Section 568.22 - Voluntary Admission(a) A request for voluntary admission: (1) may be made only by a person authorized to do so under Texas Health and Safety Code § 572.001;(2) must be in writing and signed by the individual making the request; and(3) must include a statement that the individual making the request: (A) certifies that the individual is legally authorized to act on the prospective patient's behalf;(B) has provided the facility with documentation demonstrating that the individual is legally authorized to act on the prospective patient's behalf;(C) agrees that the prospective patient will remain in the hospital until discharged; and(D) consents to diagnosis, observation, care and treatment of the prospective patient until the earlier of: (i) the discharge of the prospective patient; or(ii) the prospective patient is entitled to leave the hospital, in accordance with Texas Health and Safety Code § 572.004, after a request for discharge is made.(b) The consent given under subsection (a)(3)(D) of this section does not waive any rights a patient has under any statute or rule.(c) Capacity to consent. If a prospective patient does not have the capacity to consent to diagnosis, observation, care and treatment, as determined by a physician, then the hospital may not admit the prospective patient on a voluntary basis. When appropriate, the hospital may initiate an emergency detention proceeding in accordance with Texas Health and Safety Code Chapter 573 or file an application for court-ordered inpatient mental health services in accordance with Texas Health and Safety Code Chapter 574.(d) An individual who voluntarily presents to the hospital may leave the hospital at any time during the pre-admission screening and assessment process prior to their admission.(e) Pre-admission screening. (1) Before voluntary admission of a prospective patient, pre-admission screening personnel (PASP) shall conduct a pre-admission screening of the prospective patient.(2) If the PASP determines that the prospective patient does not need an admission examination, the hospital may not admit the prospective patient and shall refer the prospective patient to alternative services. If the PASP determines the prospective patient needs an admission examination, a physician shall conduct an admission examination of the prospective patient.(3) If the pre-admission screening is conducted by a physician, the physician may conduct the pre-admission screening as part of the admission examination referenced in subsection (f)(2)(A) of this section.(f) Requirements for voluntary admission. A hospital may voluntarily admit a prospective patient only if: (1) a request for admission is made in accordance with subsection (a) of this section;(2) a physician has, in accordance with Texas Health and Safety Code § 572.0025: (A) conducted, or consulted with a physician who has conducted, either in person or through telemedicine medical services, an admission examination in accordance with subsection (h) of this section within 72 hours before or 24 hours after admission; and(B) issued an order admitting the prospective patient;(3) the prospective patient meets the hospital's admission criteria;(4) the prospective patient is a person: (A) with mental illness or who demonstrates symptoms of a serious emotional disorder; and(B) who presents a risk of serious harm to self or others if not immediately restrained or hospitalized; and(5) in accordance with Texas Health and Safety Code § 572.0025(f)(2), the administrator or administrator's designee has signed a written statement agreeing to admit the prospective patient.(g) Intake. In accordance with Texas Health and Safety Code § 572.0025(b), a hospital shall, before voluntary admission of a prospective patient, conduct an intake process, that includes: (1) obtaining relevant information about the prospective patient, including information about finances, insurance benefits and advance directives; and(2) explaining, orally and in writing, the prospective patient's rights described in 25 TAC Chapter 404, Subchapter E (concerning Rights of Persons Receiving Mental Health Services), including: (A) the hospital's services and treatment as they relate to the prospective patient; and(B) explaining, orally and in writing, the existence, purpose, telephone number, and address of the protection and advocacy system of the state of Texas, pursuant to Texas Health and Safety Code § 576.008.(h) Admission examination. (1) The admission examination referenced in subsection (d)(2)(A) of this section shall be conducted by a physician in accordance with Texas Health and Safety Code Chapter 572 and include a physical and psychiatric examination conducted in the physical presence of the patient or by using audiovisual telecommunications.(2) The physical examination may consist of an assessment for medical stability.(3) The physician may not delegate conducting the admission examination to a non-physician.(i) Documentation of admission order. In accordance with Texas Health and Safety Code § 572.0025(f)(1), the order described in subsection (f)(2)(B) of this section shall: (1) be issued in writing and signed by the issuing physician; or(2) be issued orally or electronically if, within 24 hours after its issuance, the hospital has a written order signed by the issuing physician.26 Tex. Admin. Code § 568.22
Adopted by Texas Register, Volume 46, Number 21, May 21, 2021, TexReg 3283, eff. 5/27/2021