The purpose of this section shall be to establish the standards of professional and ethical conduct required of a respiratory care practitioner pursuant to the Act, §604.201(b)(4).   (1) Professional representation and responsibilities.     (A) A practitioner shall not misrepresent any professional qualifications or credentials or provide any information that is false, deceptive, or misleading to the department, for employment or work assignment as a respiratory care practitioner, or fail to disclose any information that could affect the decision to employ or assign a task as a respiratory care practitioner.     (B) A practitioner shall not make any false or misleading claims about the efficacy of any services or methods of treatment.     (C) A practitioner shall not extend his or her practice beyond his or her competence and authority vested in him or her by a physician or this Act.     (D) A practitioner shall not permit the use of his or her name for the purpose of documenting that respiratory care services have been rendered unless that practitioner has provided those services.     (E) A practitioner shall not promote or endorse products, services, or equipment in a manner that is false and misleading.     (F) A practitioner shall maintain knowledge and skills for continuing professional competence. A practitioner shall participate in continuing education programs and activities as set out in §140.210 of this title (relating to Continuing Education Requirements).     (G) A practitioner shall not use alcohol or any drugs in any manner which detrimentally affects the provision of respiratory care.     (H) A practitioner shall have the responsibility of reporting alleged misrepresentations or violations of the Act or these sections to the department.     (I) The practitioner shall be responsible for competent and efficient performance of his assigned duties and shall report to the department incompetence and illegal or unethical conduct of members of the profession.     (J) A practitioner shall not retaliate against any person who reported in good faith to the department alleged incompetence; illegal, unethical, or negligent conduct of any practitioner; or alleged misrepresentation or any violation(s) of the Act or these sections.     (K) A practitioner shall keep his or her file updated by notifying the department of changes in preferred mailing address and telephone number.     (L) A practitioner shall not make any false, misleading, or deceptive claims in any advertisement, announcement, presentation, or in competitive bidding.     (M) A practitioner shall conform to medically accepted principles and standards of respiratory care which are generally recognized by the profession as appropriate for the situation presented, including those promulgated or interpreted by or under the American Association for Respiratory Care, the National Board for Respiratory Care, the Texas Society for Respiratory Therapy, the department, and other professional or governmental bodies.     (N) A practitioner shall not delegate respiratory care functions or responsibilities to a person who lacks the ability or knowledge to perform the function or responsibility. A practitioner providing respiratory care services may be assisted by an aide or orderly. Aides, orderlies and other unlicensed assistive personnel may not perform respiratory care procedures.     (O) A practitioner shall not leave an assignment without being properly relieved by appropriate personnel.     (P) The department shall consider the failure of a practitioner to respond to a request for information or other correspondence relating to the certification process or these sections as unprofessional conduct and grounds for disciplinary proceedings in accordance with §140.214 of this title (relating to Violations, Complaints and Subsequent Actions).     (Q) A practitioner shall not employ another person in the capacity of a respiratory care practitioner who does not hold a certificate or permit to practice respiratory care.     (R) A respiratory care practitioner shall not falsify or make grossly incorrect, grossly inconsistent, or unintelligible entries in a patient, hospital or other record.     (S) A respiratory care practitioner shall not exhibit a pattern of substandard care in the performance of duties related to the practice of respiratory care.     (T) A respiratory care practitioner shall not change the prescription of a physician or falsify verbal or written orders for treatment diagnostic regimen received, whether or not that action resulted in actual patient harm.   (2) Relationships with patients/clients.     (A) A practitioner shall make known to a prospective patient the important aspects of the professional relationship, including fees and arrangement for payment which might affect the decision to enter into a contractual relationship.     (B) A practitioner shall not receive or give a commission or rebate or any other form of direct or indirect remuneration or benefit for the referral of patients/clients for professional services.     (C) A practitioner shall disclose to patients or clients any interest in commercial enterprises which the practitioner promotes through patients or clients for the purpose of direct or indirect personal gain or profit.     (D) A practitioner shall not accept gratuities for preferential consideration of the patient. The practitioner shall guard against conflicts of interest.     (E) A practitioner shall take reasonable action to inform a patient's/client's physician and any appropriate allied health care provider in cases where a patient's/client's cardiorespiratory status indicates a change in medical status.     (F) A practitioner shall not violate any provision of any federal or state statute relating to confidentiality of patient/client communication and/or records. All inquiries shall be referred to the physician in charge of the patient's medical care.     (G) A practitioner shall not engage in any activities that seek to meet the practitioner's personal needs at the expense or detriment of a patient/client.     (H) A practitioner shall practice respiratory care only under the direction of a qualified medical director or other physician licensed by the Texas Medical Board. For the purpose of this section direction shall mean:       (i) assuring that established policies are carried out;       (ii) monitoring and evaluating the quality, safety, and appropriateness of respiratory care services and taking action based on findings; and       (iii) providing consultation whenever required, particularly on patients receiving continuous ventilatory or oxygenation support.     (I) A practitioner or temporary permit holder shall not engage in sexual conduct with a client, patient, co-worker, employee, staff member, contract employee, practitioner, temporary permit holder or any other person on the premises of any job establishment. For the purposes of this section, sexual conduct includes:       (i) any touching of any part of the genitalia or anus;       (ii) any touching of the breasts of a female except as necessary for the performance of a respiratory care procedure as defined in §140.202 of this title (relating to Definitions);       (iii) any offer or agreement to engage in any activity described in this subsection;       (iv) kissing without the consent of both persons;       (v) deviate sexual intercourse, sexual contact, sexual intercourse, indecent exposure, sexual assault, prostitution, and promotion of prostitution as described in the Texas Penal Code, Chapters 21, 22, and 43, or any offer or agreement to engage in any such activities;       (vi) any behavior, gestures, or expressions which may reasonably be interpreted as inappropriately seductive or sexual; or       (vii) inappropriate sexual comments, including making sexual comments about a person's body.   (3) Billing information required; prohibited practice.     (A) On the written request of a client, a client's guardian, or a client's parent, if the client is a minor, a practitioner shall provide, in plain language, a written explanation of the charges for respiratory care services previously made on a bill or a statement for the client. This requirement applies even if the charges are to be paid by a third party.     (B) A practitioner may not persistently or flagrantly overcharge or overtreat a client.   (4) Sanctions. A practitioner shall be subject to disciplinary action by the department if the practitioner is issued a public letter of reprimand, is assessed a civil penalty by a court, or has an administrative penalty imposed by the attorney general's office under the Crime Victims Compensation Act, Code of Criminal Procedure, Article 56.31 et seq.   (5) Disclosure. A practitioner shall make a reasonable attempt to notify each client of the name, mailing address, and telephone number of the department for the purpose of directing complaints to the department by providing notification:     (A) on each written contract for services of a practitioner;     (B) on a sign prominently displayed in the primary place of business of each practitioner; or     (C) in a bill for service provided by a practitioner to a client or third party.   (6) Unlawful, false, misleading, or deceptive advertising.     (A) A practitioner shall not use advertising that is false, misleading, or deceptive or that is not readily subject to verification.     (B) False, misleading, or deceptive advertising or advertising that is not readily subject to verification includes advertising that;       (i) makes a material misrepresentation of fact or omits a fact necessary to make the statement as a whole not materially misleading;       (ii) makes a representation likely to create an unjustified expectation about the results of a health care service or procedure;       (iii) compares a health care professional's services with another health care professional's services unless the comparison can be factually substantiated;       (iv) contains a testimonial;       (v) causes confusion or misunderstanding as to the credentials, education, or licensure of a health care professional;       (vi) advertises or represents that health care insurance deductibles or copayments may be waived or are not applicable to health care services to be provided if the deductibles or copayments are required;       (vii) advertises or represents that the benefits of a health benefit plan will be accepted full payment when deductibles or copayments are required;       (viii) makes a representation that is designed to take advantage of the fears or emotions of a particularly susceptible type of patient; or       (ix) advertises or represents in the use of a professional name a title or professional identification that is expressly or commonly reserved to or used by another profession or professional. A "health care professional" includes a certified respiratory care practitioner, temporary permitted respiratory care practitioner, or any other person licensed, certified, or registered by the state in a health-related profession.

Source Note: The provisions of this §140.212 adopted to be effective December 16, 2007, 32 TexReg 9131