Texas Register, Volume 47, Number 7, Pages 715-820, February 18, 2022 Page: 725
717-820 p. ; 28 cm.View a full description of this periodical.
Extracted Text
The following text was automatically extracted from the image on this page using optical character recognition software:
EMERGENCY _
Emergency Rules include new rules, amendments to existing rules, and the repeals of existing
UL ES rules. A state agency may adopt an emergency rule without prior notice or hearing if the agency
finds that an imminent peril to the public health, safety, or welfare, or a requirement of state or
federal law, requires adoption of a rule on fewer than 30 days' notice. An emergency rule may be effective for not longer than
120 days and may be renewed once for not longer than 60 days (Government Code, 2001.034).TITLE 26. HEALTH AND HUMAN SERVICES
PART 1. HEALTH AND HUMAN
SERVICES COMMISSION
CHAPTER 500. COVID-19 EMERGENCY
HEALTH CARE FACILITY LICENSING
SUBCHAPTER B. END STAGE RENAL
DISEASE FACILITIES
26 TAC 500.21
The Executive Commissioner of the Texas Health and Human
Services Commission (HHSC) adopts on an emergency basis
in Title 26 Texas Administrative Code, Chapter 500 COVID-19
Emergency Health Care Facility Licensing, new 500.21, con-
cerning an emergency rule in response to COVID-19 in order to
update and continue the regulatory requirements for end stage
renal disease (ESRD) facilities to reduce barriers to treatment
during the COVID-19 pandemic. As authorized by Texas Gov-
ernment Code 2001.034, HHSC may adopt an emergency rule
without prior notice or hearing upon finding that an imminent peril
to the public health, safety, or welfare requires adoption on fewer
than 30 days' notice. Emergency rules adopted under Texas
Government Code 2001.034 may be effective for not longer
than 120 days and may be renewed for not longer than 60 days.
BACKGROUND AND PURPOSE
The purpose of the emergency rulemaking is to support the
Governor's March 13, 2020 proclamation certifying that the
COVID-19 virus poses an imminent threat of disaster in the
state and declaring a state of disaster for all counties in Texas.
In this proclamation, the Governor authorized the use of all
available resources of state government and of political subdi-
visions that are reasonably necessary to cope with this disaster
and directed that government entities and businesses would
continue providing essential services. HHSC accordingly finds
that an imminent peril to the public health, safety, and welfare
of the state requires immediate adoption of this rule for ESRD
Facility Requirements During the COVID-19 Pandemic.
To protect dialysis patients and the public health, safety, and
welfare of the state during the COVID-19 pandemic, HHSC is
adopting an emergency rule to reduce barriers to treatment for
dialysis patients by updating ESRD facility regulatory guidelines
regarding staffing ratios, in-home visits, telemedicine, incident
reporting, and education and training requirements for staff.
STATUTORY AUTHORITY
The emergency rulemaking is adopted under Texas Govern-
ment Code 2001.034 and 531.0055 and Texas Health and
Safety Code 251.003 and 251.014. Texas Government Code
2001.034 authorizes the adoption of emergency rules withoutprior notice and hearing, if an agency finds that an imminent
peril to the public health, safety, or welfare requires adoption of
a rule on fewer than 30 days' notice. Texas Government Code
531.0055 authorizes the Executive Commissioner of HHSC
to adopt rules and policies necessary for the operation and
provision of health and human services by the health and hu-
man services system. Texas Health and Safety Code 251.003
authorizes the Executive Commissioner of HHSC to adopt
rules governing ESRD facilities. Texas Health and Safety Code
251.014 requires these rules to include minimum standards to
protect the health and safety of a patient of an ESRD facility.
The new section implements Texas Government Code
531.0055 and Texas Health and Safety Code 251.003 and
251.014.
500.21. ESRD Facility Requirements During the COVID-19 Pan-
demic.
(a) Based on Governor Greg Abbott's March 13, 2020, dec-
laration of a state of disaster in all Texas counties, the Texas Health
and Human Services Commission (HHSC) adopts this emergency rule
to establish continuing requirements and flexibilities to protect public
health and safety during the COVID-19 pandemic. The requirements
and flexibilities established in this section are applicable during an ac-
tive declaration of a state of disaster in all Texas counties due to the
COVID-19 pandemic, declared pursuant to Texas Government Code
418.014.
(b) Notwithstanding 25 TAC 117.43(e), core staff members
shall actively participate in quality assessment and performance im-
provement (QAPI) activities and attend meetings every other month.
(c) Notwithstanding 25 TAC 117.45(c)(3), all verbal or tele-
phone physician orders shall be documented and authenticated or coun-
tersigned by the physician not more than 30 calendar days from the date
the order was given.
(d) Notwithstanding 25 TAC 117.45(i)(2)(C), at a minimum,
each patient receiving dialysis in the facility shall be seen by a physi-
cian on the medical staff once per month during the patient's treatment
time. Home dialysis patients shall be seen by a physician, advanced
practice registered nurse, or physician's assistant no less than one time
a month. Ifhome dialysis patients are seen by an advanced practice reg-
istered nurse or a physician's assistant, the physician shall see the pa-
tient at least one time every three months. This visit may be conducted
using telemedicine medical services. The record of these contacts shall
include evidence of assessment for new and recurrent problems and re-
view of dialysis adequacy each month.
(e) Notwithstanding 25 TAC 117.45(j)(4), the staffing level
for home dialysis patients, including all modalities, shall be one full-
time equivalent registered nurse per 25 patients, or portion thereof.
(f) Notwithstanding 25 TAC 117.45(j)(5)(A), the home dial-
ysis training curriculum shall be conducted by a registered nurse with
at least 12 months clinical experience and three months experience inEMERGENCY RULES February 18, 2022 47 TexReg 725
Upcoming Pages
Here’s what’s next.
Search Inside
This issue can be searched. Note: Results may vary based on the legibility of text within the document.
Tools / Downloads
Get a copy of this page or view the extracted text.
Citing and Sharing
Basic information for referencing this web page. We also provide extended guidance on usage rights, references, copying or embedding.
Reference the current page of this Periodical.
Texas. Secretary of State. Texas Register, Volume 47, Number 7, Pages 715-820, February 18, 2022, periodical, February 18, 2022; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1462843/m1/11/: accessed July 17, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.