{"ref":"TX-HH-CS-02","title":"Skilled Nursing Services and Nursing Practice","category":"Clinical tasks","summary":"Requires every nurse to hold a current Texas license or multistate privilege and to practice within the Texas Board of Nursing standards, sets out what RNs and LVNs each do, requires LVNs to work under RN supervision, and sets the rules for clinical notes, reporting changes in condition, clarifying orders, and nursing procedures.","inShort":["Your nursing license must be current before every visit. Tell your supervisor at once if anything changes with your license.","LVNs work under RN supervision. Only an RN does the comprehensive assessment, writes the nursing plan, and delegates tasks.","Write a timed and dated note for every patient contact on the day of the visit.","If the patient’s condition changes, give the care needed, call 911 if it is an emergency, and tell the practitioner and your supervisor.","If an order looks wrong, check it with the practitioner before you carry it out, and write down what you did."],"primaryCitation":"26 TAC §558.299","citations":["26 TAC §558.299","26 TAC §558.243","26 TAC §558.2","26 TAC §558.301","22 TAC §217.11","22 TAC §217.19","22 TAC §217.20","22 TAC ch. 224","22 TAC ch. 225"],"federalCitations":["42 CFR §484.75","42 CFR §484.115(e)","42 CFR §484.115(k)","42 CFR §484.2","42 CFR §484.60(c)","42 CFR §484.110(b)"],"surveyorAsks":["Show me how you verified this nurse’s license before her first visit and how you track expiration.","Who supervises your LVNs, and how do you show it?"],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (26 TAC §558.299)","5. RN and LVN Roles","6. License Verification and Practice Within Scope","7. Responsibilities of Nurses as Skilled Professionals","8. Nursing Visits and Clinical Notes","9. Supervision of LVNs","10. Reporting Changes in Condition and Clarifying Orders","11. Nursing Procedures and Competency","12. Nursing Peer Review and Duty to Report","13. Responsibilities","14. Records and Compliance Monitoring","15. Staff Training","16. References","17. Related Policies and Forms","18. Approval","19. Revision History"],"version":"1.0","sample":false,"pack":"tx-lhhs","state":"Texas","service":"Home health","guides":[{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Home Health Agency","legalName":"Sample Home Health Agency, LLC","logo":null}}