(a)Based on Texas Health and Safety Code (HSC) Chapter
241, Subchapter K (relating to Limited Services Rural Hospital), as
added by Senate Bill 1621, 86th Legislature, Regular Session, 2019,
the Texas Health and Human Services Commission (HHSC) adopts this
emergency rule to establish requirements for qualified rural hospitals
to apply to HHSC for a limited services rural hospital (LSRH) license
and forego any conflicting inpatient license and operational requirements,
to protect public health and safety of rural communities until HHSC
adopts standard rules for LSRH licensure in the Texas Administrative
(b)To the extent this emergency rule conflicts with
Texas Administrative Code Title 25 (25 TAC) Chapter 133 (relating
to Hospital Licensing), this emergency rule controls.
(c)In this section, "qualified rural hospital" means
a hospital that meets the requirements to be designated as a rural
emergency hospital under the Code of Federal Regulations Part 42 (42
CFR) §485.502 (relating to Definitions), and §485.506 (relating
to Designation and Certification of REHs) that is currently licensed
under HSC Chapter 241 (relating to Hospitals); and is:
(1)located in a rural area, as defined by United State
Code Title 42 Section 1395ww(d)(2)(D); or
(2)designated by the Centers for Medicare and Medicaid
Services as a critical access hospital, rural referral center, or
sole community hospital.
(d)Notwithstanding the licensing and operational requirements
in 25 TAC Chapter 133, a qualified rural hospital may apply to HHSC
for an LSRH license using a form prescribed by HHSC as described on
the HHSC website.
(e)The presurvey conference and architectural and
compliance inspections under 25 TAC §133.22 (relating to Application
and Issuance of Initial License) are not required for licensure under
this emergency rule.
(f)If HHSC approves a hospital's LSRH application,
HHSC will issue the hospital an LSRH license with the same expiration
date as the hospital's current license and the hospital's existing
license becomes void.
(g)An LSRH shall comply with the following:
(1)42 CFR Part 485, Subpart E (relating to Conditions
of Participation: Rural Emergency Hospitals (REHs));
(2)25 TAC §133.44 (relating to Hospital Patient
Transfer Policy); and
(3)25 TAC §133.61 (relating to Hospital Patient
(h)In addition to the conditions of participation
(CoPs) at 42 CFR Part 485, Subpart E, the hospital shall comply with
25 TAC Chapter 133 to the extent it does not conflict with the CoPs.
(i)An LSRH licensed under this section shall comply
with 25 TAC §133.23 (relating to Application and Issuance of
Renewal License). The renewal licensure fee shall be the amount the
hospital previously paid for its most recent hospital license.
The agency certifies that legal counsel has reviewed
the emergency adoption and found it to be within the state agency's
legal authority to adopt.
Filed with the Office
of the Secretary of State on January 13, 2023
Health and Human Services Commission
January 13, 2023
Expiration date: May 12, 2023
For further information, please call: (512) 834-4591