Texas nursing home responsiveness requirements

A nursing facility must report any alleged abuse, neglect, exploitation, mistreatment, injury of unknown source, or misappropriation of resident property to the facility administrator and to HHSC Complaint and Incident Intake within 2 hours if it involves abuse or results in serious bodily injury, within 24 hours otherwise, and must send the written investigation results to HHSC within 5 working days; law enforcement must also be notified for imminent-danger, death, hospitalization, sexual-offense, or bodily-injury allegations.

immediately to the administrator of the facility and to HHSC Complaint and Incident Intake, but no later than two hours after the allegation is made, if the events that cause the allegation involve abuse, or result in serious bodily injury; or ... no later than 24 hours after the allegation is made ... if the events that cause the allegation do not involve abuse and do not result in serious bodily injury

A nursing facility must staff licensed nurses and other nursing personnel on a 24-hour basis, designate a licensed nurse as charge nurse on each shift, and use the services of a registered nurse at least eight consecutive hours a day, seven days a week, absent a waiver.

The facility must use the services of a registered nurse for at least eight consecutive hours a day, seven days a week, except when waived under paragraph (5) or (6) of this subsection.

Texas imposes a hard minimum licensed-nurse ratio (one licensed nurse per 20 residents per 24-hour period, or 0.4 licensed-care hours per resident day) and — the telephone-response duty — requires that when temporary licensed personnel staff the afternoon or night shift, a full-time licensed nurse (an RN unless the facility holds a daily-RN waiver) be on call and immediately available by telephone.

If temporary personnel are used for afternoon or night shifts, a full-time, licensed nurse must be on call and immediately available by telephone. The on-call nurse must be a registered nurse unless the facility has a current waiver from DHS and is not required to provide daily RN coverage.

A nursing facility resident has the right to reasonable access to a non-pay telephone where calls can be made without being overheard and which can be used to summon help in an emergency, and the facility must permit residents to contract for private telephones at their own expense.

The resident has the right to have reasonable access to the use of a telephone, other than a pay phone, where calls can be made without being overheard, and which can also be used for making calls to summon help in case of emergency.

A nursing facility must be equipped with a nurse call system that relays a resident's call directly to a staff member or a centralized staff work area — from each resident's bedside (from each resident's room before Nov. 28, 2019) and from toilet and bathing facilities.

Nurse call system. The facility must be adequately equipped to allow residents to call for staff assistance through a communication system which relays the call directly to a staff member or to a centralized staff work area: (A) before November 28, 2019, from each resident's room; (B) beginning November 28, 2019, from each resident's beside; and (C) from toilet and bathing facilities.