to act for him, such as with a Durable
Power of Attorney;
(2) when the
resident has been adjudicated to be incompetent by a court of law and a
guardian has been appointed; or
(3)
when the physician has determined that, for medical reasons, the resident is
incapable of understanding and exercising such rights. The Health and Safety
Code, Chapter 313, Consent to Medical Treatment, provides guidance under
certain circumstances when a resident is comatose, incapacitated, or otherwise
mentally or physically incapable of communication.
(b) In order to assure preservation of
rights, the physician and the facility must document specific information
concerning the incapability of the resident to understand and exercise his
rights.
(c) Facility documentation
must cover:
(1) the relationship of the
resident to the person assuming his rights and responsibilities;
(2) the authority allowing the responsible
person to act for the resident;
(3)
resident assessments, care plans, and progress notes that address the
resident's inability to exercise his rights and responsibilities; and
(4) assurance that the resident who is
mentally capable of understanding and exercising his rights, but physically
incapable of doing so, receives interventions which facilitate the exercise of
his rights.
(d)
Physician documentation must cover:
(1)
resident's comatose state, incapacity, or other mental or physical inability to
communicate;
(2) proposed medical
treatment or decision;
(3) periodic
assurance that there has been no essential change in the resident's mental
function; and
(4) reevaluation
whenever a significant change in resident status occurs or for orders that
impact on resident rights (such as "No CPR").
Notes
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