| exception, with a specific
timeline based on the public interest, or deny the exception. If the
facility is not granted an exception, or it is not compliant to the
requirements at the end of the exception period, the department shall
elect one of the following:
(A) re-designate the facility at the level appropriate
to its revised capabilities; or
(B) accept the facility's surrender of its stroke facility
designation certificate and designation award letter after the requirements
in subsection (k) of this section have been completed.
(j) An application for a higher or lower level of stroke
facility designation may be submitted to the department at any time.
(1) A designated stroke facility that is increasing
its stroke capabilities may choose to apply for a higher level of
designation at any time. The facility must follow the designation
process as described in subsection (g)(1) of this section to apply
for the higher level.
(2) A designated stroke facility that is unable to
maintain compliance with the facility's current level of stroke designation
may choose to apply for a lower level of designation at any time.
(k) If the facility chooses to relinquish its stroke
facility designation, the facility shall provide a 30 days written,
advance notice prior to the relinquishment of the designation to the
department, the applicable RACs, EMS providers, and health care facilities
it customarily transfers-out or transfers-in stroke patients. The
facility is responsible to continue providing stroke care services
and ensure that stroke care continuity for the region remains in place
for the 30 days following the notice of relinquishing its stroke designation.
(l) A hospital shall not use or authorize the use of
any public communication or advertising containing false, misleading,
or deceptive claims regarding its stroke designation status. Public
communication or advertising shall be deemed false, misleading, or
deceptive if the facility uses these terms:
(1) "stroke facility," "stroke hospital," "stroke center,"
or similar terminology and the facility is not currently designated
as a stroke facility in accordance with this section; or
(2) "comprehensive Level I stroke center," "advanced
Level II stroke center," "primary Level III stroke center," "acute
stroke ready Level IV center," or similar terminology in its signs,
advertisements or in the printed materials the facility provides to
the public, unless the hospital is currently designated at that defined
level of stroke facility in accordance with this section.
(m) The department has the right to review, inspect,
evaluate, and audit all stroke patient records, stroke multidisciplinary
QAPI plan documents, and peer review activities, as well as, any other
documents relevant to stroke care in a designated stroke facility
or facility seeking stroke facility designation at any time to verify
compliance with the Texas Health and Safety Code, Chapter 773 and
(n) The department maintains confidentiality of such
records to the extent authorized by Texas Government Code, Chapter
(o) Stroke designation site review of the hospital
applying for stroke facility designation will be scheduled with the
department-approved survey organization and follow the department
(p) The department may deny, suspend, or revoke a stroke
facility designation if a designated stroke facility ceases to provide
services to meet or maintain compliance with the requirements of this
section or if it violates the Chapter 133 of this title, concerning
requirements resulting in enforcement action.