Health & Safety Code § 242.505 – Requirement to Post Resident Rights and Violation Notices

Health & Safety Code § 242.505 Summary

This specific section of the Texas Health & Safety Code, despite its article title, actually outlines the strict requirements for the prescription and administration of psychoactive medication to residents in Texas convalescent and nursing facilities. It defines “medication-related emergency” and “psychoactive medication,” which includes various classes like antipsychotics, antidepressants, and antianxiety agents. The core principle is that psychoactive medication cannot be administered without the resident’s consent, or the consent of a legally authorized representative, unless there is a medication-related emergency. The statute details what constitutes valid consent, including requirements for voluntary action, comprehensive information disclosure (condition, benefits, side effects, course of treatment), and written notification of the right to revoke consent. Special written consent rules apply to antipsychotic or neuroleptic medications. If medication is administered in an emergency without consent, strict documentation and least restrictive treatment requirements apply. The statute also provides a limited immunity for physicians regarding certain confidentiality breaches related to the consent process.

Purpose of Health & Safety Code § 242.505

The legislative purpose behind this Texas statute is to protect the fundamental rights and autonomy of vulnerable residents in nursing facilities, particularly concerning critical medical decisions involving psychoactive medications. It aims to prevent the unauthorized or coercive use of powerful drugs that can profoundly affect a person’s behavior, cognition, and emotional state. By establishing clear consent procedures and emergency exceptions, the law ensures that residents or their legal representatives are fully informed about treatment options, potential risks, and their right to refuse or revoke consent. This statute addresses the historical problem of “chemical restraints” or over-medication without proper consent, promoting patient dignity, safety, and informed decision-making within the healthcare setting.

Real-World Example of Health & Safety Code § 242.505

Imagine Mrs. Eleanor Vance, an 85-year-old resident of a Texas nursing home, who has recently been experiencing increased anxiety. Her physician suggests prescribing a new antianxiety medication, which is a psychoactive medication.

Under Health & Safety Code § 242.505, the nursing home and physician cannot simply start Mrs. Vance on the medication. Before administration, either Mrs. Vance herself must consent, or if she lacks capacity, her legally authorized daughter, Sarah, must consent. To obtain valid consent, the physician or their designee must explain to Mrs. Vance and/or Sarah:
1. The specific condition: That the medication is to treat her increased anxiety.
2. Expected beneficial effects: That it should help reduce her feelings of anxiousness and improve her comfort.
3. Probable significant side effects and risks: Such as drowsiness, dizziness, or potential for dependency.
4. Proposed course of medication: How often and for how long it will be given.

This information must be provided in a standard, understandable format. Furthermore, Mrs. Vance and Sarah must be informed in writing that Mrs. Vance’s consent can be revoked at any time. Finally, the consent must be given voluntarily, without pressure, and properly documented in Mrs. Vance’s medical record with a signed form. If the proposed medication were an antipsychotic, Sarah’s consent would specifically need to be in writing on a form prescribed by the commission. If at any point Mrs. Vance (or Sarah) refuses consent, this refusal must also be documented.

Related Statutes

Several other Texas statutes are directly related to or commonly referenced alongside Health & Safety Code § 242.505, particularly concerning patient rights and medical consent:

• Texas Civil Practice and Remedies Code § 74.104 – Disclosure of Information and § 74.105 – Form of Disclosure: These sections, explicitly referenced in Subsection (c-3) of § 242.505, establish the general requirements for informed consent for medical procedures and treatments in Texas. They mandate that physicians disclose material risks and hazards of a proposed treatment. Health & Safety Code § 242.505 builds upon these by creating a rebuttable presumption that the specific written consent form for antipsychotics satisfies these broader disclosure requirements, streamlining the process for these particular medications.
• Texas Health & Safety Code Chapter 242 (General): This entire chapter governs convalescent and nursing facilities, containing numerous provisions related to resident rights, care standards, and facility operations. Other sections within this chapter would reinforce the general principles of patient autonomy and appropriate medical care that § 242.505 specifically addresses for psychoactive medications.
• Texas Occupations Code Chapter 157 – Medical Consent: This chapter details various circumstances under which medical consent can be given, including by minors, by those lacking capacity, and by emergency medical personnel. While broader than § 242.505, it provides the general legal framework for who can give consent when a patient cannot, which is crucial for determining who is “the person authorized by law to consent on behalf of the resident” under § 242.505.

Case Law Interpreting Health & Safety Code § 242.505

One significant case interpreting this statute is _Matter of M.A.S._, 356 S.W.3d 588 (Tex. App.—Houston [1st Dist.] 2011). This case involved the involuntary commitment of an individual and the administration of psychoactive medication. The court discussed the application of Health and Safety Code § 242.505 in the context of a person’s rights regarding the prescription of such medication, emphasizing the stringent consent requirements even in involuntary commitment scenarios. The court’s analysis highlighted the importance of documented, informed consent, or the existence of a medication-related emergency, as prerequisites to administering psychoactive drugs.

For more information, you can view the search results for this case law here.

Why Health & Safety Code § 242.505 Matters in Personal Injury Litigation

Health & Safety Code § 242.505 is critically important in Texas personal injury litigation, particularly in cases involving nursing home abuse and neglect. When a resident is injured or suffers adverse effects due to psychoactive medication, this statute provides a clear legal framework to assess whether the medication was administered lawfully and ethically.

For plaintiffs, a violation of this statute can form a strong basis for claims of negligence, medical malpractice, or even elder abuse. If a nursing facility or its medical staff administered psychoactive medication without proper, informed consent, or outside of a documented medication-related emergency, it could constitute a breach of the standard of care. This may lead to liability if the unauthorized medication caused injury, worsened the resident’s condition, or violated their civil rights. Attorneys representing injured residents or their families will meticulously investigate clinical records to determine if all consent requirements – including adequate disclosure of risks and benefits, voluntary nature, and proper documentation – were met.

Conversely, for the defense, demonstrating strict adherence to Health & Safety Code § 242.505 is crucial. If the facility can prove that all consent protocols were followed, or that an emergency situation justified the administration, it strengthens their defense against claims of improper medication. The limited immunity granted in Subsection (f) also offers some protection to physicians regarding the disclosure of information during the consent process, provided certain conditions are met. Understanding this statute helps both plaintiff and defense attorneys navigate complex cases involving medication errors, patient autonomy, and the vulnerable population in long-term care facilities.