| (a) A limited services rural hospital (LSRH) shall
have in effect an agreement with at least one general hospital that
is a level I or level II trauma center as designated by the Texas
Department of State Health Services (DSHS), certified by the Centers
for Medicare & Medicaid Services for the referral and transfer
of patients requiring emergency medical care beyond the capabilities
of the LSRH, and is:
(1) licensed under Texas Health and Safety Code (HSC)
Chapter 241;
(2) maintained or operated by the state or an agency
of the federal government and exempt from licensure under HSC Chapter
241; or
(3) maintained or operated by the federal government
or an agency of the federal government and exempt from licensure under
HSC Chapter 241.
(b) An LSRH shall submit the transfer agreement to
the Texas Health and Human Services Commission (HHSC) for review to
determine whether the agreement meets the requirements of subsection
(a) of this section.
(c) An LSRH may enter into multiple transfer agreements
based on the type or level of medical services available at other
hospitals.
(d) A patient transfer agreement shall include specific
language that is consistent with the following.
(1) HSC Chapter 61 (relating to Indigent Health Care
Treatment Act) in accordance with §511.65(f) of this subchapter
(relating to Patient Transfer Policy);
(2) discrimination in accordance with §511.65(j)
of this subchapter;
(3) patient's right to request a transfer in accordance
with §511.65(k) of this subchapter;
(4) transfer of patients with emergency medical conditions
in accordance with §511.65(n) and (o) of this subchapter;
(5) physician's duties and standard of care in accordance
with §511.65(q) of this subchapter;
(6) medical records in accordance with §511.65(r)
of this subchapter; and
(7) memorandum of transfer in accordance with §511.65(s)
of this subchapter.
(e) In order for HHSC to review the transfer agreements
to determine compliance with the requirements of this section, an
LSRH shall submit the following documents to HHSC:
(1) a copy of the current or proposed agreement signed
by the representatives of the LSRH and the general or special hospital
subject to the agreement;
(2) the agreement's adoption date; and
(3) the agreement's effective date.
(f) HHSC may waive the document submission requirements
under subsection (e) of this section at its sole discretion to avoid
the repetitious submission of required documentation and approved
agreements.
(g) When an LSRH's governing body or governing body's
designee executes a transfer agreement and the text of that agreement
is the same text of a previously HHSC-approved agreement, the governing
body or the governing body's designee is not required to submit the
later agreement for review.
(h) HHSC shall review the patient transfer agreement
not later than 45 calendar days after the date HHSC receives the agreement
to determine whether the agreement complies with the requirements
of this section.
(1) After HHSC's review of the agreement, if HHSC determines
the agreement complies with the requirements contained in this section,
HHSC shall notify the LSRH's administration that HHSC has approved
the agreement.
(2) If after reviewing the agreement, HHSC determines
the agreement is not consistent with the requirements contained in
this section, HHSC shall give notice to the LSRH's administration
that the agreement is deficient and provide recommendations for correction.
(i) HHSC considers a transfer agreement in compliance
with this section if the agreement complies with the rules in effect
at the time the LSRH executed the transfer agreement and HHSC approved
the agreement.
(j) HHSC shall treat complaints alleging a transfer
agreement violation in the same manner as complaints alleging violations
of HSC Chapter 241, Subchapter K (relating to Limited Services Rural
Hospitals) or this chapter.
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