(a) An applicant who meets the definition of a qualified
rural hospital under §511.2(47) of this chapter (relating to
Definitions) and is seeking a limited services rural hospital (LSRH)
license shall submit the following documents to the Texas Health and
Human Services Commission (HHSC) within 60 calendar days before the
projected opening date of the LSRH:
(1) an accurate and complete application form;
(2) a copy of the LSRH's patient transfer policy, developed
in accordance with §511.65 of this chapter (relating to Patient
Transfer Policy) and signed by both the chairman and secretary of
the LSRH's governing body attesting to the date the governing body
adopted the policy and the policy's effective date;
(3) a copy of the LSRH's memorandum of transfer form
that contains at least the information described in §511.65 of
this chapter;
(4) a copy of a patient transfer agreement entered
into between the LSRH and at least one hospital certified by the Centers
for Medicare & Medicaid Services that is designated as a level
I or level II trauma center in accordance with §511.66 of this
chapter (relating to Patient Transfer Agreements);
(5) a copy of a fire inspection approved by an individual
certified by the Texas Commission on Fire Protection that is dated
no earlier than one year before the application submission date; and
(6) the appropriate license fee as required in §511.17
of this subchapter (relating to Fees).
(b) In addition to the document submittal requirements
in subsection (a) of this section, the applicant must complete the
following before HHSC will issue an LSRH license.
(1) When HHSC requires an architectural inspection,
per HHSC instructions, submit written approval from HHSC confirming
compliance with Subchapters F and G of this chapter (relating to Fire
Prevention and Safety and Physical Plant and Construction Requirements,
respectively).
(A) HHSC requires an architectural inspection when
a qualifying rural hospital that has closed subsequently applies for
an LSRH license.
(B) A hospital applying for an LSRH license after being
closed for 90 days or fewer shall inform HHSC of the entity maintaining
the facility during the closure period, if any, and provide maintenance
and facility condition documentation, such as logbooks and photographs.
HHSC may waive the architectural inspection if HHSC determines the
documentation indicates an acceptable maintenance history and facility
condition.
(C) HHSC may waive the architectural inspection for
a currently operating qualifying rural hospital that applies for an
LSRH license.
(2) If the applicant intends to add on any new services
as an LSRH that the applicant did not offer while licensed as a general
or special hospital, the applicant must comply with Subchapter G of
this chapter as applicable.
(3) The applicant or the applicant's representative
shall attend a prelicensure conference conducted by HHSC. HHSC may
waive the prelicensure conference requirement at its discretion.
(c) Subject to subsection (g) of this section, when
HHSC determines the applicant has complied with subsections (a) and
(b) of this section, HHSC shall issue the LSRH license to the applicant.
(1) The license is effective on the issue date.
(2) The license expires on the last day of the month
two years after the issue date.
(d) If an applicant decides not to continue the application
process for a license, the applicant may withdraw the application.
The applicant shall submit a written withdrawal request to HHSC. HHSC
shall acknowledge receipt of the application withdrawal request.
(e) If the applicant does not complete all requirements
of subsections (a) and (b) of this section within six months after
the date HHSC receives the application and payment, HHSC may deny
the application.
(f) Any fee paid for a withdrawn application under
subsection (d) or (e) of this section is nonrefundable, as indicated
by §511.17(a) of this subchapter.
(g) Denial of a license shall be governed by §511.121
of this chapter (relating to Enforcement).
(h) Once the LSRH is operational and providing services,
HHSC shall conduct an inspection of the LSRH to ascertain compliance
with the provisions of Texas Health and Safety Code Chapter 241 to
the extent it does not conflict with Subchapter K and this chapter.
This inspection may be conducted at the same time as the inspection
to determine compliance with Code of Federal Regulations Title 42,
Part 482 (relating to Conditions of Participation for Hospitals).
(i) An LSRH seeking relocation shall comply with all
requirements of this section, except the prelicensure conference required
under subsection (b)(3) of this section. An initial license for the
relocated facility is effective on the issue date. The previous license
is void on the date the previous location closes. The facility must
notify HHSC once the previous location has closed.
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