reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter A - OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS › Section 135.18 - Unlicensed Ambulatory Surgical Center

Current through Reg. 49, No. 28; July 12, 2024
(a) If the department has reason to believe
				  that a person or facility may be providing ambulatory surgical services without
				  a license as required by the Act, the person or facility shall be so notified
				  in writing by certified mail, return receipt requested, and shall submit to the
				  department the following information within 20 days of receipt of the notice:
(1) an application for a license and the
				  license fee, which is nonrefundable;
(2) a claim for exemption under §
											135.19 of
				  this title (relating to Exemptions); or
(3) any and all documentation necessary to
				  establish that ambulatory surgical services are not being provided.
				  Documentation shall include a notarized statement attesting to the fact that
				  ambulatory surgical services are not provided and a statement of the type(s) of
				  service(s) that are provided.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter A - OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS › Section 135.19 - Exemptions

Current through Reg. 49, No. 28; July 12, 2024
(a) The following
				  facilities are not required to be licensed under the Act:
(1) an office or clinic of a licensed
				  physician, dentist, or podiatrist;
(2) a licensed nursing home; or
(3) a licensed hospital.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter A - OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS › Section 135.21 - Inspections

Current through Reg. 49, No. 28; July 12, 2024
(a) The department
				  shall conduct an on-site inspection to evaluate the ambulatory surgical
				  center's (ASC's) compliance with the standards for licensing set forth in these
				  sections.
(1) The department shall evaluate
				  the ASC on a standard-by-standard basis before the first renewal license is
				  issued, unless waived in accordance with §
											135.20(e)(4)
				  of this title (relating to Initial Application and Issuance of
				  License).
(2) An on-site licensing
				  inspection may be conducted once every three years.
(3) The department may make any survey or
				  investigation that it considers necessary. A department representative(s) may
				  enter the premises of a facility at any reasonable time to make a survey or an
				  investigation to ensure compliance with or prevent a violation of Health and
				  Safety Code, Chapter 243, an order or special order of the commissioner, a
				  special license provision, a court order granting injunctive relief, or other
				  enforcement procedures. Ensuring compliance includes permitting photocopying of
				  any records or other information by or on behalf of the department as necessary
				  to determine or verify compliance with the statute or rules adopted under the
				  statute, except that the department may not photocopy, reproduce, remove or
				  dictate from any part of the root cause analysis or action plan required in
				  §
											135.27 of
				  this title (relating to Patient Safety Program).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter A - OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS › Section 135.22 - Renewal of License

Current through Reg. 49, No. 28; July 12, 2024
(a) The department
				  shall send written notice of expiration of a license to an ambulatory surgical
				  center (ASC) at least 60 days before the expiration date. If the applicant has
				  not received notice, it is the duty of the ASC to notify the department and
				  request a renewal application.
(b)
				  The department shall issue a renewal license to an ASC that meets the minimum
				  standards for a license set forth in these sections.
(1) The ASC shall submit the following to the
				  department no later than 30 days prior to the expiration date of the license:
(A) a completed renewal application
				  form;
(B) a nonrefundable license
				  fee; and
(C) if the ASC is
				  accredited by the Joint Commission, the Accreditation Association for
				  Ambulatory Health Care, or the American Association for Accreditation of
				  Ambulatory Surgery Facilities, documented evidence of current accreditation
				  status.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter A - OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS › Section 135.23 - Conditions of Licensure

Current through Reg. 49, No. 28; July 12, 2024
(a) An
				  ambulatory surgical center (ASC) license is issued only for the premises and
				  person or governmental unit named on the application.
(b) An ASC license is issued for a single
				  physical location, and shall not include multiple buildings or offsite
				  locations.
(c) Multiple ASCs may
				  share a single building, provided that:
(1)
				  each ASC is separately licensed; and
(2) no part of the building may be dually
				  licensed by more than one ASC.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter A - OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS › Section 135.24 - Enforcement

Current through Reg. 49, No. 28; July 12, 2024
(a) Reasons for
				  enforcement action.
(1) The Department of
				  State Health Services (department) may deny, suspend, or revoke an ambulatory
				  surgical center's (ASC's) license in accordance with Health and Safety Code
				  (HSC), §243.011 if the applicant or licensee:
(A) fails to comply with any provision of the
				  Act;
(B) fails to comply with any
				  provision of this chapter or any other applicable laws;
(C) fails to comply with a special license
				  condition;
(D) fails to comply with
				  an order of the commissioner or another enforcement procedure under the
				  statute;
(E) has a history of
				  noncompliance with the rules adopted under this chapter relating to patient
				  health, safety, and rights which reflects more than nominal
				  noncompliance;
(F) has aided,
				  committed, abetted, or permitted the commission of an illegal act;
(G) fails to provide an adequate application
				  or renewal information;
(H) fails
				  to timely pay assessed administrative penalties in accordance with the
				  Act;
(I) fails to comply with
				  applicable requirements within a designated probation period;
(J) fails to submit an acceptable plan of
				  correction for cited deficiencies; or
(K) if the facility is participating under
				  Title XVIII, and the Centers for Medicare and Medicare Services terminates the
				  ASC's Medicare provider agreement.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter A - OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS › Section 135.25 - Complaints

Current through Reg. 49, No. 28; July 12, 2024
(a) In response to
				  a complaint, the department or its authorized representative may enter the
				  premises of an ambulatory surgical center (ASC) during normal business hours as
				  necessary to assure compliance with the Act and these sections. The
				  investigation may be conducted on-site, unannounced or announced, or may be
				  investigated by phone or mail.
(b)
				  All licensed ambulatory surgical centers are required to provide the patient
				  and his/her guardian at time of admission a written statement identifying the
				  department as the responsible agency for ambulatory surgical centers complaint
				  investigations. The statement shall inform persons to direct complaint to the
				  Department of State Health Services, Manager, Health Facility Compliance Group,
				  Post Office Box 149347, Austin, Texas 78714-9347, (888) 973-0022. This
				  information shall also be prominently and conspicuously posted for display in
				  an area of the facility that is readily available to patients, families and
				  visitors. Complaints may be registered with the department by phone or in
				  writing. A complainant may provide his/her name, address, and phone number to
				  the department. Anonymous complaints may be registered. All complaints are
				  confidential.
(c) The department
				  shall evaluate all complaints against all ambulatory surgical centers. Only
				  those allegations determined to be relevant to the Act shall be authorized for
				  investigation.
(d) Conduct of the
				  investigation shall include, but is not limited to:
(1) a conference prior to commencing the
				  on-site inspection for the purpose of explaining the nature and scope of the
				  inspection between the department's authorized representative and the person
				  who is in charge of the ASC;
(2)
				  inspection of the ASC;
(3)
				  inspection of medical and personnel records, including administrative files,
				  reports, records, or working papers;
(4) an interview with any willing recipient
				  of ambulatory surgical center services at the ASC or in the recipient's home if
				  the recipient grants permission in writing;
(5) an interview with any health care
				  practitioner or ambulatory surgical center personnel who care for the recipient
				  of ambulatory surgical services; and
(6) a conference at the conclusion of the
				  inspection between the department's representative and the person who is in
				  charge of the ASC.
(A) The department's
				  representative shall identify any records that have been reproduced.
(B) Any records that are removed from an ASC
				  (other than those reproduced) shall be removed only with the consent of the
				  ASC. The ASC shall furnish copies of all records pertinent to the investigation
				  at the department's request.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter A - OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS › Section 135.26 - Reporting Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  ambulatory surgical center (ASC) shall make a report of the following incidents
				  to the Texas Health and Human Services Commission (HHSC) . An incident report
				  form shall be submitted to HHSC Complaint and Incident Intake within 10
				  business days of the incident.
(1) The death
				  of a patient while under the care of the ASC;
(2) The transfer of a patient to a
				  hospital;
(3) Patient development
				  of complications within 24 hours of discharge from the ASC resulting in
				  admission to a hospital; and
(4) A
				  patient stay exceeding 23 hours.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter A - OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS › Section 135.28 - Confidentiality

Current through Reg. 49, No. 28; July 12, 2024
Request for information and access to records are governed
					 by the Texas Public Information Act, Government Code, Chapter 552.
(1) A written request for information is
				  required. The request shall sufficiently identify the information
				  requested.
(2) The department may
				  ask for a clarification if it cannot reasonably understand a particular
				  request.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter A - OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS › Section 135.29 - Time Periods for Processing and Issuing a License

Current through Reg. 49, No. 28; July 12, 2024
(a) General.
(1) The date a license application is
				  received is the date the application reaches the Department of State Health
				  Services (department).
(2) An
				  application for an initial license is complete when the department has
				  received, reviewed, and found acceptable the information described in §
											135.20
				  of this title (relating to Initial Application and Issuance of
				  License).
(3) An application for a
				  renewal license is complete when the department has received, reviewed, and
				  found acceptable the information described in §
											135.22 of this
				  title (relating to Renewal of License).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter A - OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS › Section 135.30 - Miscellaneous Policies and Protocols

Current through Reg. 49, No. 28; July 12, 2024
A licensed ambulatory surgical center shall not
					 discriminate based on a patient's disability and shall comply with Texas Health
					 and Safety Code Chapter 161, Subchapter S (relating to Allocation of Kidneys
					 and Other Organs Available for Transplant).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter B - FIRE PREVENTION AND SAFETY REQUIREMENTS › Section 135.41 - Fire Prevention and Protection

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Compliance. An ambulatory surgical center (ASC) shall comply with the
				  provisions of this section with respect to fire prevention and protection.
(1) Fire inspections. An ASC shall comply
				  with local fire codes.
(2) Fire
				  reporting. Except as required under §
											135.43(b)(6)
				  of this title (relating to Handling and Storage of Gases, Anesthetics, and
				  Flammable Liquids), an ASC shall report all occurrences of fire to the local
				  fire authority and in writing to the department's facility licensing group
				  manager as soon as possible but not later than 10 calendar days following the
				  occurrence. Any fire occurrence causing injury to a person shall be reported no
				  later than the next business day to the facility licensing group manager by
				  fax, (512) 834-4514, or overnight mail to Department of State Health Services,
				  Facility Licensing Group Manager, Post Office Box 149347, Austin, Texas
				  78714-9347.
(3) Smoking policy. An
				  ASC shall adopt, implement and enforce a written smoking policy. The policy
				  shall include the minimum provisions of National Fire Protection Association
				  101, Life Safety Code, 2003 Edition (NFPA 101), §20.7.4. All documents
				  published by National Fire Protection Association (NFPA) as referenced in this
				  section may be obtained by writing or calling the NFPA at the following address
				  or telephone number: National Fire Protection Association, 1 Batterymarch Park,
				  Quincy, Massachusetts 02269-9101 or (800) 344-3555.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter B - FIRE PREVENTION AND SAFETY REQUIREMENTS › Section 135.42 - General Safety

Current through Reg. 49, No. 28; July 12, 2024
(a) Safety officer.
				  The governing body shall appoint a safety officer who is knowledgeable in
				  safety practices in health care facilities. The safety officer shall carry out
				  the functions of the safety program.
(b) Safety activities.
(1) Incident reports. The safety officer
				  shall establish an incident reporting system which includes a mechanism to
				  ensure that all incidents recorded are evaluated, and documentation is provided
				  to show follow-up and corrective actions.
(2) Safety policies and procedures. Safety
				  policies and procedures for each department or service shall be developed,
				  implemented, and enforced.
(3)
				  Safety training and continuing education. Safety training shall be established
				  as part of new employee orientation and in the continuing education of all
				  employees.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter B - FIRE PREVENTION AND SAFETY REQUIREMENTS › Section 135.43 - Handling and Storage of Gases, Anesthetics, and Flammable Liquids

Current through Reg. 49, No. 28; July 12, 2024
(a) An ambulatory
				  surgical center (ASC) shall comply with the requirements of this section for
				  handling and storage of gases, anesthetics, and flammable liquids. The ASC
				  premises shall be kept free from accumulations of combustible materials not
				  necessary for immediate operation of the facility.
(b) Flammable germicides. If flammable
				  germicides, including alcohol-based products, are used for preoperative
				  surgical skin preparation, the facility shall:
(1) use only self-contained, single-use,
				  pre-measured applicators to apply the surgical skin preparations;
(2) follow all manufacturer product safety
				  warnings and guidelines;
(3)
				  develop, implement, and enforce written policies and procedures outlining the
				  safety precautions required related to the use of the products, which, at a
				  minimum, shall include minimum drying times, prevention and management of
				  product pooling, parameters related to draping and the use of ignition sources,
				  staff responsibilities related to ensuring safe use of the product, and
				  documentation requirements sufficient to evaluate compliance with the written
				  policies and procedures;
(4) ensure
				  that all staff working in the surgical environment where flammable surgical
				  skin preparation products are in use have received training on product safety
				  and the facility policies and procedures related to the use of the
				  product;
(5) develop, implement and
				  enforce an interdisciplinary team process for the investigation and analysis of
				  all surgical suite fires and alleged violations of the policies; and
(6) provide a written report of all
				  occurrences of surgical suite fires within two business days to the department
				  in care of the facility licensing group, and complete an investigation of the
				  occurrence and develop and implement a corrective action plan within 30
				  days.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter C - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 135.51 - Construction Requirements for an Existing Ambulatory Surgical Center

Current through Reg. 49, No. 28; July 12, 2024
(a) Compliance.
(1) A licensed ambulatory surgical center
				  (ASC) which is licensed prior to the effective date of these rules is
				  considered to be an existing licensed ASC and shall continue, at a minimum, to
				  meet the licensing requirements under which it was originally
				  licensed.
(2) In lieu of meeting
				  the requirements in paragraph (1) of this subsection, an existing licensed ASC
				  may, instead, comply with National Fire Protection Association (NFPA) 101, Life
				  Safety Code 2003 Edition (NFPA 101), Chapter 21, Existing Ambulatory Health
				  Care Occupancies. All documents published by NFPA as referenced in this section
				  may be obtained by writing or calling the NFPA at the following address or
				  telephone number: National Fire Protection Association, 1 Batterymarch Park,
				  Quincy, Massachusetts 02269-9101 or (800) 344-3555.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter C - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 135.54 - Preparation, Submittal, Review and Approval of Plans, and Retention of Records

Current through Reg. 49, No. 28; July 12, 2024
(a) General.
(1) Ambulatory surgical center (ASC)
				  owners/operators shall not begin construction of a new building, additions to
				  or renovations or conversions of existing buildings until the department
				  approves final construction documents.
(2) Plans and specifications describing the
				  construction of new buildings and additions to or renovations and conversions
				  of existing buildings shall be prepared by registered architects and/or
				  licensed professional engineers and meet the requirements of this
				  subchapter.
(3) The names of spaces
				  used in the functional program narrative, preliminary documents, final
				  construction documents and specifications shall be consistent with the names of
				  the spaces used in this chapter.
(4) The department shall notify the ASC
				  owner/operator of the result of its review of each type of submission discussed
				  in this section.
(5) The ASC
				  owner/operator shall respond to all department requests for additional
				  information, including providing a plan of correction for deficiencies cited by
				  the department.
(6) Once final
				  construction documents are approved, the ASC owner/operator shall request
				  inspections in accordance with §
											135.55
				  of this title (relating to Construction, Inspections, and Approval of
				  Project).
(7) When construction is
				  delayed for longer than one year from the plan approval or self-certification
				  approval date, construction documents shall be resubmitted to the department
				  for review and approval. The plans shall be accompanied by a new application
				  for plan review and functional program narrative.
(8) The ASC owner/operator shall provide
				  written notification to the department when a project has been placed on hold,
				  canceled, or abandoned.
(9) The
				  department may close a project file after one year of assigning an application
				  number to a project if the project has been placed on hold.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter C - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 135.55 - Construction, Inspections, and Approval of Project

Current through Reg. 49, No. 28; July 12, 2024
(a) Construction.
(1) Major construction. Construction, of
				  other than minor alterations, shall not commence until the final plan review
				  deficiencies have been satisfactorily resolved, the appropriate licensing fee
				  has been paid, and the department has issued a letter granting approval to
				  begin construction. Such authorization does not constitute release from the
				  requirements contained in this chapter. If the construction takes place in or
				  near occupied areas, adequate provision shall be made for the safety and
				  comfort of occupants.
(2)
				  Construction commencement notification. The architect of record or the
				  ambulatory surgical center (ASC) owner/operator shall provide written
				  notification to the department when construction will commence. The department
				  shall be notified in writing of any change in the completion
				  schedules.
(3) Completion.
				  Construction shall be completed in compliance with the construction documents
				  including all addenda or modifications approved for the project.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 135 - AMBULATORY SURGICAL CENTERS › Subchapter C - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 135.56 - Construction Tables

Current through Reg. 49, No. 28; July 12, 2024
(a) Table 1.
				  Ventilation requirements for ambulatory surgical centers.
Attached
					 Graphic
(b)
				  Table 2. Filter efficiencies for central ventilation and air conditioning
				  systems.
Attached
					 Graphic
(c)
				  Table 3. Station outlets for oxygen, vacuum, and medical air systems.
Attached
					 Graphic
(d)
				  Table 4. Flame spread and smoke production limitations for interior finishes.
Attached
					 Graphic
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter A - GENERAL PROVISIONS › Section 137.1 - Purpose and Scope

Current through Reg. 49, No. 28; July 12, 2024
(a) The purpose of
				  this chapter is to implement the Texas Birthing Center Licensing Act, Health
				  and Safety Code, Chapter 244, which requires birthing centers (centers) to be
				  licensed by the Department of State Health Services (department) and requires
				  the department to adopt rules governing the licensing and regulation of
				  centers.
(b) This chapter
				  establishes general provisions, licensing procedures, enforcement, and
				  operational and clinical standards for the provision and coordination of
				  treatment and services.
(c) This
				  chapter applies to all centers as defined in §
										137.2 of
				  this title (relating to Definitions). Such centers must be licensed in
				  accordance with the provisions of this chapter. A person may not engage in the
				  business of providing center services, or represent to the public that the
				  person is a provider of such services for pay or other consideration without a
				  license.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter A - GENERAL PROVISIONS › Section 137.2 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this chapter,
					 shall have the following meanings, unless the context clearly indicates
					 otherwise.
(1) Act--Texas Birthing
				  Center Licensing Act, Health and Safety Code, Chapter 244, relating to the
				  licensure and regulation of centers.
(2) Acute postpartum period--A minimum of two
				  hours following the delivery of the placenta and until the client is clinically
				  stable.
(3) Administrator--A person
				  who is delegated the responsibility for the implementation and proper
				  application of policies, programs, and services established for the
				  center.
(4) Admission--A client
				  that is accepted by the center after a risk assessment is performed.
(5) Affiliate--With respect to an applicant
				  or owner which is:
(A) a
				  corporation--includes each officer, director, stockholder with a direct
				  ownership of at least 5.0%, subsidiary, and parent company;
(B) a limited liability company--includes
				  each officer, member, and parent company;
(C) an individual--includes:
(i) the individual's spouse;
(ii) each partnership and each partner
				  thereof of which the individual or any affiliate of the individual is a
				  partner; and
(iii) each corporation
				  in which the individual is an officer, director, or stockholder with a direct
				  ownership of at least 5.0%;
(D) a partnership--includes each partner and
				  any parent company; and
(E) a group
				  of co-owners under any other business arrangement--includes each officer,
				  director, or the equivalent under the specific business arrangement and each
				  parent company.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter A - GENERAL PROVISIONS › Section 137.3 - Licensing Fees

Current through Reg. 49, No. 28; July 12, 2024
(a) The schedule of
				  fees for a license is as follows:
(1) initial
				  license fee is $2,000;
(2) renewal
				  license fee is $2,000; and
(3)
				  change of ownership license fee is $2,000.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter A - GENERAL PROVISIONS › Section 137.4 - General Provisions for Licensure

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  All first-time applications for a license are applications for an initial
				  license.
(b) The applicant must be
				  at least 18 years of age.
(c) A
				  separate license is required for each place of business.
(d) A center may not admit a client in labor
				  until it has received an initial license.
(e) The licensed location must be in
				  Texas.
(f) The owner of the center
				  is responsible for ensuring the center's compliance with the Act and this
				  chapter.
(g) A license must be
				  renewed biannually.
(h) The license
				  shall be displayed in a public area of the center that is readily accessible to
				  patients, employees and visitors.
(i) The license may not be transferred or
				  assigned from one person to another person.
(j) A center shall have the financial ability
				  to carry out its functions under the Act and this chapter.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter B - LICENSING PROCEDURES › Section 137.12 - Change of Ownership or Services and Closure

Current through Reg. 49, No. 28; July 12, 2024
(a) The following provisions apply to a
				  change of ownership of a center and affect the condition of a license.
(1) A license is not transferable or
				  assignable from one person to another person.
(2) A license issued by the department may
				  not be materially altered in any way.
(3) A change of ownership of a center is
				  effective when the name of the licensed person reflected on the license
				  certificate and original application is changed by the department to reflect
				  the name of the person applying for the change of ownership.
(4) A person who desires to receive a license
				  in its name for a center licensed under the name of another person or to change
				  the ownership of any center shall submit a new license application and the
				  initial license fee at least 60 calendar days prior to the desired date of the
				  change of ownership. The application shall be in accordance with §
											137.11(a)
				  of this title (relating to Application Procedures and Issuance of
				  Licenses).
(5) An application for a
				  change of ownership shall include a notarized affidavit signed by the previous
				  owner acknowledging agreement with the change of ownership. If the applicant is
				  a corporation, the application shall include a copy of the applicant's articles
				  of incorporation. If the applicant is a business entity other than a
				  corporation, the applicant shall include a copy of the sales
				  agreement.
(6) The previous owner's
				  license shall be void on the effective date of the change of
				  ownership.
(7) This subsection does
				  not apply if a licensee is simply revising its name as allowed by law (i.e., a
				  corporation is amending the articles of incorporation to revise its
				  name).
(8) The sale of stock of a
				  corporate licensee does not cause this subsection to apply.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter B - LICENSING PROCEDURES › Section 137.13 - Time Periods for Processing and Issuing a License

Current through Reg. 49, No. 28; July 12, 2024
(a) Definition. For purposes of this section,
				  license means a license, permit, registration, or certificate issued by the
				  Department of State Health Services (department) for a birthing
				  center.
(b) General. Time periods
				  for processing and issuing a license.
(1) The
				  date a license application is received is the date the application reaches the
				  Facility Licensing Group of the Department of State Health Services
				  (department).
(2) An application
				  for an initial license is complete when the department has received, reviewed,
				  and found acceptable the information described in §
											137.11(a)(3)
				  of this title (relating to Application Procedures and Issuance of
				  Licenses).
(3) An application for a
				  renewal license is complete when the department has received, reviewed, and
				  found acceptable the information described in §
											137.11(f)(2)
				  of this title.
(4) An application
				  for a change of ownership license is complete when the department has received,
				  reviewed, and found acceptable the information described in §
											137.12
				  of this title (relating to Change of Ownership or Services and
				  Closure).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter C - SURVEY PROCEDURES AND ENFORCEMENT › Section 137.21 - On-Site Surveys

Current through Reg. 49, No. 28; July 12, 2024
(a) Requirement for
				  on-site surveys. A representative of the department may enter the premises of a
				  license applicant or license holder at reasonable times to conduct a survey
				  incidental to the issuance of a license, and at other times as it considers
				  necessary to ensure compliance with the Act and the rules adopted under the
				  Act.
(b) Initial on-site survey.
(1) The department shall conduct the on-site
				  survey within 90 calendar days of the date of issuance of the initial license
				  to determine if the center meets the requirements of the Act and this
				  chapter.
(2) The on-site survey
				  shall include a standard-by-standard evaluation.
(3) At the time of the initial on-site
				  survey, the center shall assure that the administrator or his or her
				  designee(s) is present during the survey.
(4) If at the time of the initial on-site
				  survey, the center has not admitted its first client for antepartum,
				  intrapartum, or postpartum care, the center must notify the Manager, Health
				  Facility Compliance Group, Department of State Health Services, 1100 West 49th
				  Street, Austin, Texas 78756, when the first such admission and care delivery
				  does occur.
(A) Within seven calendar days of
				  the first client admission, the center shall submit a copy of the clinical
				  record to the department for review.
(B) The department shall review the clinical
				  record(s) to evaluate the center's compliance with the care delivery standards
				  of this chapter.
(5)
				  Upon completion of the on-site survey, a department surveyor shall verify a
				  center's compliance with the provisions of the Act and this chapter and
				  recommend to the department:
(A) that the
				  center's initial license be continued for the duration of the initial license
				  period; or
(B) that the department
				  propose an enforcement action.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter C - SURVEY PROCEDURES AND ENFORCEMENT › Section 137.23 - Emergency Suspension

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  department may issue an emergency order to suspend a license issued under this
				  chapter if the department has reasonable cause to believe that the conduct of a
				  license holder creates an immediate danger to the public health and
				  safety.
(b) On written request of
				  the license holder, the department shall conduct a hearing to determine if the
				  emergency suspension is to continue, to be modified or to be rescinded. The
				  hearing shall not be conducted earlier than the seventh day or later than the
				  10th day after the date the notice of the emergency suspension is sent to the
				  license holder.
(c) The hearing and
				  any appeal are governed by the department's rules for a contested case hearing
				  and Government Code, Chapter 2001.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter C - SURVEY PROCEDURES AND ENFORCEMENT › Section 137.24 - Administrative Penalties

Current through Reg. 49, No. 28; July 12, 2024
(a) Imposition of
				  penalty.
(1) The department may impose an
				  administrative penalty on a person licensed under this chapter who violates the
				  Act, this chapter, or an order adopted under this chapter.
(2) A penalty collected under this section
				  shall be deposited in the state treasury in the general revenue fund.
(3) A proceeding to impose the penalty is
				  considered to be a contested case under Government Code, Chapter
				  2001.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter C - SURVEY PROCEDURES AND ENFORCEMENT › Section 137.25 - Complaints

Current through Reg. 49, No. 28; July 12, 2024
(a) In accordance
				  with §
										137.42 of
				  this title (relating to Disclosure Requirements), all licensed centers are
				  required to provide a client, and her guardian if the client is a minor or if
				  guardianship is required, at the time of the initial visit, with a written
				  statement that complaints relating to the center may be registered with the
				  Manager, Health Facility Compliance Group, Department of State Health Services,
				  1100 West 49th Street, Austin, Texas 78756; Telephone (888) 973-0022; (512)
				  834-6650; and Fax (512) 834-6653.
(b) Complaints may be registered with the
				  department by telephone, fax or in writing at the address listed in subsection
				  (a) of this section. A complainant may provide his or her name, address, and
				  phone number to the department. Anonymous complaints may be registered if the
				  complainant provides sufficient information.
(c) The department will evaluate all
				  complaints received.
(d) A
				  complaint containing allegations that are a violation of the Act or this
				  chapter will be investigated by the department.
(e) A department representative (surveyor)
				  may enter the premises of a center at reasonable times as necessary to assure
				  compliance with the Act and this chapter. The department is not required to
				  notify the applicant or licensee prior to a complaint investigation.
(f) If the department determines that the
				  complaint does not come within the department's jurisdiction, the department
				  shall advise the complainant and, if possible, refer the complainant to the
				  appropriate governmental agency for handling such a complaint.
(g) The department shall inform in writing a
				  complainant who identifies himself or herself by name and address of the final
				  disposition of the complaint.
(h) A
				  person may file a complaint with the department against a birthing center
				  licensed under this chapter. A person who files a false complaint may be
				  prosecuted under the Penal Code.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter C - SURVEY PROCEDURES AND ENFORCEMENT › Section 137.26 - Appointment and Qualifications of a Monitor

Current through Reg. 49, No. 28; July 12, 2024
(a) The department may appoint a monitor for
				  a birthing center to ensure compliance with this chapter when the center's
				  failure to comply with this chapter creates a serious threat to the health and
				  safety of the public.
(b) The
				  birthing center shall be liable for the cost of the monitor.
(c) The birthing center may propose up to
				  three persons to act as a monitor. The department shall approve the monitor.
				  The monitor shall be an individual or team of individuals, and must include a
				  professional with birthing center experience. The monitor may not be or include
				  individuals who are current or former employees of the birthing center or an
				  affiliated facility. The purpose of the monitor is to observe, supervise,
				  consult, and educate the birthing center employees, and report back to the
				  department according to the terms of the agreed order.
(d) A professional with birthing center
				  experience shall:
(1) have a minimum of three
				  years clinical experience providing care to pregnant women and
				  newborns;
(2) be a certified
				  nurse-midwife, licensed midwife, or physician with obstetrical experience;
				  and
(3) be currently licensed or
				  certified in the State of Texas.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.31 - Operational and Clinical Policies

Current through Reg. 49, No. 28; July 12, 2024
A center shall develop, implement, and enforce written
					 policies governing the center's total operation and ensure that these policies
					 are administered so as to provide quality health services in a safe
					 environment.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.32 - Organizational Structure and Delegation of Authority

Current through Reg. 49, No. 28; July 12, 2024
(a) A center shall establish a written
				  organizational structure which shall clearly define the lines of authority and
				  the delegation of responsibility for professional and nonprofessional
				  staff.
(b) The center shall appoint
				  an administrator and a clinical director. The administrator and clinical
				  director may be the same person and may be the owner.
(1) The administrator shall be responsible
				  for implementing and supervising the operational policies of the
				  center.
(2) The clinical director
				  shall be responsible for implementing the clinical policies of the
				  center.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.33 - Personnel Policies

Current through Reg. 49, No. 28; July 12, 2024
The center shall develop, implement, and enforce written
					 policies governing all personnel staffed by the center. The personnel policies
					 shall cover the following requirements:
(1) job descriptions for all personnel
				  providing client care;
(2)
				  orientation and training of all employees, volunteers, students and
				  contractors;
(3) an annual written
				  evaluation of employee performance;
(4) in-service and continuing
				  education;
(5) certification of all
				  birth attendants by the American Heart Association or the American Red Cross in
				  basic life support for health care providers; and
(6) certification of all birth attendants by
				  the American Academy of Pediatrics or the American Heart Association in
				  neonatal resuscitation.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.34 - Qualifications and Duties of Staff

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  One person may act in the capacity of the administrator, the clinical director,
				  and the birth attendant provided that person meets all the minimum
				  qualifications set out in paragraphs (2)(A) and (3)(A) of this subsection and
				  is capable of performing all of the duties specifically stated in paragraphs
				  (1)(B), (2)(B), and (3)(B) of this subsection. The minimum qualifications and
				  duties for the administrator, the clinical director, the birth attendant, other
				  clinical care providers and nonprofessional personnel of a center are as
				  follows.
(1) Administrator.
(A) Qualifications.
(i) Shall not have been employed in the last
				  year as an administrator with another center or health care facility at the
				  time the center or facility was cited for violations of a licensing law or rule
				  which resulted in enforcement action taken against the center or health related
				  facility. For purposes of this clause only, the term "enforcement action" means
				  license revocation, suspension, emergency suspension, or denial of a license or
				  injunction action but does not include administrative or civil
				  penalties.
(ii) Shall not have been
				  convicted of a felony or misdemeanor listed in §
													137.22
				  of this title (relating to License Denial, Suspension, Probation, or
				  Revocation).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.36 - Physical and Environmental Requirements for Centers

Current through Reg. 49, No. 28; July 12, 2024
The physical and environmental requirements for a center
					 are as follows.
(1) The center shall
				  be located within a recommended 20 minutes but with a required maximum of 30
				  minutes normal driving time of a referral hospital. The department may approve
				  the location of a center that is located a further distance away if the
				  department finds that the health and safety of the clients of the center will
				  not be adversely affected.
(2) The
				  center must have the capacity to provide clients with liquid nourishment. The
				  center may provide commercially packaged food to clients in individual
				  servings. If other food is provided by the center, it will be subject to the
				  requirements of Chapter 228 of this title (relating to Retail Food).
(3) The center must have a safe and sanitary
				  environment equipped and maintained to protect the health and safety of clients
				  and staff.
(4) The center shall
				  provide clean hand washing facilities for clients and staff including running
				  water and soap.
(5) The center must
				  have two functioning sinks and one toilet.
(6) The center must be equipped with
				  emergency lighting and have a written fire and disaster plan.
(7) The center must have equipment available
				  to sterilize instruments, equipment, and supplies before reuse in the center in
				  accordance with §
										137.37
				  of this title (relating to Infection Control Standards).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 137 - BIRTHING CENTERS › Subchapter D - OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES › Section 137.37 - Infection Control Standards

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  center shall develop, implement, and enforce written infection control policies
				  and procedures to minimize the transmission of infection. Policies shall
				  include educational course requirements; cleaning and laundry requirements; and
				  decontamination, disinfection, sterilization, and storage of sterile
				  supplies.
(b) Universal/standard
				  precautions.
(1) Ensure that all staff
				  complies with universal/standard precautions.
(2) Establish procedures for monitoring
				  compliance with universal/standard precautions.
(3) Enforce a policy to ensure compliance of
				  the center and all of the health care workers within the center with the Health
				  and Safety Code, Chapter 85, Subchapter I, concerning the prevention of the
				  transmission of human immunodeficiency virus (HIV) and hepatitis B virus (HBV)
				  by infected health care workers.
(4) Require its health care workers to
				  complete educational course work or training in infection control and barrier
				  precautions, including basic concepts of disease transmission, scientifically
				  accepted principles and practices for infection control and engineering and
				  work practice controls.