| (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.
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