1. (a) This section applies only to an end stage renal disease (ESRD) facility located in a county for which:

   1. (1) the governor declared a state of disaster due to a pandemic or epidemic, pursuant to Texas Government Code Chapter 418 (relating to Emergency Management);
   2. (2) the commissioner of the Texas Department of State Health Services determined that a public health disaster exists, pursuant to Texas Health and Safety Code Chapter 81 (relating to Communicable Diseases; Public Health Disasters; Public Health Emergencies); and
   3. (3) the Texas Health and Human Services Commission (HHSC) designated this section as applicable, pursuant to paragraphs (1) and (2) of this subsection.
2. (b) An ESRD facility may temporarily adopt accommodations under this section to meet patient needs, support infection control procedures, and maintain necessary social distancing in response to a public health disaster.
3. (c) Notwithstanding §507.52(b)(3) of this subchapter (relating to Medical Services), at a minimum, each patient receiving dialysis in the facility shall be seen by a physician on the medical staff once a month during the patient's treatment time.
4. (d) Notwithstanding §507.52(b)(4) of this subchapter, home dialysis patients shall be seen by a physician, an advanced practice registered nurse (APRN), or a physician assistant (PA) no less than once a month. This visit by a physician, an APRN, or a PA may be conducted using telemedicine medical services.

5. (e) Notwithstanding §507.53(l)(1) of this subchapter (relating to Home Dialysis Service), a registered nurse may conduct an initial monitoring visit of a patient's home adaptation before the patient beginning training for the selected home modality from outside the patient's home if the nurse performs the visit using a synchronous audiovisual interaction between the registered nurse and the patient while the patient is at home.

   1. (1) The nurse shall conduct the visit to the same review standards as a normal face-to-face visit.
   2. (2) If the nurse cannot perform the visit using a synchronous audiovisual interaction between the nurse and the patient, the nurse must conduct the visit in the patient's home.

Source Note:The provisions of this §507.59 adopted to be effective December 23, 2025, 50 TexReg 8289.