HospitalInspections.org

Based on interview and record review, the facility failed to ensure that all visitors enjoy full and equal visitation privileges consistent with patient preferences and to comply with state regulations, in that, all patients admitted from 9/1/2021 to present have not received any in person visitation.

1. The facility has not allowed any in person visitation since mid-March, 2020, due to COVID-19.

2. The facility automatically refused to allow any in person visitation due to COVID-19 and cited their facility's "Visitation During Pandemic" policy as the reason for visitation restriction.

3. House Bill (HB) 2211 related to in-person visitation with facility patients during certain periods of disaster took effect 09/01/2021.

Findings included:

During an interview on 2/13/2023 at 11:00 AM, Personnel #1 stated the facility does not currently have in person visitation. The facility has not had in person visitation since mid-March of 2020. Personnel #1 stated was not aware of House Bill 2211.

Record review of 2 of 2 patients (patient #1 and patient #2) did not reflect evidence that patient #1 and patient #2's attending physician determined that in-person visitation with that patient may lead to the transmission of an infectious agent that posed a serious community health risk

Record review of 2 of 2 patients (patient #1 and patient #2) did not reflect evidence that patient #1 and patient #2 received an in person visitor during their admission at the facility.

The facility policy on "Patients Rights" last revised on 11/2021 required ..." H. Patient Visitation Rights: All Patients shall be informed, before care is furnished to the Patient whenever possible, of their visitation rights, and any clinically necessary or reasonable restriction or limitation the Hospital may place on such rights, and the reason for such restriction or limitation. I. (1) All Patients (or their Support Person, where appropriate) shall have the right, subject to his or her consent, to receive visitors whom he or she designates, including, but not limited to, a spouse, a domestic partner (including same-sex domestic partner), another family, or a friend, and the Patient (or their Support Person, where appropriate) shall have the right to withdraw or deny such consent at any time;...(3) All visitors shall enjoy full and equal visitation privileges consistent with Patient preferences...K. The hospital may impose clinically appropriate limitations on patient visitation when visitation would interfere with the care of the patient, whether the reason for limiting or restricting visitation is infection control, disruptive behavior of visitors, or patient or roommate need for rest or privacy..."

The facility policy on "Visitation During Pandemic" last revised on 4/2020 required, "1. Subject and Purpose: The Health and Human Services Commission (HHSC) has adopted emergency rules in response to the state of disaster declared in Texas and the United States of America relating to COVID-19. Private Psychiatric Hospitals and Crisis Stabilization Units are now instructed to implement and enforce written policies and procedures related to visitation and the entry of the hospital's workforce to protect the health and safety of patients, employees, and the public ...2. Emergency Rule Details: Emergency rule 510.48, related to Private Psychiatric Hospital Response to COVID-19 is adopted under Texas Administrative Code (TAC) Title 26, Part 1, Chapter 510, Subchapter C. Under this emergency rule, Private Psychiatric Hospitals and Crisis Stabilization Units must follow operational requirements in response to COVID-19. The emergency rule is reproduced as below:
510.48 Emergency Rule for Facility Response to COVID-19: a. Based on state law and federal guidance, HHSC deems COVID-19 a health and safety risk to facility patients, staff, and the public and requires a facility to restrict entry to the facility ...e. A facility must prohibit visitors, except as provided by subsection (f) of this section. f. A facility may allow entry of persons providing critical assistance, unless the person meets one or more of the following screening criteria: 1. Fever ...2. Contact in the last 14 days with someone who has a confirmed diagnosis of COVID-19 ...3. International travel with the last 14 days ...3. Background History: In accordance with Texas Government Code 2001.031, the Executive Commissioner on April 3, 2020 granted HHSC's request to adopt emergency rule 510.48 in Texas Administrative Code (TAC), Title 26, Chapter 510, relating to Private Psychiatric Hospital Response to COVID-19, due to imminent peril to the public health, safety or welfare. This emergency rule may not be effective for longer than 120 days and may not be renewed for longer than 60 days."

HEALTH AND SAFETY CODE, TITLE 4, HEALTH FACILITIES, SUBTITLE B, LICENSING OF HEALTH FACILITIES. CHAPTER 241. HOSPITALS SUBCHAPTER A. GENERAL PROVISIONS.
SECTION 241.001. SHORT TITLE "This chapter may be cited as the Texas Hospital Licensing Law"
SECTION 241.012. " ...(b) A hospital may not during a qualifying period of disaster prohibit in-person visitation with a patient receiving care or treatment at the hospital unless federal law or a federal agency requires the hospital to prohibit in-person visitation during that period.
(c) Notwithstanding Subsection (b), a hospital may during a qualifying period of disaster:
(1) restrict the number of visitors a patient receiving care or treatment at the hospital may receive to not fewer than one;
(2) require a visitor to the hospital to:
(A) complete a health screening before entering the hospital; and
(B) wear personal protective equipment at all times while visiting a patient at the hospital; and
(3) deny entry to or remove from the hospital's premises a visitor who fails or refuses to:
(A) submit to or meet the requirements of a health screening administered by the hospital; or
(B) wear personal protective equipment that meets the hospital's infection control and safety requirements in the manner prescribed by the hospital.
(d) A health screening administered by a hospital under this section must be conducted in a manner that, at a minimum, complies with:
(1) hospital policy; and
(2) if applicable, guidance or directives issued by the commission, the Centers for Medicare and Medicaid Services, or another agency with regulatory authority over the hospital ...
(f) This section may not be construed as requiring a hospital to:
(1) provide a specific type of personal protective equipment to a visitor to the hospital; or
(2) allow in-person visitation with a patient receiving care or treatment at the hospital if an attending physician determines that in-person visitation with that patient may lead to the transmission of an infectious agent that poses a serious community health risk.
(g) A determination made by an attending physician under Subsection (f)(2) is valid for not more than five days after the date the determination is made unless renewed by an attending physician ..."

House Bill (HB) 2211 related to in-person visitation with hospital patients during certain periods of disaster. The HB took effect 09/01/2021.
HB 2211 amended Texas Health and Safety Code (HSC) Chapter 241 by adding 2441.012, which required a general or special hospital to allow each hospital patient at least one in-person visitor during a qualifying period of disaster unless: A federal law or agency required the hospital to prohibit in-person visitation during that period; or the patient's attending physician determined in-person visitation with that patient could transmit an infectious agent that posed a serious community health risk.
HB2211 authorized a general or special hospital to take any of the following actions to ensure health and safety during a qualifying period of disaster:
1) Restrict the number of hospital patient in-person visitors, if the hospital permitted each hospital patient at least one in-person visitor.
2) Require a visitor to the hospital to: Complete a health screening before entry to the hospital; and wear personal protective equipment at all times while visiting a patient at the hospital; and
3) Deny a visitor's entry to the hospital or remove a visitor from the hospital's premises who failed or refused to:
Permit the hospital to perform a health screening prior to the visitor entering the hospital; Pass the hospital's health screening requirements; or wear personal protective equipment meeting the hospital's infection control and safety requirements as prescribed by this hospital.