| (a) A limited services rural hospital (LSRH) may submit
a written request to the Texas Health and Human Services Commission
(HHSC) for a waiver or modification of a particular provision of Texas
Health and Safety Code (HSC) Chapter 241 (relating to Hospitals) or
a standard in this chapter, except fire safety requirements. The written
request shall specify the section or sections of HSC Chapter 241 or
this chapter for which the LSRH is requesting a waiver.
(b) In requesting the waiver, the LSRH must address
each of the following requirements and provide documentation as necessary
to support its position. The LSRH must:
(1) provide evidence to support why the requested waiver
will not adversely affect the health and safety of the hospital patients,
employees, or the general public;
(2) indicate how the LSRH determined that granting
the waiver would not adversely impact the LSRH's participation in
the federal Medicare program or accreditation by a Centers for Medicare &
Medicaid Services-approved organization;
(3) describe how not granting the waiver would impose
an unreasonable hardship on the LSRH in providing adequate care for
patients;
(4) describe how the waiver would facilitate creating
or operating the LSRH; and
(5) explain why the waiver would be appropriate when
balanced against the best interests of the individuals served or to
be served by the LSRH.
(c) The LSRH must submit supporting documentation with
the waiver request. HHSC may request additional written documentation
from the LSRH to support the waiver or modification.
(d) In accordance with HSC §241.302(f) (relating
to License Required), HHSC may grant a waiver under this section if
HHSC determines the waiver or modification will facilitate creating
or operating the LSRH and that the waiver or modification is in the
best interests of the individuals served or to be served by the LSRH.
(e) The HHSC Health Care Regulation licensing director
("licensing director") shall submit a written recommendation for granting
or denying the waiver to the HHSC executive commissioner or designee.
(f) If the licensing director recommends that the waiver
or modification be granted, the executive commissioner may issue a
written order granting the waiver or modification.
(g) If the licensing director recommends that the waiver
or modification be denied, the executive commissioner may issue a
written order denying the waiver or modification.
(h) The LSRH's licensing file maintained by HHSC shall
contain a copy of the request, any supporting documents the LSRH provided,
and the order. The LSRH shall maintain the original order in their
permanent records.
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