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RULE §511.112Inspections

(a) The Texas Health and Human Services Commission (HHSC) may inspect a limited services rural hospital (LSRH) before issuing or renewing an LSRH license.

  (1) An LSRH is not subject to additional annual licensing inspections after HHSC issues the initial license while the LSRH maintains:

    (A) certification under Title XVIII of the Social Security Act, 42 United States Code (USC), §§1395 et seq; or

    (B) accreditation from The Joint Commission, the American Osteopathic Association, or other national accreditation organization for the offered services.

  (2) HHSC may inspect an LSRH that is exempt from an annual licensing inspection under paragraph (1) of this subsection before issuing a renewal license to the LSRH if the certification or accreditation body has not conducted an on-site inspection of the LSRH in the preceding three years and HHSC determines an inspection of the LSRH by the certification or accreditation body is not scheduled within 60 days of the license expiration date.

(b) HHSC may conduct an unannounced, on-site inspection of an LSRH at any reasonable time, including when treatment services are provided, to inspect, investigate, or evaluate compliance with or prevent a violation of:

  (1) any applicable statute or rule;

  (2) an LSRH's plan of correction;

  (3) an order or special order of the executive commissioner or the executive commissioner's designee;

  (4) a court order granting injunctive relief; or

  (5) for other purposes relating to regulation of the LSRH.

(c) An applicant or licensee, by applying for or holding a license, consents to entry and inspection of any of its LSRHs by HHSC.

(d) HHSC inspections to evaluate an LSRH's compliance may include:

  (1) initial, change of ownership, or relocation inspections, which HHSC may conduct when issuing a new license;

  (2) inspections related to changes in status, such as new construction or changes in services, designs, or patient station numbers;

  (3) routine inspections, which HHSC may conduct without notice and at HHSC's discretion, or before HHSC renews an LSRH license;

  (4) follow-up on-site inspections, which HHSC may conduct to evaluate implementation of a plan of correction for previously cited deficiencies;

  (5) inspections to determine whether an unlicensed LSRH is offering or providing, or purporting to offer or provide, treatment or services; and

  (6) entry in conjunction with any other federal, state, or local agency's entry.

(e) An LSRH shall cooperate with any HHSC inspection and shall permit HHSC to examine the LSRH's grounds, buildings, books, records, video surveillance, and other documents and information maintained by or on behalf of the LSRH.

(f) An LSRH shall permit HHSC access to interview members of the governing body, personnel, and patients, including the opportunity to request a written statement.

(g) An LSRH shall permit HHSC to inspect and copy any requested information, unless prohibited by law.

(h) HHSC shall maintain the confidentiality of LSRH records as applicable under state or federal law. All information and materials obtained or compiled by HHSC in connection with an inspection are confidential and not subject to disclosure under Texas Government Code Chapter 552 (relating to Public Information), and not subject to disclosure, discovery, subpoena, or other means of legal compulsion for their release to anyone other than HHSC or its employees or agents involved in the enforcement action except that this information may be disclosed to:

  (1) persons involved with HHSC in the enforcement action against the LSRH;

  (2) the LSRH that is the subject of the enforcement action, or the LSRH's authorized representative;

  (3) appropriate state or federal agencies that are authorized to inspect, survey, or investigate LSRH services;

  (4) law enforcement agencies; and

  (5) persons engaged in bona fide research, if all individual-identifying and LSRH-identifying information has been deleted.

(i) The following information is subject to disclosure in accordance with Texas Government Code Chapter 552:

  (1) a notice of alleged violation against the LSRH, which notice shall include the provisions of law that the LSRH is alleged to have violated, and a general statement of the nature of the alleged violation;

  (2) the pleadings in the administrative proceeding;

  (3) a final decision or order by HHSC; and

  (4) any other information required by law to be disclosed under public information request laws.

Source Note: The provisions of this §511.112 adopted to be effective October 5, 2023, 48 TexReg 5668

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