reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 565 - HOME AND COMMUNITY-BASED (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS › Subchapter F - CERTIFICATION STANDARDS: QUALITY ASSURANCE › Section 565.33 - Restraints

Current through Reg. 49, No. 28; July 12, 2024
(a) Within 30 calendar
				  days of receiving services from a program provider and annually thereafter, a
				  program provider must:
(1) with the
				  involvement of a physician, identify:
(A) the
				  individual's known physical or medical conditions that might constitute a risk
				  to the individual during the use of restraint;
(B) the individual's ability to communicate;
				  and
(C) other factors that must be
				  taken into account if the use of restraint is considered, including the
				  individual's:
(i) cognitive functioning
				  level;
(ii) height;
(iii) weight;
(iv) emotional condition that could
				  contraindicate the use of restraint, including whether the individual has a
				  history of having been physically or sexually abused; and
(v) age;
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 565 - HOME AND COMMUNITY-BASED (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS › Subchapter F - CERTIFICATION STANDARDS: QUALITY ASSURANCE › Section 565.35 - Enclosed Beds

Current through Reg. 49, No. 28; July 12, 2024
(a) The
program provider may allow the use of an enclosed bed in a residence
				  if the enclosed bed is purchased, obtained, and complies with the requirements
				  in subsection (c) of this section prior to June 19, 2023.
(b) An enclosed bed is prohibited in a
				  residence if it is purchased or obtained on or after June 19, 2023, even if it
				  complies with subsection (c) of this section.
(c) If the program provider allows the use of
				  an enclosed bed in a residence, the program provider must:
(1) visually inspect the enclosed bed to
				  ensure it meets the criteria of an enclosed bed as defined in §
											565.3 of this chapter (related to
				  Definitions);
(2) ensure that a
				  physician, occupational therapist, or physical therapist:
(A) conducts an annual assessment to
				  determine:
(i) if the individual has a medical
				  need for the enclosed bed;
(ii) the
				  circumstances under which the enclosed bed may be used;
(iii) that less restrictive methods would be
				  ineffective in protecting the individual and the reasons for that
				  determination;
(iv) how to use the
				  enclosed bed and any contraindications specific to the individual;
(v) how and when to document the use of the
				  enclosed bed; and
(vi) how to
				  monitor the use of the enclosed bed to ensure it is being used in accordance
				  with the assessment; and
(B) follows up after any significant change
				  to determine if the individual still has a medical need for the enclosed
				  bed;
(3) obtain and
				  retain the following documentation:
(A) a
				  letter of medical necessity from the prescribing physician or professional
				  therapist; and
(B) a receipt from a
				  durable medical equipment company for the enclosed bed;
(4) develop and implement policies and
				  procedures that require:
(A) routine checks of
				  the enclosure bed to ensure it is in good repair and safe for the
				  individual;
(B) a documented
				  quarterly review by a registered nurse (RN) or professional therapist to ensure
				  the enclosed bed is still safe and necessary given the individual's current
				  needs and other less restrictive options available; and
(C) an order for the enclosed bed updated
				  annually, or sooner if the RN has determined there is a significant change to
				  the individual's condition.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 565 - HOME AND COMMUNITY-BASED (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS › Subchapter F - CERTIFICATION STANDARDS: QUALITY ASSURANCE › Section 565.37 - Protective Devices

Current through Reg. 49, No. 28; July 12, 2024
(a) Except as provided
				  in §
										565.35 of this subchapter
				  (relating to Enclosed Beds), if a protective device is used, the program
				  provider must ensure that it is used in accordance with this section.
(b) A program provider must not use a
				  protective device:
(1) to modify or control
				  an individual's behavior;
(2) for
				  disciplinary purposes;
(3) for
				  staff convenience; or
(4) as a
				  substitute for an effective, less restrictive method.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 565 - HOME AND COMMUNITY-BASED (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS › Subchapter F - CERTIFICATION STANDARDS: QUALITY ASSURANCE › Section 565.39 - Prohibitions

Current through Reg. 49, No. 28; July 12, 2024
(a) A program provider
				  must not use seclusion.
(b) An
				  enclosed bed must not be used for behavioral management.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 565 - HOME AND COMMUNITY-BASED (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS › Subchapter G - HHSC ACTIONS › Section 565.41 - HHSC Surveys of a Program Provider

Current through Reg. 49, No. 28; July 12, 2024
(a) A program provider
				  must be in continuous compliance with the certification standards contained in
				  this subchapter that apply to program providers.
(b) The Texas Health and Human Services
				  Commission (HHSC) conducts the following unannounced surveys:
(1) an initial certification
				  survey;
(2) a recertification
				  survey;
(3) a follow-up
				  survey;
(4) a residential survey;
				  and
(5) an intermittent
				  survey.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 565 - HOME AND COMMUNITY-BASED (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS › Subchapter G - HHSC ACTIONS › Section 565.43 - HHSC Approval of Four Person Residences

Current through Reg. 49, No. 28; July 12, 2024
(a) A program provider
				  must obtain written approval from the Texas Health and Human Services
				  Commission (HHSC) in accordance with subsection (b) of this section before
				  providing residential support in a four-person residence.
(b) To obtain approval of a four-person
				  residence, the program provider must submit the following written documentation
				  to HHSC:
(1) the address and county of the
				  residence;
(2) certification from
				  the program provider that the program provider intends to provide residential
				  support to one or more individuals who will live in the residence;
(3) one of the certifications required by
				  §
											565.23(i)(1)(A)
				  of this chapter (relating to Residential Requirements); and
(4) written certification from the program
				  provider that the residence to be approved is not the residence of any person
				  other than a person permitted to live in a "four-person residence," as defined
				  in §
											565.3 of this chapter (relating to
				  Definitions).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 565 - HOME AND COMMUNITY-BASED (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS › Subchapter G - HHSC ACTIONS › Section 565.47 - Amelioration

Current through Reg. 49, No. 28; July 12, 2024
(a) In lieu of
				  requiring payment for an administrative penalty imposed against a program
				  provider in accordance with §
										565.45 of this chapter (relating
				  to Administrative Penalties), the Texas Health and Human Services Commission
				  (HHSC) may give the program provider the opportunity for amelioration in
				  accordance with this section.
(b)
				  HHSC does not give a program provider the opportunity for amelioration:
(1) more than three times in a two-year
				  period;
(2) more than one time in a
				  two-year period for the same or similar violation;
(3) for a critical violation that is an
				  immediate threat; or
(4) for the
				  actions or failures to act described in §
											565.45(a)(2) of
				  this chapter.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 565 - HOME AND COMMUNITY-BASED (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS › Subchapter G - HHSC ACTIONS › Section 565.49 - Program Provider Compliance and Corrective Action

Current through Reg. 49, No. 28; July 12, 2024
(a) If the Texas Health
				  and Human Services Commission (HHSC) determines from a survey that a program
				  provider complies with the certification standards, HHSC:
(1) sends the program provider a final survey
				  report stating that the program provider complies with the certification
				  standards;
(2) does not require any
				  action by the program provider; and
(3) if the survey is an initial or a
				  recertification survey, certifies the program provider as described in §
											565.41(f) of this
				  subchapter (relating to HHSC Surveys of a Program
				  Provider).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 566 - TEXAS HOME LIVING (TXHML) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS › Section 566.1 - Emergency Response System

Current through Reg. 49, No. 28; July 12, 2024
(a) The program
				provider designee must enroll in an emergency communication system in
				accordance with instructions from HHSC.
(b) The program provider designee must
				respond to requests for information received through the emergency
				communication system in the format established by HHSC.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter A - GENERAL PROVISIONS › Section 567.1 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this chapter is to implement Texas Health
					 and Safety Code Chapter 314A, which requires qualifying hospitals seeking to
					 negotiate and enter into a merger agreement to be certified by the Texas Health
					 and Human Services Commission through the issuance of a Certificate of Public
					 Advantage.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter A - GENERAL PROVISIONS › Section 567.2 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this chapter,
					 shall have the following meanings, unless the context clearly indicates
					 otherwise.
(1) Certificate of Public
				  Advantage (COPA)--The written approval by the Texas Health and Human Services
				  Commission (HHSC) that governs a cooperative agreement between hospitals that
				  are party to a merger.
(2)
				  Hospital--A nonpublic general hospital that is licensed under Texas Health and
				  Safety Code Chapter 241 and is not maintained or operated by a political
				  subdivision of this state.
(3)
				  Merger Agreement--An agreement among two or more hospitals for the
				  consolidation by merger, or other acquisition or transfer of assets, by which
				  ownership or control over substantially all the stock, assets, or activities of
				  one or more previously licensed and operating hospitals is placed under the
				  control of another licensed hospital, or hospitals, or another entity that
				  controls the hospitals.
(4) Terms
				  or conditions--Any actions or measures that HHSC may require as a condition for
				  issuing a COPA or allowing continued operation under a COPA.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter A - GENERAL PROVISIONS › Section 567.3 - Applicability

Current through Reg. 49, No. 28; July 12, 2024
This chapter only applies to a merger agreement among
					 hospitals, each of which is located within a county that:
(1) contains two or more hospitals; and
(2) has a population of:
(A) less than 100,000 and is not adjacent to
				  a county with a population of 250,000 or more; or
(B) more than 100,000 and less than 150,000
				  and is not adjacent to a county with a population of 100,000 or more.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter A - GENERAL PROVISIONS › Section 567.4 - Certificate of Public Advantage Required

Current through Reg. 49, No. 28; July 12, 2024
A merger agreement between hospitals may not receive
					 immunity under Texas Health and Safety Code Chapter 314A without a Certificate
					 of Public Advantage.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter A - GENERAL PROVISIONS › Section 567.5 - Compliance

Current through Reg. 49, No. 28; July 12, 2024
(a) Each party to a merger agreement shall
				  comply with Texas Health and Safety Code Chapter 314A (relating to Merger
				  Agreements Among Certain Hospitals), this chapter, and all statutes and rules
				  applicable under the hospital license.
(b) Each hospital operating under a
				  Certificate of Public Advantage shall agree to any ongoing supervision the
				  Texas Health and Human Services Commission may require.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter A - GENERAL PROVISIONS › Section 567.6 - Scope

Current through Reg. 49, No. 28; July 12, 2024
(a) A Certificate of
				  Public Advantage (COPA) is issued for a merger agreement between the parties
				  identified in a COPA application.
(b) A COPA is limited to the parties that
				  apply for a COPA.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter B - APPLICATION AND ISSUANCE › Section 567.21 - Changes That May Affect the Certificate of Public Advantage Application

Current through Reg. 49, No. 28; July 12, 2024
A Certificate of Public Advantage (COPA) applicant shall
					 notify the Texas Health and Human Services Commission of the following in
					 writing no later than five business days after:
(1) cessation of operation of any hospital
				  party to the agreement, and the certificate holder shall include in the written
				  notice the location where the medical records will be stored and the identity
				  and telephone number of the custodian of the medical records;
(2) change in Centers for Medicare and
				  Medicaid Services Certification Number of any hospital party to the
				  agreement;
(3) change to the
				  accrediting organization status of any hospital party to the
				  agreement;
(4) change in hospital
				  name, telephone number, or administrator of any hospital party to the
				  agreement;
(5) pending sale of or
				  change in ownership of any hospital party to the agreement;
(6) bankruptcy filing of any hospital party
				  to the agreement; or
(7) federal
				  antitrust action related to the COPA.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter B - APPLICATION AND ISSUANCE › Section 567.22 - Application

Current through Reg. 49, No. 28; July 12, 2024
(a) The acquiring party
				  in a proposed merger agreement (the applicant) may apply to the Texas Health
				  and Human Services Commission (HHSC) for a Certificate of Public Advantage
				  (COPA) governing the merger agreement.
(b) The acquiring party must submit an
				  application as specified by HHSC and the following information:
(1) the entities party to the proposed merger
				  agreement, including names, addresses, contact information, and licensure and
				  accreditation information;
(2) the
				  specifics of the proposed transaction, including a letter of intent from each
				  party, and alternatives to the merger agreement;
(3) post-transaction governance structure of
				  the merged entity;
(4)
				  post-transaction competition in the market area;
(5) financial strength of the merged
				  entity;
(6) impact of the proposed
				  merger agreement on employees;
(7)
				  the geographic service areas and services offered by each party to the proposed
				  merger agreement, including designations made by the state or other
				  organizations;
(8) quality
				  initiatives for each party to the proposed merger agreement;
(9) physicians, primary care services, and
				  other healthcare services available to the public in the market area;
(10) community health needs;
(11) the condition of the physical plant and
				  equipment of each party to the proposed merger agreement;
(12) financial assistance policies and the
				  amount of uncompensated care provided by each party to the proposed merger
				  agreement;
(13) current hospital
				  rates and third-party reimbursement agreements;
(14) savings from the proposed merger
				  agreement;
(15) benefits of the
				  proposed merger agreement to the public;
(16) public comments regarding the proposed
				  merger agreement; and
(17) any
				  additional information HHSC deems necessary based on the circumstances specific
				  to the application.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter B - APPLICATION AND ISSUANCE › Section 567.23 - Texas Health and Human Services Commission Review

Current through Reg. 49, No. 28; July 12, 2024
Upon reception of a complete application, the Texas Health
					 and Human Services Commission will review the application in accordance with
					 the standards prescribed by Texas Health and Safety Code §
										314A.056 and
					 this chapter.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter B - APPLICATION AND ISSUANCE › Section 567.24 - Attorney General Review

Current through Reg. 49, No. 28; July 12, 2024
The Texas Health and Human Services Commission will
					 consult with the Attorney General regarding each Certificate of Public
					 Advantage application.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter B - APPLICATION AND ISSUANCE › Section 567.25 - Application Fees

Current through Reg. 49, No. 28; July 12, 2024
(a) All application fees
				  shall be paid to the Texas Health and Human Services Commission and are
				  nonrefundable.
(b) The fee for a
				  Certificate of Public Advantage application is $75,000 and must be submitted
				  with the application.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter B - APPLICATION AND ISSUANCE › Section 567.26 - Conditions for Issuing a Certificate of Public Advantage

Current through Reg. 49, No. 28; July 12, 2024
The Texas Health and Human Services Commission (HHSC) will
					 issue a Certificate of Public Advantage (COPA) if:
(1) it determines under the totality of the
				  circumstances that:
(A) the proposed merger
				  would likely benefit the public by maintaining or improving the quality,
				  efficiency, and accessibility of health care services offered to the public;
				  and
(B) the likely benefits
				  resulting from the proposed merger agreement outweigh any disadvantages
				  attributable to a reduction in competition that may result from the proposed
				  merger; and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter C - OPERATIONAL REQUIREMENTS › Section 567.31 - Terms

Current through Reg. 49, No. 28; July 12, 2024
(a) The Texas Health
				  and Human Services Commission (HHSC) may include terms or conditions of
				  compliance in connection with issuing a Certificate of Public Advantage (COPA),
				  if necessary, to ensure that the proposed merger likely benefits the public as
				  specified in this chapter.
(b) A
				  hospital operating under a COPA shall comply with all terms or conditions
				  required in the issuance of a COPA.
(c) Any terms or conditions for a COPA are
				  separate from the COPA itself. HHSC retains the authority to amend the terms or
				  conditions. HHSC shall notify the hospital of any change in the terms or
				  conditions not less than 30 days before the change takes effect.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter C - OPERATIONAL REQUIREMENTS › Section 567.32 - Changes that May Affect the Certificate of Public Advantage

Current through Reg. 49, No. 28; July 12, 2024
A hospital operating under a Certificate of Public
					 Advantage (COPA) shall notify the Texas Health and Human Services Commission of
					 the following in writing no later than five business days after:
(1) cessation of operation of any hospital
				  that was party to the merger agreement, and the certificate holder shall
				  include in the written notice the location where the medical records will be
				  stored and the identity and telephone number of the custodian of the medical
				  records;
(2) change in the Centers
				  for Medicare and Medicaid Services Certification Number of any hospital party
				  to the agreement;
(3) change to the
				  accrediting organization status of any hospital party to the
				  agreement;
(4) change in hospital
				  name, telephone number, or administrator of any hospital party to the
				  agreement;
(5) pending sale of or
				  change in ownership of any hospital party to the agreement;
(6) bankruptcy filing of any hospital party
				  to the agreement; or
(7) federal
				  antitrust action related to the COPA.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter C - OPERATIONAL REQUIREMENTS › Section 567.33 - Annual Public Hearing

Current through Reg. 49, No. 28; July 12, 2024
(a) A hospital operating
				  under a Certificate of Public Advantage (COPA) shall conduct a live, annual
				  public hearing that is held face-to-face either in-person or using synchronous
				  audiovisual interaction between the meeting attendees to obtain input from the
				  public regarding the hospital's COPA.
(1) The
				  public hearing must occur no sooner than one month before and no later than the
				  anniversary of the date the Texas Health and Human Services Commission issued
				  the COPA.
(2) If the hospital
				  operating under the COPA holds the hearing in-person, the hearing shall take
				  place within the geographic service area of the hospital operating under the
				  COPA. The location shall be open to the public.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter C - OPERATIONAL REQUIREMENTS › Section 567.34 - Annual Report

Current through Reg. 49, No. 28; July 12, 2024
(a) No later than 90
				  days after the anniversary of the date the Texas Health and Human Services
				  Commission (HHSC) issued a Certificate of Public Advantage (COPA), each
				  hospital operating under the COPA shall submit an annual report to HHSC. The
				  report must include:
(1) information about the
				  extent of the benefits attributable to the issuance of the COPA;
(2) if applicable, information about the
				  hospital's actions taken:
(A) in furtherance
				  of any commitments made by the parties to the merger; and
(B) to comply with terms imposed by HHSC as a
				  condition for approval of the merger agreement;
(3) a description of the activities conducted
				  by the hospital under the merger agreement;
(4) information relating to the price, cost,
				  and quality of and access to health care for the population served by the
				  hospital; and
(5) any other
				  information required by HHSC to ensure compliance with Texas Health and Safety
				  Code Chapter 314A and this chapter, including information relating to
				  compliance with any terms or conditions for issuance of the COPA.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter C - OPERATIONAL REQUIREMENTS › Section 567.35 - Voluntary Termination

Current through Reg. 49, No. 28; July 12, 2024
In accordance with Texas Health and Safety Code §
										314A.058, a
					 hospital operating under a Certificate of Public Advantage (COPA) approved
					 under this chapter may voluntarily terminate its COPA by giving the Texas
					 Health and Human Services Commission notice at least 30 days before the date of
					 the termination.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter C - OPERATIONAL REQUIREMENTS › Section 567.36 - Supervision Fees

Current through Reg. 49, No. 28; July 12, 2024
In accordance with Texas Health and Safety Code §
										314A.105, the
					 Texas Health and Human Services Commission (HHSC) may assess an annual
					 supervision fee in an amount that is at least $75,000 but not more than
					 $200,000 for each hospital operating under a Certificate of Public Advantage
					 (COPA).
(1) The amount of the annual
				  supervision fee is $100,000 for each hospital operating under the COPA.
				  However, HHSC may decrease this amount to the statutory minimum or increase
				  this amount to the statutory maximum by the amount needed to cover the
				  reasonable costs incurred in supervising hospitals and in implementing and
				  administering Texas Health and Safety Code Chapter 314A and this
				  chapter.
(2) The amount of any
				  increase of the annual supervision fee may not exceed 25% of the previous
				  annual supervision fee.
(3) HHSC
				  shall publish on its website and directly notify each hospital operating under
				  the COPA of the amount of the supervision fee annually and at least 90 days
				  before any increase takes effect.
(4) Each hospital operating under a COPA
				  shall pay the first supervision fee no later than 30 calendar days after the
				  date HHSC issues the COPA.
(5) Each
				  hospital operating under a COPA shall pay each subsequent supervision fee no
				  later than the anniversary of the date HHSC issued the COPA.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter E - ENFORCEMENT › Section 567.51 - Supervision

Current through Reg. 49, No. 28; July 12, 2024
The Texas Health and Human Services Commission will
					 supervise each hospital operating under a Certificate of Public Advantage to
					 ensure that the immunized conduct of a merged entity furthers the purposes of
					 this chapter.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter E - ENFORCEMENT › Section 567.52 - Annual Review

Current through Reg. 49, No. 28; July 12, 2024
(a) Upon receipt of the
				  annual report required by §
										567.34 of this chapter (relating
				  to Annual Report), the Texas Health and Human Services Commission (HHSC) will
				  conduct an annual review of each approved Certificate of Public Advantage
				  (COPA).
(b) Prior to any review,
				  HHSC will ask the Attorney General whether the Attorney General intends to
				  conduct any review of the COPA.
(c)
				  HHSC will not complete an annual review until:
(1) the Attorney General informs HHSC whether
				  that office intends to conduct any review of the COPA; and
(2) the Attorney General has had the
				  opportunity to conduct the review, if needed.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter E - ENFORCEMENT › Section 567.53 - Investigation; Consequences

Current through Reg. 49, No. 28; July 12, 2024
(a) To ensure that the
				  activities of a hospital resulting from a merger agreement continue to benefit
				  the public, the Texas Health and Human Services Commission (HHSC) may:
(1) investigate the hospital's activities;
				  and
(2) require the hospital to
				  perform a certain action or refrain from a certain action or revoke the
				  hospital's certificate of public advantage, if HHSC determines that:
(A) the hospital is not complying with Texas
				  Health and Safety Code Chapter 314A, this chapter, or a term or condition of
				  compliance with the Certificate of Public Advantage (COPA) governing the
				  hospital's immunized activities;
(B) HHSC's approval and issuance of the COPA
				  was obtained as a result of material misrepresentation;
(C) the hospital has failed to pay any fee
				  required under this chapter; or
(D)
				  the benefits resulting from the approved merger no longer outweigh the
				  disadvantages attributable to the reduction in competition resulting from the
				  approved merger.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 567 - CERTIFICATE OF PUBLIC ADVANTAGE › Subchapter E - ENFORCEMENT › Section 567.54 - Corrective Action Plan

Current through Reg. 49, No. 28; July 12, 2024
(a) If the Texas Health
				  and Human Services Commission (HHSC) determines that an activity of a hospital
				  operating under a Certificate of Public Advantage does not benefit the public
				  as described by this chapter or no longer meets the standard prescribed by this
				  chapter, HHSC will notify the hospital that it must adopt a plan to correct any
				  deficiency in the hospital's activities.
(b) No later than 20 calendar days after
				  receipt of notification by HHSC, the hospital shall return a written corrective
				  action plan to HHSC responding to each cited deficiency, including time frame
				  for corrections, together with any additional evidence of compliance.
(c) If HHSC determines the corrective action
				  plan does not sufficiently address each cited deficiency, HHSC will notify the
				  hospital that it must submit a revised corrective action plan. A hospital shall
				  submit a revised corrective action plan no later than 20 calendar days after
				  receipt of notification by HHSC.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter A - GENERAL REQUIREMENTS › Section 568.1 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this chapter is to describe standards to
					 ensure the proper care and treatment of prospective patients and patients in
					 private psychiatric hospitals licensed under Texas Health and Safety Code
					 Chapter 577, and Chapter 510 of this title (relating to Private Psychiatric
					 Hospitals and Crisis Stabilization Units), and in identifiable mental health
					 services units in hospitals licensed under Texas Health and Safety Code Chapter
					 241, and 25 TAC Chapter 133 (relating to Hospital Licensing).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter A - GENERAL REQUIREMENTS › Section 568.2 - Application

Current through Reg. 49, No. 28; July 12, 2024
This chapter applies to:
(1) private psychiatric hospitals licensed
				  under Texas Health and Safety Code Chapter 577 (relating to Private Mental
				  Hospitals and Other Mental Health Facilities) and Chapter 510 of this title
				  (relating to Private Psychiatric Hospitals and Crisis Stabilization Units); and
(2) identifiable mental health
				  services units in hospitals licensed under Texas Health and Safety Code Chapter
				  241 (relating to Hospitals) and 25 TAC Chapter 133 (relating to Hospital
				  Licensing).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter A - GENERAL REQUIREMENTS › Section 568.3 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this chapter,
					 have the following meanings, unless the context clearly indicates
					 otherwise.
(1) Administrator--The
				  individual, appointed by a governing body, who has authority to represent the
				  hospital and, as delegated by the governing body, has responsibility for
				  operating the hospital in accordance with the hospital's written policies and
				  procedures.
(2) Administrator's
				  designee--An individual designated in a hospital's written policies and
				  procedures to act for a specified purpose on behalf of the
				  administrator.
(3) Admission--The
				  acceptance of an individual to a hospital's custody and care for inpatient
				  mental health treatment based on:
(A) a
				  physician's order issued in accordance with § 568.22(f)(2)(B) of this
				  chapter (relating to Voluntary Admission);
(B) a physician's order issued in accordance
				  with § 568.23(c)(3) of this chapter (relating to Emergency
				  Detention);
(C) an order of
				  protective custody issued in accordance with Texas Health and Safety Code
				  §
											574.022;
(D) an order for temporary inpatient mental
				  health services issued in accordance with Texas Health and Safety Code §
											574.034;
(E) an order for extended inpatient mental
				  health services issued in accordance with Texas Health and Safety Code §
											574.035;
(F) an order for commitment issued in
				  accordance with Texas Code of Criminal Procedure Chapters 46B or 46C;
				  or
(G) an order for placement in
				  accordance with Texas Family Code Chapter 55.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter A - GENERAL REQUIREMENTS › Section 568.4 - General Provisions

Current through Reg. 49, No. 28; July 12, 2024
(a) Written
				  policies and procedures. A hospital shall develop written policies and
				  procedures that ensure compliance with this subchapter.
(b) Compliance by staff. All staff members
				  shall comply with this subchapter and the policies and procedures of the
				  hospital required by subsection (a) of this section.
(c) Responsibility of hospital. A hospital
				  shall be responsible for a staff member's compliance with this subchapter and
				  the policies and procedures required by subsection (a) of this
				  section.
(d) Enforcement of
				  policies and procedures. A hospital shall take appropriate measures to ensure a
				  staff member's compliance with this subchapter and the policies and procedures
				  required by subsection (a) of this section.
(e) Implementation of physician orders. A
				  hospital shall implement all orders issued by a physician for a patient or
				  provide adequate written justification for failing to implement the
				  orders.
(f) Physician delegation.
				  Except as provided by § 568.22(h)(3) of this chapter (relating to
				  Voluntary Admission), or other state law as applicable, a physician may
				  delegate any medical service described in this subchapter in accordance with
				  Texas Occupations Code §
										157.001.
(g) Compliance with rules. A hospital shall
				  comply with the following HHSC rules:
(1) 25
				  TAC Chapter 405, Subchapter E (relating to Electroconvulsive Therapy
				  (ECT));
(2) 25 TAC Chapter 415,
				  Subchapter A (relating to Prescribing of Psychoactive Medication);
(3) 25 TAC Chapter 415, Subchapter F
				  (relating to Interventions in Mental Health Services) however, this does not
				  prohibit the use of law enforcement in a situation that sufficiently warrants
				  the need for law enforcement assistance, including to regain safety in the
				  hospital;
(4) 25 TAC Chapter 414,
				  Subchapter I (relating to Consent to Treatment with Psychoactive
				  Medication-Mental Health Services); and
(5) 25 TAC Chapter 404, Subchapter E
				  (relating to Rights of Persons Receiving Mental Health Services).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter A - GENERAL REQUIREMENTS › Section 568.5 - Individuals with a Sole Diagnosis of a Substance-related or Addictive Disorder

Current through Reg. 49, No. 28; July 12, 2024
A hospital shall comply with 25 TAC Chapter 448 (relating
					 to Standard of Care) in admitting, treating, and discharging an individual with
					 a sole diagnosis of a substance-related or addictive
					 disorder.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter B - ADMISSION › Section 568.21 - Admission Criteria

Current through Reg. 49, No. 28; July 12, 2024
A hospital shall develop and implement written admission
					 criteria that:
(1) uniformly apply to
				  all prospective patients;
(2)
				  permit the admission of a prospective patient only if the patient has a mental
				  illness of sufficient severity to require inpatient mental health treatment;
				  and
(3) prevent the admission of a
				  prospective patient who:
(A) requires
				  specialized care not available at the hospital; or
(B) has a physical medical condition that is
				  unstable and could reasonably be expected to require inpatient medical
				  treatment for the condition.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter B - ADMISSION › Section 568.22 - Voluntary Admission

Current through Reg. 49, No. 28; July 12, 2024
(a) A request for
				  voluntary admission:
(1) may be made only by
				  a person authorized to do so under Texas Health and Safety Code §
											572.001;
(2) must be in writing and signed by the
				  individual making the request; and
(3) must include a statement that the
				  individual making the request:
(A) certifies
				  that the individual is legally authorized to act on the prospective patient's
				  behalf;
(B) has provided the
				  facility with documentation demonstrating that the individual is legally
				  authorized to act on the prospective patient's behalf;
(C) agrees that the prospective patient will
				  remain in the hospital until discharged; and
(D) consents to diagnosis, observation, care
				  and treatment of the prospective patient until the earlier of:
(i) the discharge of the prospective patient;
				  or
(ii) the prospective patient is
				  entitled to leave the hospital, in accordance with Texas Health and Safety Code
				  §
													572.004, after a
				  request for discharge is made.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter B - ADMISSION › Section 568.23 - Emergency Detention

Current through Reg. 49, No. 28; July 12, 2024
(a) Acceptance for
				  preliminary examination. In accordance with Texas Health and Safety Code §
										573.021
				  and §
										573.022,
				  a hospital shall accept for a preliminary examination:
(1) an individual who has been transported to
				  a hospital by peace officer or emergency medical services personnel in
				  accordance with Texas Health and Safety Code §
											573.001
				  or §
											573.012;
				  or
(2) an individual who is at
				  least 18 years of age or older and who has been transported to the hospital by
				  the individual's guardian of the person in accordance with Texas Health and
				  Safety Code §
											573.003.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter B - ADMISSION › Section 568.24 - Admission of an Individual under an Order of Protective Custody, for Court-Ordered Inpatient Mental Health Services, or Under Order for Commitment or Order for Placement

Current through Reg. 49, No. 28; July 12, 2024
(a) Requirements
				  for admission under court order. A hospital may admit an individual:
(1) under an order of protective custody only
				  if a court has issued an order in accordance with Texas Health and Safety Code
				  §
											574.022;
(2) for court-ordered inpatient mental health
				  services only if a court has issued:
(A) an
				  order for temporary inpatient mental health services in accordance with Texas
				  Health and Safety Code §
												574.034;
				  or
(B) an order for extended
				  inpatient mental health services in accordance with Texas Health and Safety
				  Code §
												574.035;
(3) under an order for commitment
				  issued in accordance with the Texas Code of Criminal Procedure Chapters 46B or
				  46C; or
(4) under an order for
				  placement issued in accordance with Texas Family Code Chapter 55.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter B - ADMISSION › Section 568.25 - Monitoring Upon Admission

Current through Reg. 49, No. 28; July 12, 2024
At the time a patient is admitted, a hospital shall assign
					 and implement one of the levels of monitoring identified by the hospital in
					 accordance with § 568.67(b) of this chapter (relating to Protection of a
					 Patient), based on the patient's needs.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter B - ADMISSION › Section 568.26 - Voluntary Treatment Following Involuntary Admission

Current through Reg. 49, No. 28; July 12, 2024
A hospital may provide inpatient mental health treatment to
					 an involuntary patient after the patient is eligible for discharge, as
					 described in § 568.84 of this chapter (relating to Discharge of an
					 Involuntary Patient), if before the provision of such treatment:
(1) the hospital obtains written consent for
				  voluntary inpatient mental health treatment that meets the requirements of a
				  request for voluntary admission, as described in § 568.22(a) of this
				  subchapter (relating to Voluntary Admission); and
(2) the patient's treating physician:
(A) examines the patient; and
(B) based on that examination, issues an
				  order for voluntary inpatient mental health treatment that meets the
				  requirements of § 568.22(i) of this subchapter.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter C - EMERGENCY TREATMENTS › Section 568.41 - Responding to an Emergency Medical Condition

Current through Reg. 49, No. 28; July 12, 2024
(a) Planning responses to emergency medical
				  conditions. A hospital shall:
(1) identify
				  potential emergency medical conditions of:
(A) a patient;
(B) a prospective patient; and
(C) an individual who arrives on hospital
				  property, as defined in
				  42
				  CFR §
													489.24(b),
				  requesting examination or treatment for a medical condition; and
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter D - SERVICE REQUIREMENTS › Section 568.61 - Inpatient Mental Health Treatment and Treatment Planning

Current through Reg. 49, No. 28; July 12, 2024
(a) Inpatient mental health treatment. A
				  hospital shall provide inpatient mental health treatment and medical care to a
				  patient under the direction of a physician, in accordance with the highest
				  standards accepted in medical practice, and in accordance with the patient's
				  treatment plan and this subchapter. The treatment plan shall be appropriate to
				  the needs and interests of the patient and be directed toward restoring and
				  maintaining optimal levels of physical and psychological functioning.
(b) Treatment plan content within 24 hours. A
				  hospital, in collaboration with the patient and LAR, when applicable, shall
				  develop and implement a written treatment plan within 24 hours after the
				  patient's admission. If the patient is unable or unwilling to collaborate with
				  the hospital, the circumstances of such inability or unwillingness shall be
				  documented in the patient's medical record.
(1) The treatment plan shall be based on the
				  findings of:
(A) the physical examination
				  described in § 568.62(e)(1)(A) or (B) of this subchapter (relating to
				  Medical Services);
(B) the
				  psychiatric evaluation described in § 568.62(f) of this subchapter;
				  and
(C) the initial nursing
				  assessment described in § 568.63(e) of this subchapter (relating to
				  Nursing Services).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 568 - STANDARDS OF CARE AND TREATMENT IN PSYCHIATRIC HOSPITALS › Subchapter D - SERVICE REQUIREMENTS › Section 568.62 - Medical Services

Current through Reg. 49, No. 28; July 12, 2024
(a) Medical
				  services in treatment plan. A hospital shall provide medical services to a
				  patient in accordance with a treatment plan developed in accordance with §
				  568.61 of this subchapter (relating to Inpatient Mental Health Treatment and
				  Treatment Planning).
(b) Director
				  of psychiatric services. A hospital shall have a director of psychiatric
				  services who directs, monitors, and evaluates the psychiatric services
				  provided.
(c) Qualifications of
				  director of psychiatric services. In accordance with Texas Health and Safety
				  Code §
										577.008,
				  the director of psychiatric services shall be a physician who:
(1) is certified in psychiatry by the
				  American Board of Psychiatry and Neurology or by the American Osteopathic Board
				  of Psychiatry and Neurology; or
(2) has three years of experience as a
				  physician in psychiatry in a "mental hospital" as defined in Texas Health and
				  Safety Code §
											571.003.