reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter C - OPERATIONAL REQUIREMENTS › Section 133.53 - Hospital Price Transparency Reporting and Enforcement

Current through Reg. 49, No. 28; July 12, 2024
(a) A hospital
				  shall comply with the disclosure and reporting requirements of Texas Health and
				  Safety Code (HSC) Chapter 327 (relating to Disclosure of Prices) as described
				  in this section.
(b) In this
				  section, "prominent location" or "prominently displayed" means a size and font
				  at least as large as that of surrounding text, links, or buttons, distinct from
				  the background of the website, immediately viewable upon accessing the home
				  page of the hospital's publicly accessible website without having to
				  scroll.
(c) A hospital shall make
				  the information required by HSC Chapter 327 available in a prominent location
				  on the home page of its publicly accessible website or accessible by selecting
				  a dedicated link that is prominently displayed on the home page of its publicly
				  accessible website. If the facility operates multiple locations and maintains a
				  single website, the homepage must contain a link to the list containing the
				  links to each location the facility operates in a manner that clearly
				  associates the list with the applicable location of the facility.
(d) Each time a hospital updates a list as
				  required by HSC §327.003 and §327.004, it shall submit the updated
				  list to the Texas Health and Human Services Commission (HHSC) in the manner
				  specified by HHSC on its website.
(e) HHSC has jurisdiction to impose an
				  administrative penalty against a hospital licensed under this chapter for
				  violations of HSC Chapter 327 and this section. An administrative penalty
				  imposed under this section shall be in accordance with the provisions of HSC
				  §327.008.
(f) In determining
				  the amount of any penalty sought pursuant to HSC §327.008, HHSC shall
				  consider:
(1) previous violations by the
				  hospital's operator;
(2) the
				  seriousness of the violation;
(3)
				  the demonstrated good faith of the hospital's operator; and
(4) any other matters that justice may
				  require.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter C - OPERATIONAL REQUIREMENTS › Section 133.54 - Hospital at Home Program Application and Operational Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) As defined by Texas Health and Safety
				  Code §
										241.401, and
				  when used in this subchapter, the following words and terms have the following
				  meanings.
(1) "Acute hospital care at home
				  waiver program" means:
(A) the program
				  established by the Centers for Medicare and Medicaid Services under United
				  States Code Title 42 Section 1320b-5 that waives the requirements of
				  42 CFR Sections
				  482.23(b) and (b)(1);
				  and
(B) a successor program to the
				  program described by subparagraph (A) of this paragraph that is established by
				  the United States Congress or the Centers for Medicare & Medicaid
				  Services.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter D - VOLUNTARY AGREEMENTS › Section 133.61 - Hospital Patient Transfer Agreements

Current through Reg. 49, No. 28; July 12, 2024
(a) General provisions.
(1) Transfer agreements between hospitals are
				  voluntary.
(2) Transfer agreements
				  must comply with the transfer policies required under §
											133.44
				  of this title (relating to Hospital Patient Transfer Policy).
(3) The transfer agreement shall be submitted
				  to the Department of State Health Services (department) for review to determine
				  if the agreement meets the requirements of subsection (b) of this
				  section.
(4) Multiple transfer
				  agreements may be entered into by a hospital based upon the type or level of
				  medical services available at other hospitals.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter D - VOLUNTARY AGREEMENTS › Section 133.62 - Cooperative Agreements

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				  cooperative agreement is an agreement among two or more hospitals for the
				  allocation or sharing of health care equipment, facilities, personnel, or
				  services, and may be established in accordance with Health and Safety Code
				  (HSC), Chapter 314.
(b) For
				  purposes of this section only, the term hospital is limited to a general or
				  special hospital licensed under HSC, Chapter 241, or a private mental hospital
				  licensed under HSC, Chapter 577.
(c) A hospital may negotiate and enter into
				  cooperative agreements with other hospitals in the state if the likely benefits
				  resulting from the agreement outweigh any disadvantages attributable to a
				  reduction in competition that may result from the agreements. Acting through
				  their boards of directors, a group of hospitals may conduct discussions or
				  negotiations concerning cooperative agreements, provided that the discussions
				  or negotiations do not involve price fixing or predatory pricing.
(d) Parties to a cooperative agreement may
				  apply to the department for a certification of public advantage governing the
				  cooperative agreement. The application must include the application fee in
				  accordance with §
										133.26(e)
				  of this title (relating to Fees), and a written copy of the cooperative
				  agreement that describes the nature and scope of the cooperation in the
				  agreement and any consideration passing to any party under the agreement. A
				  copy of the application and copies of all additional related materials must be
				  submitted to the attorney general and to the department at the same
				  time.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter E - WAIVER PROVISIONS › Section 133.81 - Waiver Provisions

Current through Reg. 49, No. 28; July 12, 2024
(a) Request for
				  a waiver. A hospital may submit a written request to the director for a waiver
				  or modification of a particular provision of the Texas Hospital Licensing Act
				  (Act) or a minimum standard in this chapter, except fire safety requirements.
				  The written request shall specify the section(s) of the Act or this chapter for
				  which a waiver is requested.
(b)
				  Waiver request requirements. In requesting the waiver, the hospital must
				  address each of the following points and provide documentation as necessary to
				  support their position. The hospital 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 it was determined that
				  granting the waiver would not adversely impact the hospital's participation in
				  the federal Medicare program or accreditation by a Centers for Medicare and
				  Medicaid Services-approved organization;
(3) describe how not granting the waiver
				  would impose an unreasonable hardship on the hospital in providing adequate
				  care for patients;
(4) describe how
				  the waiver would facilitate the creation or operation of the hospital;
				  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 hospital.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter F - INSPECTION AND INVESTIGATION PROCEDURES › Section 133.101 - Inspection and Investigation Procedures

Current through Reg. 49, No. 28; July 12, 2024
(a) Routine inspections. The Department of
				  State Health Services (department) may conduct an inspection of each hospital
				  prior to the issuance or renewal of a hospital license.
(1) A hospital is not subject to routine
				  inspections subsequent to the issuance of the initial license while the
				  hospital maintains:
(A) certification under
				  Title XVIII of the Social Security Act, 42 United States Code (USC),
				  §§1395 et seq; or
(B)
				  accreditation by a Centers for Medicare and Medicaid Services-approved
				  organization.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter F - INSPECTION AND INVESTIGATION PROCEDURES › Section 133.102 - Complaint Against a Department of State Health Services Surveyor

Current through Reg. 49, No. 28; July 12, 2024
(a) A hospital may
				  register a complaint against a Department of State Health Services surveyor who
				  conducts an inspection or investigation in accordance with §
										133.101
				  of this title (relating to Inspection and Investigation Procedures).
(b) A complaint against a surveyor shall be
				  registered with the Patient Quality Care Unit, Department of State Health
				  Services, 1100 West 49th Street, Austin, Texas 78756-3199, telephone (512)
				  834-6650 or (888) 973-0022.
(1) A complaint
				  against a surveyor which is received by telephone will be referred within two
				  working days to the appropriate supervisor. The caller will be requested to
				  submit the complaint in writing.
(2) When a complaint is received in writing,
				  it will be forwarded to the appropriate supervisor within two working days.
				  Within 10 calendar days of receipt of the complaint, the department will inform
				  the complainant in writing that the complaint has been forwarded to the
				  appropriate supervisor.
(3) Within
				  10 calendar days of the supervisor's receipt of the complaint, the supervisor
				  will notify the complainant in writing that an investigation will be
				  done.
(4) The supervisor will
				  review the documentation in the survey packet and interview the surveyor
				  identified in the complaint to obtain facts and assess the objectivity of the
				  surveyor in the surveyor's application of this chapter during the hospital's
				  inspection or investigation.
(5)
				  The supervisor will review the applicable rules, personnel policies, and review
				  the training and qualifications of the surveyor as it relates to the inspection
				  or investigation.
(6) The
				  supervisor will document the investigation. A report of the investigation will
				  be placed in the hospital's file if the complaint and investigation affected
				  the inspection process. A counseling form will be used and placed in the
				  surveyor's personnel file if the complaint relates to personnel
				  performance.
(7) The supervisor
				  shall offer to meet with the complainant to resolve the issue. The surveyor
				  identified in the complaint will participate in the discussion. The resolution
				  meeting may be conducted at the division's office or during an on-site
				  follow-up visit to the hospital.
(8) Changes and deletions will be made to the
				  inspection report, if necessary.
(9) The supervisor will notify the
				  complainant in writing of the status of the investigation within 30 calendar
				  days of the date the supervisor received the complaint.
(10) The supervisor will forward all final
				  documentation to the director of the Patient Quality Care Unit and notify the
				  complainant of the results.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter G - ENFORCEMENT › Section 133.121 - Enforcement Action

Current through Reg. 49, No. 28; July 12, 2024
Enforcement action may be taken for the following
					 reasons.
(1) Denial, suspension or
				  revocation of a license or imposition of an administrative penalty. The
				  department has jurisdiction to enforce violations of the Act or the rules
				  adopted under this chapter. The department may deny, suspend, or revoke a
				  license or impose an administrative penalty if the licensee or applicant:
(A) fails to comply with any provision of
				  Health and Safety Code (HSC), Chapters 241 or 311;
(B) fails to comply with any provision of
				  this chapter (25 Texas Administrative Code, Chapter 133);
(C) fails to comply with a special license
				  condition;
(D) fails to comply with
				  an order of the department or another enforcement procedure under HSC, Chapters
				  241 or 311;
(E) has a history of
				  failure to comply with the rules adopted under this chapter relating to patient
				  environment, health, safety, and rights;
(F) has aided, abetted or permitted the
				  commission of an illegal act;
(G)
				  has committed fraud, misrepresentation, or concealment of a material fact on
				  any documents required to be submitted to the department or required to be
				  maintained by the facility pursuant to the provisions of this
				  chapter;
(H) fails to pay
				  administrative penalties in accordance with HSC, Chapter 241;
(I) fails to implement plans of corrections
				  to deficiencies cited by the department; or
(J) fails to comply with applicable
				  requirements within a designated probation period.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter H - FIRE PREVENTION AND SAFETY REQUIREMENTS › Section 133.141 - Fire Prevention and Protection

Current through Reg. 49, No. 28; July 12, 2024
(a) Fire inspections.
(1) Annual inspection. Approval of the fire
				  protection of a hospital by the local fire department shall be a prerequisite
				  for licensure.
(2) Purpose of
				  inspection. The purpose of these inspections shall be to ascertain and to cause
				  to be corrected any conditions liable to cause fire or violations of any of the
				  provisions or intent of these rules, or of any other applicable ordinances,
				  which affect fire safety in any way.
(3) Hazardous or dangerous conditions or
				  materials. Whenever any of the officers, members, or inspectors of the fire
				  department or bureau of fire prevention find in any building or upon any
				  premises dangerous or hazardous conditions or materials, removal or remedy of
				  dangerous conditions or materials shall be carried out in a manner specified by
				  the head of the local fire department.
(4) Access for inspection. At all reasonable
				  hours, the chief of the fire department, the chief of the bureau of fire
				  prevention, or any of the fire inspectors may enter any building or premises
				  for the purpose of making an inspection or investigation which may be deemed
				  necessary under the provisions of these rules.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter H - FIRE PREVENTION AND SAFETY REQUIREMENTS › Section 133.142 - General Safety

Current through Reg. 49, No. 28; July 12, 2024
(a) Safety
				  committee. Each hospital shall have a multidisciplinary safety committee. The
				  hospital chief executive officer (CEO) shall appoint the chairman and members
				  of the safety committee.
(1) Safety officer.
				  The CEO shall appoint a safety officer who is knowledgeable in safety practices
				  in health care facilities. The safety officer shall be a member of the safety
				  committee, and shall carry out the functions of the safety program.
(2) Safety committee meetings. The safety
				  committee shall meet as required by the chairman, but not less than quarterly.
				  Written minutes of each meeting shall be retained for at least one
				  year.
(3) Safety activities.
(A) Incident reports. The safety committee
				  shall establish an incident reporting system which includes a mechanism to
				  ensure that all incidents recorded in safety committee minutes are evaluated,
				  and documentation is provided to show follow-up and corrective
				  actions.
(B) Safety policies and
				  procedures. Safety policies and procedures for each department or service shall
				  be developed, implemented and enforced.
(C) Safety training and continuing education.
				  Safety training shall be established as part of new employee orientation and in
				  the continuing education of all employees.
(4) Written authority. The authority of the
				  safety committee to take action when conditions exist that are a possible
				  threat to life, health, or building damage, shall be defined in writing and
				  approved by the governing body.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter H - FIRE PREVENTION AND SAFETY REQUIREMENTS › Section 133.143 - Handling and Storage of Gases, Anesthetics, and Flammable Liquids

Current through Reg. 49, No. 28; July 12, 2024
(a) Flammable
				  germicides. If flammable germicides, including alcohol-based products, are used
				  for preoperative surgical skin preparation, the facility must:
(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, must 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) report all occurrences of surgical suite
				  fires to the department in care of the Facility Licensing Group within two
				  business days, 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 133 - HOSPITAL LICENSING › Subchapter I - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 133.161 - Requirements for Buildings in Which Existing Licensed Hospitals Are Located

Current through Reg. 49, No. 28; July 12, 2024
(a) Compliance. All
				  buildings in which existing hospitals licensed by the Department of State
				  Health Services (department) are located shall comply with this subsection.
(1) Minimum fire safety and construction
				  requirements.
(A) Existing licensed hospitals
				  shall meet the requirements for health care occupancies contained in the 1967,
				  1973, 1981, 1985, 1991, 1997, 2000, or 2003 editions of the National Fire
				  Protection Association 101, Life Safety Code, (NFPA 101), the Hospital
				  Licensing Standards/Rules (1969, 1985, or 1998 editions as amended), and the
				  hospital licensing rules under which the buildings or sections of buildings
				  were constructed. 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 hospitals or portions of
				  existing hospitals constructed prior to the adoption of any of the editions of
				  NFPA 101, the Hospital Licensing Standards, and the hospital licensing rules
				  listed in subparagraph (A) of this paragraph, shall comply with this section
				  and Chapter 19, NFPA 101, 2003 edition.
(C) Compliance with the requirements of
				  Chapter 4 of the National Fire Protection Association 101A, Alternative
				  Approaches to Life Safety, 2001 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, 2003 edition.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter I - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 133.162 - New Construction Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) Hospital location. Any proposed new
				  hospital 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 hospital 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 hospitals or additions to existing hospitals shall
				  not be constructed within 150 feet of easement boundaries or setbacks of
				  hazardous underground locations including but not limited to liquid butane or
				  propane, liquid petroleum or natural gas transmission lines, high pressure
				  lines, and not within the easement of high voltage electrical lines.
(B) Fire hazards. New hospitals and additions
				  to existing hospitals 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 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter I - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 133.163 - Spatial Requirements for New Construction

Current through Reg. 49, No. 28; July 12, 2024
(a) Administration and public suite.
(1) Architectural requirements. The following
				  rooms or areas shall be provided.
(A) 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.
(B) 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.
(C) 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. The admission area may be omitted if exclusive bedside registration is
				  used.
(D) General or individual
				  office(s). Office space shall be provided for business transactions, medical
				  and financial records, and administrative and professional staffs.
(E) Multipurpose room(s). Room(s) shall be
				  provided for conferences, meetings, and health education purposes including
				  provisions for showing visual aids.
(F) 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,
				  Life Safety Code, 2003 edition (NFPA 101), §18.3.2. 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; the NFPA website address is http://catalog.nfpa.org.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter I - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 133.165 - Building with Multiple Occupancies

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Multiple hospitals located within one building.
(1) Identifiable location. Each hospital
				  shall conform with all the requirements contained in Chapter 18 of the National
				  Fire Protection Association 101, Life Safety Code, 2003 edition (NFPA 101),
				  relating to New 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, Post Office Box 9101, Quincy, MA 02269-9101
				  or (800) 344-3555.
(A) The guest hospital
				  shall be in one separately contiguous location.
(B) In no case may a person leave the guest
				  hospital, traverse the host hospital, and then reenter the guest hospital to
				  access the remaining portion of the guest hospital.
(C) A connecting stair within the host
				  hospital may be used to connect the vertical contiguous areas of the guest
				  hospital.
(D) A guest hospital may
				  not occupy two or more noncontiguous areas of a host hospital which contain
				  intervening space of the host hospital even if on the same floor.
(E) Construction of the host hospital
				  building shall conform to the requirements of NFPA 101, Chapter 18, and the
				  building shall be fully sprinklered.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter I - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 133.166 - Mobile, Transportable, and Relocatable Units

Current through Reg. 49, No. 28; July 12, 2024
(a) Definitions.
(1) Mobile unit--Any pre-manufactured
				  structure, trailer, or self-propelled unit equipped with a chassis on wheels
				  and intended to provide shared medical services to the community on a temporary
				  basis. Some of these units are equipped with expanding walls and designed to be
				  moved on a daily basis.
(2)
				  Relocatable unit--Any structure, not on wheels, that is built to be relocated
				  at any time and provide medical services. These structures vary in
				  size.
(3) Transportable unit--Any
				  pre-manufactured structure or trailer, equipped with a chassis on wheels,
				  intended to provide shared medical services to the community on an extended
				  temporary basis. These units are designed to be moved periodically, depending
				  on need.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter I - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 133.167 - Preparation, Submittal, Review and Approval of Plans, and Retention of Records

Current through Reg. 49, No. 28; July 12, 2024
(a) General.
(1) Hospital owners/operators may 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 hospital owner/operator of the result of its review
				  of each type of submission discussed in this section.
(5) The hospital 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 hospital owner/operator shall request inspections in accordance
				  with §
											133.168
				  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, plan review fee, and functional program narrative.
(8) The hospital 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. Plan review fees
				  are nonrefundable.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter I - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 133.168 - 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 plan review fee
				  according to the plan review schedule in §
											133.26 of this
				  title (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 hospital 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 133 - HOSPITAL LICENSING › Subchapter I - PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS › Section 133.169 - Tables

Current through Reg. 49, No. 28; July 12, 2024
(a) Table 1. Sound
				  transmission limitations in hospitals.
Attached
					 Graphic
(b)
				  Table 2. Flame spread and smoke production limitations for interior finishes.
Attached
					 Graphic
(c)
				  Table 3. Ventilation requirements for hospitals and outpatient 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
(g)
				  Table 7. Nurses Calling Systems.
Attached
					 Graphic
(h)
				  Table 8. Multiple Bed Room Configurations.
Attached
					 Graphic
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter J - HOSPITAL LEVEL OF CARE DESIGNATIONS FOR NEONATAL CARE › Section 133.181 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this section is to implement Texas Health
					 and Safety Code, Chapter 241, Subchapter H, Hospital Level of Care Designations
					 for Neonatal and Maternal Care, which requires a level of care designation of
					 neonatal services to be eligible to receive reimbursement through the Medicaid
					 program for neonatal services.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter J - HOSPITAL LEVEL OF CARE DESIGNATIONS FOR NEONATAL CARE › Section 133.182 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this
					 subchapter, have the following meanings, unless the context clearly indicates
					 otherwise.
(1) Attestation--A written
				  statement, signed by the chief executive officer of the facility, verifying the
				  results of a self-survey represent a complete and accurate assessment of the
				  facility's capabilities required in this subchapter.
(2) Available--Relating to staff who can be
				  contacted for consultation at all times without delay.
(3) Birth weight--The weight of the neonate
				  recorded at time of birth.
(A) Low birth
				  weight--Birth weight less than 2500 grams (5 lbs., 8 oz.);
(B) Very low birth weight (VLBW)--Birth
				  weight less than 1500 grams (3 lbs., 5 oz.); and
(C) Extremely low birth weight (ELBW)--Birth
				  weight less than 1000 grams (2 lbs., 3 oz.).
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter J - HOSPITAL LEVEL OF CARE DESIGNATIONS FOR NEONATAL CARE › Section 133.183 - General Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) The department
				  reviews the applicant documents and approves the appropriate level of facility
				  designation.
(b) A facility is
				  defined under this subchapter as a single location where inpatients receive
				  hospital services; or each location, if there are multiple buildings where
				  inpatients receive hospital services and are covered under a single hospital
				  license.
(c) Each location must be
				  considered separately for designation and the department approves the
				  designation level for each location based on the location's ability to
				  demonstrate designation criteria are met. A stand-alone children's facility
				  that does not provide obstetrical services is exempt from obstetrical
				  requirements.
(d) The department
				  determines requirements for the levels of neonatal designation. Facilities
				  seeking Levels II, III, and IV neonatal designation must meet
				  department-approved requirements validated by a department-approved survey
				  organization.
(e) Facilities
				  seeking Level I neonatal designation must submit a self-survey and attest to
				  meeting department-approved requirements.
(f) The four levels of neonatal designation
				  are:
(1) Level I (Well Care). The Level I
				  neonatal designated facility must:
(A) provide
				  care for mothers and their infants of generally more than or equal to 35 weeks
				  gestational age who have routine, transient perinatal problems;
(B) have skilled medical staff and personnel
				  with documented training, competencies, and annual continuing education
				  specific for the patient population served; and
(C) provide the same level of care that the
				  neonate would receive at a higher-level designated neonatal facility and
				  complete an in-depth critical review and assessment of the care provided to
				  these infants through the neonatal QAPI Plan and process if an infant less than
				  35 weeks gestational age is retained.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter J - HOSPITAL LEVEL OF CARE DESIGNATIONS FOR NEONATAL CARE › Section 133.184 - Designation Process

Current through Reg. 49, No. 28; July 12, 2024
(a) A facility
				  seeking neonatal designation or renewal of designation must submit a completed
				  application packet.
(1) The completed
				  application packet includes:
(A) an accurate
				  and complete neonatal designation application for the requested level of
				  designation;
(B) a completed
				  neonatal attestation and self-survey report for Level I applicants, or the
				  documented neonatal designation site survey summary that validates the
				  department requirements are met and the medical record reviews for Levels II,
				  III and IV applicants, submitted to the department no later than 90 days after
				  the neonatal designation site survey date;
(C) if the facility has three or more
				  department-approved designation requirements that are defined as not met in the
				  neonatal designation site survey summary, the facility must contact the
				  department's designation unit within 10 business days to discuss the Plan of
				  Correction (POC);
(D) the POC, if
				  required by the department, which must include:
(i) a statement of the cited designation
				  requirement not met;
(ii) a
				  statement describing the corrective action taken by the facility seeking
				  neonatal designation to meet the requirement;
(iii) the title of the individuals
				  responsible for ensuring the corrective actions are implemented;
(iv) the date the corrective actions were
				  implemented;
(v) how the corrective
				  actions will be monitored; and
(vi)
				  documented evidence that the POC was implemented within 90 days of the
				  designation survey;
(E)
				  written evidence of annual participation in the applicable PCRs; and
(F) any subsequent documents submitted by the
				  date requested by the department.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter J - HOSPITAL LEVEL OF CARE DESIGNATIONS FOR NEONATAL CARE › Section 133.186 - Neonatal Designation Level I

Current through Reg. 49, No. 28; July 12, 2024
(a) Level I (Well
				  Care). The Level I neonatal designated facility must:
(1) provide care for mothers and their
				  infants of generally more than or equal to 35 weeks gestational age who have
				  routine, transient perinatal problems;
(2) have skilled medical staff and personnel
				  with documented training, competencies, and annual continuing education
				  specific for the patient population served; and
(3) provide the same level of care that the
				  neonate would receive at a higher-level designated neonatal facility and
				  complete an in-depth critical review and assessment of the care provided to
				  these infants through the neonatal QAPI Plan and process if an infant less than
				  35 weeks gestational age is retained.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter J - HOSPITAL LEVEL OF CARE DESIGNATIONS FOR NEONATAL CARE › Section 133.187 - Neonatal Designation Level II

Current through Reg. 49, No. 28; July 12, 2024
(a) Level II
				  (Special Care). The Level II neonatal designated facility must:
(1) provide care for mothers and their
				  infants of generally more than or equal to 32 weeks gestational age and birth
				  weight more than or equal to 1500 grams who have physiologic immaturity or
				  problems that are expected to resolve rapidly and are not anticipated to
				  require subspecialty services on an urgent basis; and
(A) if a facility is located more than 75
				  miles from the nearest Level III or IV designated neonatal facility and retains
				  a neonate less than 32 weeks of gestation or having a birth weight of less than
				  1500 grams, the facility must provide the same level of care that the neonate
				  would receive at a higher-level designated neonatal facility; and
(B) any facility that retains a neonate less
				  than 32 weeks of gestation or a birth weight less than 1500 grams, must,
				  through the neonatal QAPI Plan, complete an in-depth critical review and
				  assessment of the care provided;
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter J - HOSPITAL LEVEL OF CARE DESIGNATIONS FOR NEONATAL CARE › Section 133.188 - Neonatal Designation Level III

Current through Reg. 49, No. 28; July 12, 2024
(a) Level III
				  (Neonatal Intensive Care). The Level III neonatal designated facility must:
(1) provide care for mothers and
				  comprehensive care for their infants of all gestational ages with mild to
				  critical illnesses or requiring sustained life support;
(2) ensure access to consultation to a full
				  range of pediatric medical subspecialists and pediatric surgical specialists,
				  and the capability to perform major pediatric surgery on-site or at another
				  appropriate neonatal designated facility;
(3) have skilled medical staff and personnel
				  with documented training, competencies, and annual continuing education
				  specific for the patient population served;
(4) facilitate neonatal transports;
				  and
(5) provide outreach education
				  related to trends identified through the neonatal QAPI Plan, specific requests,
				  and system needs to lower-level neonatal designated facilities, and as
				  appropriate and applicable, to non-designated facilities, birthing centers,
				  independent midwife practices, and prehospital providers.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter J - HOSPITAL LEVEL OF CARE DESIGNATIONS FOR NEONATAL CARE › Section 133.189 - Neonatal Designation Level IV

Current through Reg. 49, No. 28; July 12, 2024
(a) Level IV
				  (Advanced Neonatal Intensive Care). The Level IV neonatal designated facility
				  must:
(1) provide care for the mothers and
				  comprehensive care for their infants of all gestational ages with the most
				  complex and critical medical and surgical conditions or requiring sustained
				  life support;
(2) ensure access to
				  a comprehensive range of pediatric medical subspecialists and pediatric
				  surgical subspecialists are available to arrive on-site in person for
				  consultation and care, and the capability to perform major pediatric surgery
				  including the surgical repair of complex conditions on-site;
(3) have skilled medical staff and personnel
				  with documented training, competencies, and annual continuing education
				  specific for the patient population served;
(4) facilitate neonatal transports;
				  and
(5) provide outreach education
				  related to trends identified through the neonatal QAPI Plan, specific requests,
				  and system needs to lower-level neonatal designated facilities, and as
				  appropriate and applicable, to non-designated facilities, birthing centers,
				  independent midwife practices, and prehospital providers.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter J - HOSPITAL LEVEL OF CARE DESIGNATIONS FOR NEONATAL CARE › Section 133.190 - Survey Team

Current through Reg. 49, No. 28; July 12, 2024
(a) The survey team
				  composition must be as follows:
(1) Level I
				  facilities neonatal program staff must conduct a self-survey, documenting the
				  findings on the approved department survey form. The department may
				  periodically require validation of the survey findings by an on-site review
				  conducted by department staff.
(2)
				  Level II facilities must be surveyed by a multidisciplinary team that includes,
				  at a minimum, one neonatologist and one neonatal nurse who:
(A) have completed a department survey
				  training course;
(B) have observed
				  a minimum of one neonatal survey;
(C) are currently active in the management of
				  neonatal patients and active in the neonatal QAPI Plan and process at a
				  facility providing the same or a higher-level of neonatal care; and
(D) meet the criteria outlined in the
				  department survey guidelines.
(3) Level III facilities must be surveyed by
				  a multidisciplinary team that includes, at a minimum, one neonatologist, one
				  neonatal nurse, and a pediatric surgeon when neonatal surgery is performed in
				  the facility, who:
(A) have completed a survey
				  training course;
(B) have observed
				  a minimum of one neonatal survey;
(C) are currently active in the management of
				  neonatal patients and active in the neonatal QAPI Plan and process at a
				  facility providing the same or a higher-level of neonatal care; and
(D) meet the criteria outlined in the
				  department survey guidelines.
(4) Level IV facilities must be surveyed by a
				  multidisciplinary team that includes, at a minimum, one neonatologist, one
				  neonatal nurse, and one pediatric surgeon, who:
(A) have completed a survey training
				  course;
(B) have observed a minimum
				  of one neonatal survey;
(C) are
				  currently active in the management of neonatal patients and active in the
				  neonatal QAPI Plan and process at a facility providing the same level of
				  neonatal care; and
(D) meet the
				  criteria outlined in the department survey guidelines.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter J - HOSPITAL LEVEL OF CARE DESIGNATIONS FOR NEONATAL CARE › Section 133.191 - Perinatal Care Regions (PCRs)

Current through Reg. 49, No. 28; July 12, 2024
(a) The PCR must
				  consider and facilitate transfer agreements through regional
				  coordination.
(b) The PCR must
				  coordinate regional perinatal system QAPI reviews.
(c) The PCRs must not restrict patient
				  referrals.
(d) The PCR integrates
				  with the Regional Advisory Council (RAC) system plans to ensure there is a
				  written perinatal system plan specific to the regional area utilizing the RAC
				  criteria and self-assessment tools.
(e) The PCRs must be administratively
				  supported by the RAC and must have fair and equitable representation on the
				  board of the applicable RAC.
(f)
				  Each PCR may define data needs for regional collaboratives.
Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 133 - HOSPITAL LICENSING › Subchapter K - HOSPITAL LEVEL OF CARE DESIGNATIONS FOR MATERNAL CARE › Section 133.201 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this subchapter is to implement Texas Health
					 and Safety Code, Chapter 241, Subchapter H, Hospital Level of Care Designations
					 for Neonatal and Maternal Care, which requires a level of care designation of
					 maternal services to be eligible to receive reimbursement through the Medicaid
					 program for maternal services.