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147 Cards in this Set

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what culpable mental state is when it is person's conscious objective or desire to engage in conduct or cause the result
INTENTIONAL (vs knowing mental state when person is aware that his conduct is reasonably certain to cause bad result)
get life in prison for what 2 types of felonies
capital felony and 1st degree
if provider has cause to believe that a child has been or may be abused/neglected, how long does he have to report incident
48hrs
what type of injuries must be reported to dept of health
spinal cord, traumatic brain, and submersion injuries.
if make oral report about nursing home abuse/neglect, how many days do you have file written report
5
person who makes reckless or bad faith report of abuse, neglect, exploitation of nursing home resident is subject to
Criminal charge of Class A misdemeanor (same one you get if you report something) + civil penalties
what department is responsible for investigating abuse, exploitation, or neglect of elderly or disabled person
Department of Protective and Regulatory Services
what agency should child abuse cases be reported to
Department of Protective and Regulatory Services
if fail to report child abuse/neglect, then you commit a...
class B misdemeanor (remember that failure to report elder abuse is Class A)
does a provider need consent of parents to order labs, xrays, etc on child if abuse/neglect suspected
No BUT....if child is >16 y/o then cant if that child refuses to consent.
if dont report abuse/neglect of mental health facility pt, what type of misdemeanor
class A (same as elderly abuse/neglect) vs class B for child abuse/neglect
what STDs are required to be reported
HIV, chancroid, syphillis, gonorrhea, chlamydia
to whom do you report STDs
local health dept director
records of medical peer review committee may be disclosed to
-another medical peer review committee
-state board in own state & others
-national accreditation body
-appropriate state or federal agency
pt in hospital died but reason for death is unclear OR child >6 dies of reason other than MVA OR think may be suicide...what must you do
contact local justice of peace so that an inquest can be conducted
how many times must a nursing home resident have a medical exam
at least once a yr
victim of sexual assault has right to forensic medical exam but victim must report incident to law agency in what time frame
within 96 hrs
how many mandatory unannounced inspections must be made in nursing home
2 per yr
once a minor is admitted to mental health facility, an applicable "bill od right" should be explained to minor and guardian within what time fram
24 hrs
in county of 3 million or more, the forensic portion of medical exam of child thats alleged to be sexual assault victim, must include......
photo documentation of an injured area (includes anogenital area pics) UNLESS medical provider documents good cause for not doing so)
gestational agreement must be signed how far in advance
before the 14th day preceding the transfer of embryo/sperm/ etc to gestational mother (must sign agreement at least 15 days before
requirement for prospective gestational mother
has had at least one previous pregnancy and delivery and carrying another preg & having delivery will not put her in harm
state cant stop abortions in first trimester, BUT if doctor performs abortion in 3rd trimester then what must he do
must send to dept of state health services the medical indication for abortion (must do this within 30 days of abortion)
what happens if F has abortion but child born alive
child can be taken away from parents and placed into custody of texas dept of Protective and Regulatory Services
what can a minor do before having an abortion if she doesnt want parents/guardian to know about it
can file application for a court order authorizing the minor to consent to the abortion (can file this application using only initials or pseudonym)
if providing prenatal care for patients, what must you document in the chart about postpartum stuff
must offer resources/
organizations of places that offer pospartum services (including for postpartum depression); must be documented before child delivered
couple wants to enter into gestational agreemen with a woman willing to donate her eggs. what information must you provide to obtain consent for procedure
--rate of successful conceptions due to procedure (specifically statistics on clinics outcome)
--risks of procedure and risks of outcomes
--nature of expenses related to procedure
if F wants to be mom but not get married finds guy that wants to be father but doesnt want to get married, what must they do to arrange for this plan so that Jared has parental rights
man must provide his sperm to doc who will conduct procedure and man & woman must sign consent
does physician have to get consent from parent to perform abortion on minor
no, just have to give 48 hrs notice in person/telephone to parent of what minor wants to do
physician who intentionally performs abortion on pregnant minor without metting proper authorization requirements is subject to fine of up to
$10,000
when do you not have to get informed consent or document explanation to pt in chart for test for HIV
if pt has already signed general consent form to allow medical test
OR
if pt's blood/bodily fluids exposed to hlth care worker
what conditions must be tested for in preg women
hep B, HIV, syphillis
what 3 facilities must offer, to the extent facility can offer it, pneumo and influenza vaccines to elderly
hospitals, doctors office, end stage renal facilities
surrogate decision maker cannot consent to.... (3)
1) voluntary inpt mental hlth services
2) electroconvulsive tx
3) appt of another surrogate decision maker
person commits ____ if he with intent aids/attempts to aid another person to commit suicide
class C misdemeanor
who is in charge of investigating HIPAA violations
Secretary of Health and Human Services
for negligent violations (ie civil penalty) of HIPAA rules, what is fine
up to $100 per violation, not to exceed $25,000per calendar yr
for criminal sanctions (ie or knowign and intentional violations) of HIPAA violations, fine is
____for knowingly misusing PHI
____for offense committed under false pretenses
____for offense committed with intent to profit/harm
up to $50,000 or 1 yr in prison if knowingly violate PHI
up to $100,000 or 5 yrs if offense committed under false pretenses
up to $250,000 or 10 yr in prison if offense committed with intent to profit/harm
how long to keep medical records of a patient <18y/o when last treated by physician
until pt reaches age 21 OR 7yrs from date of last treatment (whatever is longer)
3 ways you can notify pts that clinician is leaving practice
local newspaper, written notice at office, and sending letters to pts seen in last 2 yrs
how much can you charge for pts to obtain medical records
no more than $25 for first 20 pgs and then 50 cents per pg after that
Texas Medical Board consists of how many members (and what are "specialties" of members)
19 total (9 MDs, 3 DOs, 7 public representatives)
what are requirements for physicians to be members of Texas Medical Board
must have practiced medicine x 5yrs AND actively engaged in organized peer review at hlth care entity for at least 3 yrs preceding appt
hearing screening tests have to be given by???? but not?? (types of facilities)
must be given by birthing centers (centers in counties with pop of >50,000 & >100 births/yr) but midwife run facility doesnt have to
4 critieria for psych emerg detention:
1) pt has mental illness
2) risk of harm to self/others
3) harm imminent unless admit pt
4) restraint cant be accomplished without emerg detention
court ordered chemical dependency treatment can only be held if, on file, there's ....
2 certificates of med exam from 2 diff physicians confirming chem dependency
what type of felony if sexually assault someone
2nd degree
how many refills can you write for schedule 3-5 drugs
5
if no fam member to give consent for autopsy, can obtain consent from what dept
texas dept of criminal justice
MD who intentionally performs abortion on pregnant unemancipated minor without mtg proper authorization requirements subj to fine of up to
$10,000
if reason to believe minor has been abused, then must report it to
dept of protective and regulatory services
to meet informed consent for abortion what 3 items must be included
-name of physician
-risk of infection
-probability of inc risk of cancer associated with terminating preg
dept of state hlth services must make avail on website a list of professional org that provide postpartum counseling/assistance. how often must list be updated
monthly
must test for PKU, hypothyroidism, and other diseases at birth UNLESS
parents object based on religious beliefs
____ is something that a person must do to be in compliance with the law
affirmative duty
3 things you must do if you are treating injuries that you think are caused by family violence
1) document evidence upon which you believe injuries are caused by domestice violence
2) tell pt of nearest family violence shelter
3) give pt notice ab patients rights againt aggressor
2 types of medical examinations that are contained in the Mental Health Code
"preliminary examination" and "Certificate of Medical Examination for Mental Illness"
Preliminary examination under the Mental Health Code must contain
-nature of disorder
-risk or harm that pt's behavior could cause & that this risk/harm is imminent
-statement saying that emergency detention is least restrictive means of restraint
when is physician consider an "officer of the court" in mental cases
when he performs medical exam & provides findings to court for purposes of determining individual's mental health status
if adult client of intermediate care facility for mentally retarded pts doesnt have legal guardian nor surrogate decision maker, then who can make tx decisions
surrogate consent committee
can pt contact his attorney if he is being held on emergency detention
yes
who can file a petition for court order tx for chemically dependent pt
-any adult
-county or district attorney
the two statements from physicians who've evaluated chemically dependent pt must have been completed ___days before final hearing
30
commitment hearing must be set by county judge within WHAT TIME FRAME of filing of the petition for court-ordered tx
14 days
probable cause hearing shall be held no later than _____ after the hour when protective custody of chemically dependent indiv begins
72 hrs
judge may issue order for protective custody pending commitment hearing for chemically dependent pt. what is 2 criteria that must be met in order to do this
1) physicians opinion that person is chemically dependent
2) evident that persons presents substantial risk of harm to self or others if not immediately restrained
FDA or _____ can approve the use of a new drug (which is any drug thats NOT generally recognized safe or effective)
Texas Health Commissioners
what are considered Dangerous Drugs
those that are not safe for self medication, so they require prescription but are not controlled subs nor in pentaly groups
federal regulations require records of controlled substances to be kept for
2 yrs
cocaine is schedule ___-
II (all other illegal drugs are schedule I)
prescriptions for schedule III or IV drugs cant be filled/refilled > ____months after date of issue
6
person who uses practitioners DEA # illegally is guilty of...
Class C misdemeanor
in order to use/transport/receive/etc source of radiation, must have license or exemption from ___ or ____
Dept of State Health Services
OR
Texas Natural Resource Conxervation Commission
3 circumstances that autopsies be performed (ie who do you need permission or order from)
-permission by next of kin
-order of coroner or medical examiner
-order of health authority
If a pt dies in jail, when can justice of peace conduct an inquest
if pt dies of something other than natural causes while attended by MD or nurse
physician performing autopsy under invalid order is what type of misdemeanor
class B
if person disturbs, dissects, conceals, etc a human corpse, he commits a
class A misdemeanor and possible civil offense
what must justice of peace do if patient commits suicide
must hold an inquest
when must death of child <12 mo old be reported immed to justice of peace, medical examiner or other proper official
if pt dies suddenly or is found dead and cause of death is unknown
if have pt with reportable STD, how long do you have to make report
7 days
if fail to report reportable disease then you commit
class B misdemeanor
can you release communicable disease records if subpoena issues
no (can only be released in public hlth disaster to law enforcement solely for protecting indiv)
notification under the Partner Notification Program for HIV infxn shall be made by
employee of Partner Notification Program (but cant give identity of infected indiv NOR date/time period that partner was exposed
HIV exposure incidents must be reported to
Dept of Health
negligently breaching the confidentiality of HIV test results may result in civil penalties of
$5000
penalty for willfully releasing or disclosing a test result to unauthorized person includes
actual damages, civil penalty of 5000-10,000, court costs of person bringing forth claim
if blood bank reporting to hospital the result of an HIV + test of donors blood, what info can they give
CANNOT give name of pt
what can a blood bank report to other blood banks about donor who has dz
can only give name of blood donor and say that he or she has infectious disease (cant actually say name of disease)
can health care worker who is infected with HIV or hep B perform an exposure-prone procedure
yes as long as worker seeks counsel from expert review panel and have been advised
what immunizations do institution of higher education require
institution can decide what immunizations it will require
in addition to measles, mumps,rubella, polio, Tetanus, diphtheria, Dept of State Hlth services require child to be immunized against what 2 additional things before admission to child care center
hep A and pneumo
adult pt died. what next of kin (and in what order) may donate pt's organs
spouse, adult child, parent, guardian
if no objection from spouse, children, etc., corneal tissue removal may be permitted by what 2 ppl
justice of peace and medical examiner
if removing organ for donation from dead pt, who cannot participate
physician who determined time of death
who can enucleate an eye when eye is for anatomical gift
dentist, embalmer, or physician-supervised tech if he has completed course in eye enucleation taught by ophthalmologist
can you donate your organs to a forensic science program
yes if it is at general academica teaching institution as defined by Texas Education Code
if person wanted to donate organs then dies but doesnt specify specific person to receive organ then where does organ go
qualified organ procurement organization
who represents the interests of a mentally retarded ward when kidney donation is sought
appoint attorney and guardian ad litem BUT neither one can be 1st/2nd degree relative
any person who furnished false or fraudulent info for purpose of making an incorrect record of a birth or death has committed a
3rd degree felony
death certificate must be filed within 10 days with the
local registrar of district in which death occurred
birth certificate must be filed within ____ after birth to Dept of Hlth
5 days
if procedure is not listed on Texas Medical Disclosure Panel Act, physician must disclose to a patient what info about procedure
an info that a reasonable patient would want to know
person is incapacitated to make own medical decision if that person....?
lacks ability to understand consequences of his or her decision
who makes up Medical Disclosure Panel
9 ppl (6 physicians and 3 attorneys)
must give info re: advanced directive to pts in what 3 situations
1) if admit pt to hospital or SNF unit
2) if pt goes under home hlth agency
3) if becomes hospice pt
a valid directive must be signed by 2 witnesses and at least one of them must be a qualified witness. what makes someone a qualified witness?
cant be attending doc NOR heirs pts stuff. person CANNOT be employed by hospital or doc
upon admission to nursing home, does pt need Medical Power of Attorney
NO cannot require resident to obtain medical POA before admitting to nursing home
if attending physician refuses to honor pt's advance directive and refusal is being reviewed by ethics committee, pt must receive life-sustaining tx for how long?
at least 10 days
order of ppl that can consent to tx of a minor if parents cant be contacted
grandparent, adult sibling, aunt uncle, any adult with written authorization
what is exception to rule that minors cant consent to tx
minor can consent if he's serving term of confinement in facility under contract with Texas Dept of Criminal Justice
if you are providing sports physicals, how do you avoid being liable for sports player dropping dead while playing sport
if you dont receive or expect to receive compensation
if you volunteer to provide health services for charitable organization, what do you need to do to be immune from liability
-you must act within scope of license
-you must have pt sign form saying that you are not getting paid to do what you're doing
can physician destroy medical records that relate to civil, criminal, etc. proceeding
yes but only if proceeding has been completely resolved
deadline for releasing copies of med/billing records after recepit of request & payment of fees
15 days
what can a sole managing conservator of a child do that a joint managing conservator of a child cant?
they both can review child's records BUT only the sole managing conservator can consent to a procedure
a disclosure authorization to a hospital is valid but only if it is not....
if its not contained in same document as the consent to medical treatment obtained from pt
person who discloses another person's genetic info without appropriate privilege may beliable for a civil penalty of
up to $10,000 plus attorney fees
when pt sues his physician for malpractice, the pt is waiving what right
pt waives confidentiality privilege
Texas Medical Board consists of how many/what types of ppl
9 MDs, 3 DOs, 7 public reps (the physicians must have been licensed in Tx x 3yrs)
Each District Review Committee of the TMB is made up of
9 MDs, 3 DOs, 7 public reps who serve 6 yr terms
(all of these must have resided in district for past 3 yrs)
in order to be licensed physician, must be ___y/o, completed ____hrs of undergrad classes, and how many years of graduate medical training (if med school was in US vs foreign)
-21 y/o
-60 hrs of college credits
-if US med school, then 1 yr of graduate medical training (vs 3 yrs if FMG)
have to register with TMB q 2 yrs but if registration expires then you have grade period of
30 days
how must licensed physicians notify public of how to contact TMB (3 ways)
-sign displayed in office
-on pt's bill
-on registration forms
if doc performs surgery while intoxicated and puts pt at danger, then he commits
state jail felony
if doc is going to self-report intemperate use of drugs/etoh to board, when should he do it
within 5 yrs from last use
can pending malpractice claim filed against a particular physician be made public
no
if malpractice complaint filed against physician, then he or his liability company must report it to board within
30 days
physicians may complete how much of informal CME hours by providing volunteer med services at site serving medically-underserved area
1/2
all docs, except retired ones or those who only practice charity work, must complete ___hrs of CME q 12 months in order to be registered
24
an out of state physician who orders home health or hospice services for a resident of Texas to be delivered in Texas will not be subject to regulation by the board as long as the physician
is located in another state whose borders are contiguous with Texas
every doc who administers anesthesia or performs a surgical procedurewith anesthesia in outpt setting must
register with board and pay fee to board
state rural medical education board consists of
3 docs with rural practices and 3 citizens with rural residencies
physicians who agree to serve medically underserved communities are eligible to receive
loan reimbursements
if person holds special purpose license, can he physically practice medicine in tx
no
medical license can be suspended if doc hasnt pd child support for
3 month
how long to file claim about incident of medical fraud
4 yrs from incident
provider must bill for services not later than date set in a contract OR
first day of 11th month after date of services
if physician supervising midlevel who works at med underserved clinic, the doc must visit clinic how often
once every 10 business days
who can/cant directly bill for his/her assistance in surgery
surg assistant can
CANT: RN assistant
physician can delegate Rx authority to PA practicing at doc's alternate site so as long as site is within ___ miles of doc's primary site
60
if submit fraud insurance claim of < $20
then commit a...
class C misdemeanor
if submit fraud insurance claim of $20-500
then commit a...
class B misdemeanor
if submit fraud insurance claim of $500-1500
then commit a...
class A misdemeanor
if submit fraud insurance claim of $1500-$20,000
then commit a...
state jail felony
if submit fraud insurance claim of $20,000-$100,000
then commit a...
3rd degree felony
if submit fraud insurance claim of $100,000-$200,000
2nd degree felony
if submit fraud insurance claim of > $200,000 or less but put pt at serious risk
1st degree felony