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RULE §511.54General Outpatient Requirements

(a) In addition to providing emergency services and observation care, a limited services rural hospital (LSRH) may provide outpatient and medical health diagnostic and therapeutic items and services that are commonly furnished in a physician's office or at another entry point into the health care delivery system that include: radiology, laboratory, outpatient rehabilitation, surgical, maternal health, and behavioral health services. If an LSRH provides additional outpatient and medical health diagnostic and therapeutic items and services, the LSRH shall comply with the requirements of this section.

(b) The outpatient and medical health diagnostic and therapeutic items and services the LSRH provides shall:

  (1) align with the health needs of the community served by the LSRH; and

  (2) be appropriately organized and meet the needs of the patients in accordance with acceptable standards of practice.

(c) The LSRH shall:

  (1) provide items and services based on nationally recognized guidelines and standards of practice;

  (2) have a system in place for referral from the LSRH to different levels of care, including follow-up care, as appropriate;

  (3) have effective communication systems in place between the LSRH and the patient (or responsible individual) and their family, ensuring that the LSRH is responsive to their needs and preferences;

  (4) have established relationships with hospitals that have the resources and capacity available to deliver care that is beyond the scope of care delivered at the LSRH; and

  (5) have personnel providing these services who meet the requirements in subsection (d) of this section.

(d) The LSRH shall meet the following personnel requirements for outpatient services.

  (1) The LSRH shall assign one or more individuals to be responsible for outpatient services.

  (2) The LSRH shall have appropriate professional and nonprofessional personnel available at each location where outpatient services are offered, based on the scope and complexity of outpatient services.

  (3) For any specialty services offered at the LSRH, the LSRH shall have a physician, advanced practice registered nurse, or physician assistant providing services with experience and training in the specialty service area and in accordance with their scope of practice.

(e) Outpatient medical and health services shall be ordered by a practitioner who is:

  (1) responsible for the care of the patient for whom the practitioner is ordering the services;

  (2) licensed in the state of Texas;

  (3) acting within their scope of practice under state law;

  (4) authorized, in accordance with state law and policies adopted by the medical staff; and

  (5) approved by the governing body, to order the applicable outpatient services and either:

    (A) appointed to the LSRH's medical staff and who have been granted privileges to order the applicable outpatient services; or

    (B) not appointed to the medical staff, but who satisfy the requirements for authorization by the medical staff and the LSRH for ordering the applicable outpatient services for their patients.

Source Note: The provisions of this §511.54 adopted to be effective October 5, 2023, 48 TexReg 5668

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