Section 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.26 Tex. Admin. Code § 550.607
The provisions of this §550.607 adopted to be effective September 1, 2014, 39 TexReg 6569; Transferred from Title 40, Chapter 15 by Texas Register, Volume 44, Number 15, April 12, 2019, TexReg 1875, eff. 5/1/2019; Amended by Texas Register, Volume 49, Number 39, September 27, 2024, TexReg 7931, eff. 10/16/2024