reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 510 - PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS › Subchapter F - FIRE PREVENTION AND SAFETY REQUIREMENTS › Section 510.103 - Handling and Storage of Gases and Flammable Liquids

Current through Reg. 49, No. 28; July 12, 2024
(a) Flammable and nonflammable gases and
				  liquids. Flammability of liquids and gases shall be determined by National Fire
				  Protection Association 325, Guide to Fire Hazard Properties of Flammable
				  Liquids, Gases, and Volatile Solids, 1994 edition. 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,
				  P.O. Box 9101, Quincy, MA 02269-9101 or (800) 344-3555.
(1) Nonflammable gases shall be stored and
				  distributed in accordance with Chapter 4 of the National Fire Protection
				  Association 99, Standard for Health Care Facilities, 1999 edition (NFPA 99).
(A) Medical gases and liquefied medical gases
				  shall be handled in accordance with the requirements of NFPA 99, Chapter
				  8.
(B) Oxygen shall be administered
				  in accordance with NFPA 99 § 8-6.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 510 - PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS › Subchapter G - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 510.121 - Requirements for Buildings in which Existing Licensed Facilities are Located

Current through Reg. 49, No. 28; July 12, 2024
(a) Compliance. All
				  buildings in which existing facilities licensed by the department are located
				  shall comply with this subsection.
(1)
				  Minimum fire safety and construction requirements.
(A) Existing licensed facilities shall meet
				  the requirements for health care occupancies contained in the 1985, 1988, 1991
				  or 2000 editions of the National Fire Protection Association 101, Code for
				  Safety to Life from Fire in Buildings and Structures, (NFPA 101), and the
				  facility licensing rules (1988, 1989 or 1994) under which the buildings or
				  sections of buildings were constructed or last modified. 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, P.O. Box 9101, Quincy, MA
				  02269-9101 or (800) 344-3555.
(B)
				  Existing facilities or portions of existing facilities constructed prior to the
				  adoption of any of the editions of NFPA 101, the Facility Licensing Standards,
				  and the facility licensing rules listed in subparagraph (A) of this paragraph,
				  shall comply with this section and Chapter 19, NFPA 101, 2000
				  edition.
(C) Compliance with the
				  requirements of Chapter 3 of the National Fire Protection Association 101A,
				  Alternative Approaches to Life Safety, 1998 edition, (relating to Fire Safety
				  Evaluation System for Health Care Occupancies) will be acceptable in lieu of
				  complying with the requirements of Chapter 19, NFPA 101, 2000
				  edition.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 510 - PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS › Subchapter G - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 510.122 - New Construction Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) Facility location. Any proposed new
				  facility shall be easily accessible to the community and to service vehicles
				  such as delivery trucks, ambulances, and fire protection apparatus. No building
				  may be converted for use as a facility which, because of its location, physical
				  condition, state of repair, or arrangement of facilities, would be hazardous to
				  the health and safety of the patients.
(1)
				  Hazardous locations.
(A) Underground and
				  above ground hazards. New facilities or additions to existing facilities shall
				  not be built within 125 feet of right away/easement of hazardous locations
				  including but not limited to underground liquid butane or propane, liquid
				  petroleum or natural gas transmission lines, high pressure lines, and not under
				  high voltage electrical lines.
(B)
				  Fire hazards. New facilities shall not be built within 300 feet of above ground
				  or underground storage tanks containing liquid petroleum or other flammable
				  liquids used in connection with a bulk plant, marine terminal, aircraft
				  refueling, bottling plant of a liquefied petroleum gas installation, or near
				  other hazardous or hazard producing plants.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 510 - PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS › Subchapter G - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 510.123 - Spatial Requirements for New Construction

Current through Reg. 49, No. 28; July 12, 2024
(a) Administration and public suite. The
				  following rooms or areas shall be provided.
(1) Primary entrance. An entrance at grade
				  level shall be accessible and protected from inclement weather with a
				  drive-under canopy for loading and unloading passengers.
(2) Lobby. A main lobby shall be located at
				  the primary entrance and shall include a reception and information counter or
				  desk, waiting space(s), public toilet facilities, public telephones, drinking
				  fountain(s), and storage room or alcove for wheelchairs.
(3) Admissions area. An admissions area shall
				  include a waiting area, work counters or desk, private interview spaces, and
				  storage room or alcove for wheelchairs. The waiting area and wheelchair storage
				  may be shared with similar areas located in the main lobby.
(4) General or individual office(s). Office
				  space shall be provided for business transactions, medical and financial
				  records, and administrative and professional staffs.
(5) Multipurpose room(s). Room(s) shall be
				  provided for conferences, meetings, and health education purposes including
				  provisions for showing visual aids.
(6) Storage. Storage for office equipment and
				  supplies shall be provided. The construction protection for the storage room or
				  area shall be in accordance with the National Fire Protection Association 101,
				  Code for Safety to Life from Fire in Buildings and Structures, 1997 edition
				  (NFPA 101), § 18-3.1. All documents published by the NFPA as referenced in
				  this section may be obtained by writing or calling the NFPA at the following
				  address and telephone number: Post Office Box 9101, 1 Batterymarch Park,
				  Quincy, Massachusetts 02269-9101, (800) 344-3555.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 510 - PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS › Subchapter G - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 510.126 - Mobile, Transportable, and Relocatable Units

Current through Reg. 49, No. 28; July 12, 2024
(a) General. When mobile, transportable and
				  relocatable units are utilized to provide patient treatment services on the
				  facility premises, these units shall be treated as buildings and constructed to
				  the required occupancy as follows:
(1) When
				  such units are provided for diagnostic, treatment or procedural services to
				  patients that are litter borne or incapable of self-preservation, the unit
				  shall be constructed in accordance with Chapter 18 of the National Fire
				  Protection Association 101, Code for Safety to Life from Fire in Buildings and
				  Structures, 2000 edition (NFPA 101), relating to health care occupancy,
				  published by the National Fire Protection Association. All documents published
				  by the NFPA as referenced in this section may be obtained by writing or calling
				  the NFPA at the following address and telephone number: Post Office Box 9101, 1
				  Batterymarch Park, Quincy, Massachusetts 02269-9101, (800) 344-3555.
(2) When such units provide diagnostic,
				  treatment, or procedural services to patients, or types of services that are
				  not litter borne and are capable of self-preservation, the unit may be
				  constructed in accordance with Chapter 38 of NFPA 101 (relating to Business
				  Occupancy).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 510 - PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS › Subchapter G - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 510.127 - Preparation, Submittal, Review and Approval of Plans

Current through Reg. 49, No. 28; July 12, 2024
(a) General.
(1) Facility owners or operators may not
				  begin construction of a new building or additions to or renovations or
				  conversions of existing buildings until final construction documents are
				  reviewed and approved by the department.
(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.
(3) Preliminary plans shall be prepared and
				  submitted in accordance with subsection (b) of this section.
(4) Final plans and specifications shall be
				  prepared and submitted in accordance with subsection (c) of this
				  section.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 510 - PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS › Subchapter G - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 510.128 - Construction, Surveys, 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 plan review fee
				  according to the plan review schedule in §
											510.26 of Title 40 (relating to
				  Fees) 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 licensee
				  or applicant 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 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 510 - PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS › Subchapter G - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 510.129 - Waiver Requests

Current through Reg. 49, No. 28; July 12, 2024
(a) Request for
				  a waiver. A facility may submit a written request to the Hospital Licensing
				  Director, Health Facility Licensing and Compliance Division, Texas Department
				  of Health, 1100 West 49th Street, Austin, Texas 78756 for a waiver or
				  modification of a particular provision of §
										510.122 or §
										510.123 of Title 40 (relating to
				  New Construction Requirements and Spatial Requirements for New Construction).
				  Waivers will not be granted for fire safety requirements required by the
				  National Fire Protection Association (NFPA). The written request shall specify
				  the specific provision for which a waiver is requested.
(b) Consideration. In considering the waiver
				  or modification request, the Hospital Licensing Director (HL director) shall
				  consider whether the waiver or modification:
(1) will adversely affect the health and
				  safety of the facility patients, employees, or the general public;
(2) will adversely impact the hospital's
				  participation in the federal Medicare program or accreditation by the Joint
				  Commission on Accreditation of Healthcare Organizations or the American
				  Osteopathic Association;
(3) if not
				  granted, would impose an unreasonable hardship on the facility in providing
				  adequate care for patients;
(4)
				  will facilitate the creation or operation of the facility; and
(5) is appropriate when balanced against the
				  best interests of the individuals served or to be served by the
				  facility.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 510 - PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS › Subchapter G - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 510.130 - Record Drawings, Manuals and Design Data

Current through Reg. 49, No. 28; July 12, 2024
(a) Manuals. Upon completion of the contract,
				  the owner shall be furnished with a complete set of manufacturers' operating,
				  maintenance, and preventive maintenance instructions;parts lists; and
				  procurement information with numbers and a description for each piece of
				  equipment. Facility staff shal1 also be provided with instructions on how to
				  properly operate systems and equipment. Required information shall include
				  energy ratings as needed for future conservation calculations.
(b) Design data. The owners shall be provided
				  with complete design data for the facility. This shall include structural
				  design loadings; summary of heat loss assumption and calculations; estimated
				  water consumption; medical gas outlet listing; list of applicable codes; and
				  electric power requirements of installed equipment. All such data shall be
				  supplied to facilitate future alterations, additions, and changes, including,
				  but not limited to, energy audits and retrofit for energy
				  conservation.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 510 - PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS › Subchapter G - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 510.131 - Tables

Current through Reg. 49, No. 28; July 12, 2024
(a) Table 1. Sound
				  transmission limitations in facilities.
Attached
					 Graphic
(b)
				  Table 2. Flame spread and smoke production limitations for interior finishes.
Attached
					 Graphic
(c)
				  Table 3. Ventilation requirements for facilities.
Attached
					 Graphic
(d)
				  Table 4. Filter efficiencies for central ventilation and air conditioning
				  systems.
Attached
					 Graphic
(e)
				  Table 5. Hot water use.
Attached
					 Graphic
(f)
				  Table 6. Station outlets for oxygen, vacuum, and medical air systems.
Attached
					 Graphic
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter A - GENERAL PROVISIONS › Section 511.1 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  The purpose of this chapter is to implement Texas Health and Safety Code
				  Chapter 241, Subchapter K for Limited Services Rural Hospitals licensed by the
				  Texas Health and Human Services Commission.
(b) This chapter provides:
(1) procedures for obtaining a limited
				  services rural hospital (LSRH) license;
(2) standards for LSRH functions and
				  services;
(3) patient
				  rights;
(4) discrimination or
				  retaliation prohibitions;
(5)
				  patient transfer and other policy and protocol requirements;
(6) reporting, posting, and training
				  requirements relating to abuse and neglect;
(7) standards for voluntary
				  agreements;
(8) inspection and
				  investigation procedures;
(9)
				  enforcement standards;
(10) fire
				  prevention and protection requirements;
(11) general safety standards;
(12) physical plant and construction
				  requirements; and
(13) standards
				  for the preparation, submittal, review, and approval of construction
				  documents.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter A - GENERAL PROVISIONS › Section 511.3 - Waiver Provisions

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  limited services rural hospital (LSRH) may submit a written request to the
				  Texas Health and Human Services Commission (HHSC) for a waiver or modification
				  of a particular provision of Texas Health and Safety Code (HSC) Chapter 241
				  (relating to Hospitals) or a standard in this chapter, except fire safety
				  requirements. The written request shall specify the section or sections of HSC
				  Chapter 241 or this chapter for which the LSRH is requesting a
				  waiver.
(b) In requesting the
				  waiver, the LSRH must address each of the following requirements and provide
				  documentation as necessary to support its position. The LSRH must:
(1) provide evidence to support why the
				  requested waiver will not adversely affect the health and safety of the
				  hospital patients, employees, or the general public;
(2) indicate how the LSRH determined that
				  granting the waiver would not adversely impact the LSRH's participation in the
				  federal Medicare program or accreditation by a Centers for Medicare &
				  Medicaid Services-approved organization;
(3) describe how not granting the waiver
				  would impose an unreasonable hardship on the LSRH in providing adequate care
				  for patients;
(4) describe how the
				  waiver would facilitate creating or operating the LSRH; and
(5) explain why the waiver would be
				  appropriate when balanced against the best interests of the individuals served
				  or to be served by the LSRH.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter B - LICENSING REQUIREMENTS › Section 511.11 - General

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  limited services rural hospital (LSRH) shall obtain a license before admitting
				  patients.
(b) An applicant for an
				  LSRH license shall submit a license application to the Texas Health and Human
				  Services Commission (HHSC) in a form and manner prescribed by HHSC.
(c) An applicant shall submit a license
				  application in accordance with §
										511.12 of this subchapter
				  (relating to Application and Issuance of Initial License). The applicant shall
				  retain copies of all application documents submitted to HHSC.
(d) During the licensing period, an LSRH
				  shall comply with the other provisions of Texas Health and Safety Code Chapter
				  241 (relating to Hospitals), to the extent they do not conflict with Subchapter
				  K (relating to Limited Services Rural Hospitals), and Code of Federal
				  Regulations Title 42 Part 485 Subpart E (relating to Conditions of
				  Participation: Rural Emergency Hospitals (REHs)) and this chapter.
(e) HHSC issues an LSRH license for the
				  premises and person named in the application.
(1) An LSRH license shall not include
				  off-site outpatient facilities.
(2)
				  An LSRH may share a building with other licensed facilities.
(A) The LSRH must be licensed separately from
				  the other licensed facilities.
(B)
				  No identifiable part of the building may be dually licensed by more than one
				  facility.
(C) Each licensed
				  facility in the building shall comply with the requirements of §
												511.165 of this chapter (relating
				  to Building with Multiple Occupancies).
(3) A licensed LSRH shall not hold or pursue
				  dual licensure as any other facility type.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter B - LICENSING REQUIREMENTS › Section 511.12 - Application and Issuance of Initial License

Current through Reg. 49, No. 28; July 12, 2024
(a) An applicant who meets the definition of
				  a qualified rural hospital under §
										511.2(47) of this
				  chapter (relating to Definitions) and is seeking a limited services rural
				  hospital (LSRH) license shall submit the following documents to the Texas
				  Health and Human Services Commission (HHSC) within 60 calendar days before the
				  projected opening date of the LSRH:
(1) an
				  accurate and complete application form;
(2) a copy of the LSRH's patient transfer
				  policy, developed in accordance with §
											511.65 of this chapter (relating
				  to Patient Transfer Policy) and signed by both the chairman and secretary of
				  the LSRH's governing body attesting to the date the governing body adopted the
				  policy and the policy's effective date;
(3) a copy of the LSRH's memorandum of
				  transfer form that contains at least the information described in §
											511.65 of this chapter;
(4) a copy of a patient transfer agreement
				  entered into between the LSRH and at least one hospital certified by the
				  Centers for Medicare & Medicaid Services that is designated as a level I or
				  level II trauma center in accordance with §
											511.66 of this chapter (relating
				  to Patient Transfer Agreements);
(5) a copy of a fire inspection approved by
				  an individual certified by the Texas Commission on Fire Protection that is
				  dated no earlier than one year before the application submission date;
				  and
(6) the appropriate license fee
				  as required in §
											511.17 of this subchapter
				  (relating to Fees).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter B - LICENSING REQUIREMENTS › Section 511.13 - Application and Issuance of Renewal License

Current through Reg. 49, No. 28; July 12, 2024
(a) The Texas Health and Human Services
				  Commission (HHSC) shall send written notice of license expiration to a limited
				  services rural hospital (LSRH) at least 60 calendar days before the expiration
				  date of the license. If the LSRH has not received notice, it is the LSRH's duty
				  to notify HHSC and request a renewal notice.
(b) The LSRH shall submit the following to
				  HHSC before the license expiration date:
(1)
				  a complete and accurate application;
(2) a copy of two fire inspections that are
				  conducted and approved by an individual certified by the Texas Commission on
				  Fire Protection to conduct fire inspections and meet the requirements of §
											511.141 of this chapter (relating
				  to Fire Prevention and Protection), one from within the last 12 months and one
				  from the year before, as the LSRH must obtain an approved fire inspection
				  annually;
(3) the renewal license
				  fee; and
(4) if the applicant is
				  accredited by a Centers for Medicare & Medicaid Services-approved
				  organization, a copy of documentation from the accrediting body showing the
				  current accreditation status of the hospital.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter B - LICENSING REQUIREMENTS › Section 511.14 - Inactive Status and Closure

Current through Reg. 49, No. 28; July 12, 2024
(a) A limited services rural hospital (LSRH)
				  that is not offering services under its license shall immediately inform the
				  Texas Health and Human Services Commission (HHSC). HHSC may automatically close
				  an LSRH facility if the facility does not offer services for more than 60 days,
				  unless the facility sends a written request to place the license on inactive
				  status.
(1) To be eligible for inactive
				  status, an LSRH must be in good standing with no pending enforcement action or
				  investigation.
(2) The licensee is
				  responsible for any license renewal requirements or fees, and for proper
				  maintenance of patient records, while the license is inactive.
(3) A license may not remain inactive for
				  more than 60 calendar days without an approved extension from HHSC.
(4) To reactivate the license, the LSRH must
				  inform HHSC no later than 60 calendar days after the LSRH stopped offering
				  services under its license.
(5) An
				  LSRH that does not reactivate its license by the 60th calendar day may request
				  an extension of the inactive status from HHSC through a written
				  request.
(6) If by the 60th
				  calendar day after it stopped offering services, the LSRH does not reactivate
				  its license or request an extension for inactive status, HHSC may consider the
				  facility closed.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter B - LICENSING REQUIREMENTS › Section 511.15 - Change of Ownership

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  change of ownership of a limited services rural hospital (LSRH) occurs when
				  there is a change in the person or governmental entity legally responsible for
				  the operation of the LSRH, whether by lease or by ownership.
(1) If a licensee amends its articles of
				  incorporation to revise its name and the tax identification number does not
				  change, this section does not apply, except that the corporation must notify
				  the Texas Health and Human Services Commission (HHSC) within 10 calendar days
				  after the effective date of the name change.
(2) The sale of stock of a licensee does not
				  cause this section to apply.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter B - LICENSING REQUIREMENTS › Section 511.16 - Time Periods for Processing and Issuing Limited Services Rural Hospital Licenses

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  The application receipt date for an initial license or a renewal license is the
				  date the Texas Health and Human Services Commission (HHSC) receives the
				  application and fee.
(b) An initial
				  license application is complete when HHSC receives, reviews, and finds
				  acceptable the information described in §511.12(a) - (b) of this
				  subchapter (relating to Application and Issuance of Initial License).
(c) A renewal license application is complete
				  when HHSC receives, reviews, and finds acceptable the information described in
				  §
										511.13(b) of this
				  subchapter (relating to Application and Issuance of Renewal License).
(d) HHSC shall process a limited services
				  rural hospital (LSRH) initial or renewal license in accordance with the
				  following time periods.
(1) The first time
				  period begins on the date HHSC receives the application and supporting
				  documents and ends on the date HHSC issues the LSRH license. If HHSC receives
				  an incomplete application, the time period ends on the date HHSC issues a
				  written notice to the applicant that the application is incomplete. The written
				  notice shall describe the specific documents or information required to
				  complete the application. The first time period is 45 calendar days.
(2) For incomplete applications, the second
				  time period begins on the date HHSC determines the application is complete and
				  ends on the date HHSC issues the LSRH license. The second time period is 45
				  calendar days.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.41 - Governing Body Organization

Current through Reg. 49, No. 28; July 12, 2024
(a) A limited services rural hospital (LSRH)
				  shall have an identified governing body responsible for the LSRH's
				  organization, management, control, and operation, including the appointment of
				  the LSRH's medical staff. For LSRHs owned and operated by an individual or by
				  partners, the individual or partners are the governing body.
(b) An LSRH shall formally organize its
				  governing body in accordance with a written constitution and bylaws, which
				  clearly set forth the organizational structure and responsibilities.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.42 - Governing Body Responsibilities

Current through Reg. 49, No. 28; July 12, 2024
(a) A limited services rural hospital's
				  (LSRH's) governing body shall address and is fully responsible, either directly
				  or by appropriate professional delegation, for the operation and performance of
				  the LSRH.
(b) The governing body is
				  responsible for all services furnished in the LSRH, whether furnished directly
				  or under contract. The governing body shall ensure:
(1) services, including any contracted
				  services, are provided in a safe and effective manner that permits the LSRH to
				  comply with all applicable rules and standards, including the federal
				  conditions of participation at Code of Federal Regulations Title 42 (42 CFR)
				  Part 485, Subchapter E and this chapter;
(2) the LSRH maintains a list of all
				  contracted services, including the scope and nature of the services
				  provided;
(3) the medical staff is
				  accountable to the governing body for the quality of care provided to patients
				  as required by 42 CFR §
												485.510; and
(4) the provision of education to students
				  and postgraduate trainees if the LSRH participates in such programs.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.43 - Administration

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  limited services rural hospital (LSRH) shall adopt, implement, and enforce
				  administrative policies and procedures to ensure the orderly and efficient
				  management of the LSRH. An LSRH's administrative policies and procedures shall
				  include the following administrative responsibilities:
(1) enforcing policies delegated by the
				  governing body;
(2) employing
				  qualified management personnel;
(3)
				  long-range and short-range planning for the LSRH's needs, as determined by the
				  governing body;
(4) using methods
				  of communicating and reporting, designed to ensure the orderly flow of
				  information within the LSRH;
(5)
				  controlling the purchase, maintenance, and distribution of the LSRH's
				  equipment, materials, and facilities;
(6) establishing lines of authority,
				  accountability, and personnel supervision;
(7) establishing controls relating to the
				  custody of the LSRH's official documents; and
(8) maintaining the confidentiality,
				  security, and physical safety of data on patients and staff.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.45 - Laboratory Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A limited services rural hospital (LSRH)
				  shall provide basic laboratory services essential to the immediate diagnosis
				  and treatment of the patient consistent with nationally recognized standards of
				  care for emergency services, patient population, and services
				  offered.
(b) The LSRH must ensure
				  laboratory services are available, either directly or through a contractual
				  agreement with a certified laboratory that complies with the Clinical
				  Laboratory Improvement Amendments of 1988 (CLIA 1988) in accordance with the
				  requirements specified in Code of Federal Regulations Title 42 (42 CFR) Part
				  493 (relating to Laboratory Requirements). CLIA 1988 applies to all hospitals
				  with laboratories that examine human specimens for the diagnosis, prevention,
				  or treatment of any disease or impairment of, or the assessment of the health
				  of, human beings.
(c) The LSRH
				  shall ensure that all laboratory services provided to its patients through a
				  contractual agreement are performed in a facility certified in the appropriate
				  specialties and subspecialties of service in accordance with the requirements
				  specified in 42 CFR Part 493 to comply with CLIA 1988.
(d) Emergency laboratory services shall be
				  available on the premises, including at least the following:
(1) assays for cardiac markers;
(2) hematology;
(3) chemistry; and
(4) pregnancy testing.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.46 - Radiologic Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A limited services rural hospital (LSRH)
				  shall maintain, or have available, diagnostic radiologic services according to
				  needs of the patients. All radiology equipment, including X-ray equipment,
				  mammography equipment and laser equipment, shall be licensed and registered as
				  required under Texas Administrative Code Title 25 (25 TAC) Chapter 289
				  (relating to Radiation Control). When therapeutic services are also provided,
				  the services, as well as the diagnostic services, shall meet professionally
				  approved standards for safety and personnel qualifications as required in 25
				  TAC §§
										289.227,
				  289.229,
				  289.230, and
				  289.231(relating to Use of
				  Radiation Machines in the Healing Arts; Radiation Safety Requirements for
				  Accelerators, Therapeutic Radiation Machines, Simulators, and Electronic
				  Brachytherapy Devices; Certification of Mammography Systems and Mammography
				  Machines Used for Interventional Breast Radiography; and General Provisions and
				  Standards for Protection Against Machine-Produced Radiation, respectively).
				  Portable X-ray equipment may be acceptable as a minimum requirement.
(b) An LSRH shall adopt, implement, and
				  enforce policies and procedures describing the radiologic services provided in
				  the LSRH and how the LSRH maintains employee and patient safety.
(c) LSRH policies shall address the quality
				  aspects of radiologic services by:
(1)
				  performing radiologic services only upon the written order of a physician,
				  podiatrist, dentist, or other practitioner, who is practicing within the scope
				  of their license and education, and a concise statement of the reason for the
				  examination; and
(2) limiting the
				  use of any radioactive sources in the facility to physicians who have been
				  granted privileges for such use based on their training, experience, and
				  current competence.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.47 - Pharmaceutical Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A limited services rural hospital (LSRH)
				  shall provide pharmaceutical services that meet the needs of the patients. The
				  LSRH shall provide a pharmacy that is licensed, as required, by the Texas State
				  Board of Pharmacy. Pharmacy services shall comply with all applicable statutes
				  and rules.
(b) The LSRH pharmacy
				  shall be directed by a licensed pharmacist.
(c) The LSRH medical staff shall develop
				  policies and procedures that minimize drug errors. This function may be
				  delegated to the LSRH's organized pharmaceutical services.
(d) The LSRH pharmacy or drug storage area
				  shall be administered in accordance with accepted professional
				  principles.
(e) Standards of
				  practice as defined by state law shall be followed regarding the provision of
				  pharmacy services.
(f) The
				  pharmaceutical services shall have an adequate number of personnel to ensure
				  quality pharmaceutical services, including emergency services.
(1) The staff shall be sufficient in number
				  and training to respond to the pharmaceutical needs of the patient population
				  being served. There shall be an arrangement for emergency services.
(2) Employees shall provide pharmaceutical
				  services within the scope of their license and education.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.49 - Medical Director

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  The medical director shall be on-site at the limited services rural hospital
				  (LSRH) when necessary to fulfill the responsibilities of the position, as
				  described by this chapter and the LSRH's governing body.
(b) Notwithstanding subsection (a) of this
				  section, each LSRH's medical director shall be on-site at the LSRH for at least
				  12 hours per month.
(c) The medical
				  director's responsibilities shall include:
(1)
				  organizing the emergency services to be provided at the LSRH;
(2) supervising and overseeing the infection
				  control program, quality assessment and performance improvement program, and
				  patient safety program; and
(3)
				  regularly attending meetings of the infection control program, quality
				  assessment and performance improvement program, and patient safety
				  program.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.51 - Provision of Services

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  The limited services rural hospital (LSRH) shall adopt, implement, train, and
				  enforce written policies to ensure all provided services are consistent with
				  accepted professional standards and practice and compliance in accordance with
				  applicable federal and state law.
(b) The LSRH must develop policies with the
				  advice of members of the LSRH's professional health care staff, including:
(1) one or more physicians; and
(2) one or more of the following if they are
				  on staff under the provisions of Code of Federal Regulations Title 42 (42 CFR)
				  §485.528(b)(1):
(A) physician assistants;
				  or
(B) advanced practice registered
				  nurses.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.52 - Surgical Services within the Scope of the Practice of Emergency Medicine

Current through Reg. 49, No. 28; July 12, 2024
(a) A limited
				  services rural hospital (LSRH) shall limit the surgical procedures performed at
				  the LSRH to procedures the governing body approved upon the medical staff's
				  recommendation.
(b) Adequate
				  supervision of surgical procedures conducted in the LSRH shall be:
(1) a responsibility of the governing
				  body;
(2) recommended by medical
				  staff; and
(3) provided by
				  appropriate medical staff.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.53 - Dietary Services

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  limited services rural hospital (LSRH) shall have organized dietary services
				  that are directed and staffed by adequate qualified personnel.
(1) An LSRH that has a contract with an
				  outside food management company or an arrangement with another hospital may
				  meet this requirement if the food management company or other hospital:
(A) has a dietitian who serves the LSRH on a
				  full-time, part-time, or consultant basis;
(B) maintains at least the minimum
				  requirements specified in this section; and
(C) provides for the frequent and systematic
				  liaison with the LSRH medical staff for recommendations of dietetic policies
				  affecting patient treatment.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.54 - General Outpatient Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) In addition to providing emergency
				  services and observation care, a limited services rural hospital (LSRH) may
				  provide outpatient and medical health diagnostic and therapeutic items and
				  services that are commonly furnished in a physician's office or at another
				  entry point into the health care delivery system that include: radiology,
				  laboratory, outpatient rehabilitation, surgical, maternal health, and
				  behavioral health services. If an LSRH provides additional outpatient and
				  medical health diagnostic and therapeutic items and services, the LSRH shall
				  comply with the requirements of this section.
(b) The outpatient and medical health
				  diagnostic and therapeutic items and services the LSRH provides shall:
(1) align with the health needs of the
				  community served by the LSRH; and
(2) be appropriately organized and meet the
				  needs of the patients in accordance with acceptable standards of
				  practice.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.55 - Surgical Services

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  If a limited services rural hospital (LSRH) performs outpatient surgical
				  services, emergency surgical services, or both, the LSRH shall comply with this
				  section.
(b) The LSRH's governing
				  body, on recommendation of the LSRH's medical staff, shall approve surgical
				  procedures performed in the LSRH.
(c) Surgical services shall be well-organized
				  and provided in accordance with acceptable standards of practice.
(d) An LSRH shall provide adequate space,
				  equipment, and personnel to ensure a safe environment for treating patients
				  during surgical procedures, including adequate safeguards to protect the
				  patient from cross infection.
(e)
				  The organization of the surgical services shall be appropriate for the scope of
				  the services offered.
(f) The LSRH
				  shall periodically review surgical procedures performed in the LSRH as part of
				  the LSRH's quality assessment and performance improvement program.
(g) Appropriate medical staff shall provide
				  adequate supervision of surgical procedures conducted in the LSRH under the
				  recommendation of medical staff and approval of the governing body.
(h) The LSRH shall establish a written
				  procedure for observation and care of the patient during and after surgical
				  procedures.
(i) The LSRH shall
				  establish written protocols for instructing patients in self-care after
				  surgical procedures, including written instructions to be given to patients who
				  receive conscious sedation, regional anesthesia, or both.
(j) The LSRH shall develop an effective
				  written procedure for the immediate transfer to a hospital of patients
				  requiring emergency care beyond the capabilities of the LSRH. The LSRH shall
				  have a written transfer agreement with a hospital as set forth in §
										511.65 of this subchapter
				  (relating to Patient Transfer Policy).
(k) Surgical procedures shall be performed
				  only by a physician, dentist, podiatrist, or practitioner, practicing within
				  the scope of their license and education, who:
(1) is licensed to perform surgical
				  procedures in Texas; and
(2) has
				  been granted privileges to perform those procedures by the governing body, upon
				  the recommendation of the medical staff, and after medical review of the
				  physician's, dentist's, podiatrist's, or practitioner's documented education,
				  training, experience, and current competence.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.56 - Anesthesia Services

Current through Reg. 49, No. 28; July 12, 2024
(a) The anesthesia services must be provided:
(1) in a well-organized manner;
(2) under the direction of a qualified
				  physician approved by the governing body; and
(3) in accordance with Texas Occupations Code
				  Title 3, Subtitle B (relating to Physicians) and Texas Occupations Code Chapter
				  301 (relating to Nurses).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.57 - Therapy Services

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  If a limited services rural hospital (LSRH) provides physical therapy,
				  occupational therapy, audiology, or speech pathology services as outpatient
				  services, the services shall be organized and staffed to ensure the health and
				  safety of patients.
(b) The
				  organization of the services shall be appropriate to the scope of the services
				  offered.
(c) The director of the
				  services shall have the necessary knowledge, experience, and capabilities to
				  properly supervise and administer the services.
(d) Physical therapy, occupational therapy,
				  speech therapy, or audiology services, if provided, shall be provided by staff
				  who meet the qualifications specified by the medical staff, consistent with
				  state law.
(e) Services shall be
				  furnished in accordance with a written plan of treatment. Services to be
				  provided shall be consistent with applicable state laws and regulations, and in
				  accordance with orders of the physician, podiatrist, dentist, or other licensed
				  practitioner who is authorized by the medical staff to order the services.
				  Therapy orders shall be incorporated in the patient's medical record.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 511 - LIMITED SERVICES RURAL HOSPITALS › Subchapter C - OPERATIONAL REQUIREMENTS › Section 511.59 - Infection Prevention and Control and Antibiotic Stewardship Programs

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  limited services rural hospital (LSRH) shall have an infection prevention and
				  control and antibiotic stewardship program that complies with Code of Federal
				  Regulations Title 42 §485.528 to the extent it does not conflict with this
				  chapter and state law.
(b) The
				  facility shall isolate patients with communicable diseases.