CHAPTER 222. HEALTH CARE FACILITY SURVEY, CONSTRUCTION, INSPECTION, AND REGULATION

State Codes and Statutes

Statutes > Texas > Health-and-safety-code > Title-4-health-facilities > Chapter-222-health-care-facility-survey-construction-inspection-and-regulation

HEALTH AND SAFETY CODE

TITLE 4. HEALTH FACILITIES

SUBTITLE A. FINANCING, CONSTRUCTING, AND INSPECTING HEALTH

FACILITIES

CHAPTER 222. HEALTH CARE FACILITY SURVEY, CONSTRUCTION,

INSPECTION, AND REGULATION

SUBCHAPTER A. SURVEY AND CONSTRUCTION OF HOSPITALS

Sec. 222.001. SHORT TITLE. This subchapter may be cited as the

Texas Hospital Survey and Construction Act.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 222.002. DEFINITIONS. In this subchapter:

(1) "Board" means the Texas Board of Health.

(2) "Commissioner" means the commissioner of health.

(3) "Department" means the Texas Department of Health.

(4) "Hospital" includes a public health center, a general

hospital, or a tuberculosis, mental, chronic disease, or other

type of hospital, and related facilities such as a laboratory,

outpatient department, nurses' home and training facility, or

central service facility operated in connection with a hospital.

(5) "Public health center" means a publicly owned facility for

providing public health services and includes related facilities

such as a laboratory, clinic, or administrative office operated

in connection with a facility for providing public health

services.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 222.003. EXCEPTION. This subchapter does not apply to a

hospital furnishing primarily domiciliary care.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 222.004. DIVISION OF HOSPITAL SURVEY AND CONSTRUCTION. (a)

The division of hospital survey and construction is a division

of the department.

(b) The division is administered by a full-time salaried

director appointed by the commissioner and under the supervision

and direction of the board.

division.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 222.005. SURVEY, PLANNING, AND CONSTRUCTION OF HOSPITALS.

(a) The department, through the division of hospital survey and

construction, is the only agency of the state authorized to make

an inventory of existing hospitals, survey the need for

construction of hospitals, and develop a program of hospital

construction as provided by the federal Hospital Survey and

Construction Act (42 U.S.C. Section 291 et seq.).

(b) The board may establish methods of administration and adopt

rules to meet the requirements of the federal Hospital Survey and

Construction Act relating to survey, planning, and construction

of hospitals and public health centers.

(1) require reports, make inspections and investigations, and

prescribe rules as the commissioner considers necessary; and

(2) take other action that the commissioner considers necessary

to carry out the federal Hospital Survey and Construction Act and

the regulations adopted under that Act.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 222.006. FUNDING. (a) The commissioner shall accept, on

behalf of the state, a payment of federal funds or a gift or

grant made to assist in meeting the cost of carrying out the

purpose of this subchapter, and may spend the payment, gift, or

grant for that purpose.

(b) The commissioner shall deposit the payment, gift, or grant

in the state treasury to the credit of the hospital construction

fund.

construction fund money received from the federal government for

a construction project approved by the surgeon general of the

United States Public Health Service. The commissioner shall use

the money only for payments to applicants for work performed and

purchases made in carrying out approved projects.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 222.007. AGREEMENTS FOR USE OF FACILITIES AND SERVICES OF

OTHER ENTITIES. To the extent the commissioner considers

desirable to carry out the purposes of this subchapter, the

commissioner may enter into an agreement for the use of a

facility or service of another public or private department,

agency, or institution.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 222.008. EXPERTS AND CONSULTANTS. The commissioner may

contract for services of experts or consultants, or organizations

of experts or consultants, on a part-time or fee-for-service

basis. The contracts may not involve the performance of

administrative duties.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 222.009. COMMISSIONER'S REPORT. (a) The commissioner

annually shall report to the board on activities and expenditures

under this subchapter.

(b) The commissioner shall include in the report recommendations

for additional legislation that the commissioner considers

appropriate to furnish adequate hospital, clinic, and similar

facilities to the public.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

SUBCHAPTER B. LIMITATION ON INSPECTION AND OTHER REGULATION OF

HEALTH CARE FACILITIES

Sec. 222.021. PURPOSE. The purpose of this subchapter is to

require that state agencies that perform inspections of health

care facilities, including the Texas Department of Health, the

Texas Department of Human Services, the Texas Department of

Mental Health and Mental Retardation, and other agencies with

which each of those agencies contracts, do not duplicate their

procedures or subject health care facilities to duplicative

rules.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 222.022. DEFINITIONS. In this subchapter:

(1) "Health care facility" has the meaning assigned by Section

104.002, except that the term does not include a treatment

facility licensed by the Texas Commission on Alcohol and Drug

Abuse.

(2) "Inspection" includes a survey, inspection, investigation,

or other procedure necessary for a state agency to carry out an

obligation imposed by federal and state laws, rules, and

regulations.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 222.023. LIMITATION ON INSPECTIONS. (a) A state agency

may make or require only those inspections necessary to carry out

obligations imposed on the agency by federal and state laws,

rules, and regulations.

(b) Instead of making an on-site inspection, a state agency

shall accept an on-site inspection by another state agency

charged with making an inspection if the inspection substantially

complies with the accepting agency's inspection requirements.

agency and with inspections required of other agencies to ensure

compliance with this section.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 222.024. CERTIFICATION OR ACCREDITATION INSTEAD OF

INSPECTION. (a) Except as provided by Subsection (c), a

hospital licensed by the Texas Department of Health is not

subject to additional annual licensing inspections before the

department issues the hospital a license while the hospital

maintains:

(1) certification under Title XVIII of the Social Security Act

(42 U.S.C. Section 1395 et seq.); or

(2) accreditation from the Joint Commission on Accreditation of

Healthcare Organizations, the American Osteopathic Association,

or other national accreditation organization for the offered

services.

(b) If the department licenses a hospital exempt from an annual

licensing inspection under Subsection (a), the department shall

issue a renewal license to the hospital if the hospital annually:

(1) submits a complete application required by the department;

(2) remits any applicable fees;

(3) submits a copy of documentation from the certification or

accreditation body showing that the hospital is certified or

accredited; and

(4) submits a copy of the most recent fire safety inspection

report from the fire marshal in whose jurisdiction the hospital

is located.

exempt from an annual licensing inspection under Subsection (a)

before issuing a renewal license to the hospital if the

certification or accreditation body has not conducted an on-site

inspection of the hospital in the preceding three years and the

department determines that an inspection of the hospital by the

certification or accreditation body is not scheduled within 60

days.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1993, 73rd Leg., ch. 584, Sec. 16, eff. Sept. 1,

1993; Acts 1997, 75th Leg., ch. 223, Sec. 1, eff. Sept. 1, 1997.

Sec. 222.025. LIMITATION OF OTHER REGULATION. (a) The Texas

Department of Human Services, the Texas Department of Health, and

the Texas Department of Mental Health and Mental Retardation each

by rule shall execute a memorandum of understanding that

establishes procedures to eliminate or reduce duplication of

functions in certifying or licensing hospitals, nursing homes, or

other facilities under their jurisdiction for payments under the

requirements of Chapter 32, Human Resources Code, and federal law

and regulations relating to Titles XVIII and XIX of the Social

Security Act (42 U.S.C. Sections 1395 et seq. and 1396 et seq.).

The procedures must provide for use by each agency of information

collected by the agencies in making inspections for certification

purposes and in investigating complaints regarding matters that

would affect the certification of a nursing home or other

facility under their jurisdiction.

(b) The Texas Department of Health shall coordinate all

licensing or certification procedures conducted by the state

agencies covered by this section.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 222.0255. NURSING HOMES. (a) The Texas Department of

Human Services shall develop one set of standards for nursing

homes that apply to licensing and to certification for

participation in the medical assistance program under Chapter 32,

Human Resources Code.

(b) The standards must comply with federal regulations. If the

federal regulations at the time of adoption are less stringent

than the state standards, the department shall keep and comply

with the state standards.

amendments to the standards.

(d) The department shall maintain a set of standards for nursing

homes that are licensed only.

(e) Chapter 242 establishes the minimum licensing standards for

an institution. The licensing standards adopted by the department

under this chapter shall be adopted subject to Section 242.037(b)

and must comply with Section 242.037(c) and the other provisions

of Chapter 242.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 64, eff. Sept. 1,

1991. Amended by Acts 1995, 74th Leg., ch. 76, Sec. 8.079, eff.

Sept. 1, 1995; Acts 1997, 75th Leg., ch. 1159, Sec. 1.32, eff.

Sept. 1, 1997.

Sec. 222.026. COMPLAINT INVESTIGATIONS AND ENFORCEMENT

AUTHORITY. (a) Sections 222.024, 222.025, and 222.0255 do not

affect the authority of the Texas Department of Health to

implement and enforce the provisions of Chapter 241 (Texas

Hospital Licensing Law) to:

(1) reinspect a hospital if a hospital applies for the

reissuance of its license after a final ruling upholding the

suspension or revocation of a hospital's license, the assessment

of administrative or civil penalties, or the issuance of an

injunction against the hospital for violations of provisions of

the licensing law, rules adopted under the licensing law, special

license conditions, or orders of the commissioner of health; or

(2) investigate a complaint against a hospital and, if

appropriate, enforce the provisions of the licensing law on a

finding by the department that reasonable cause exists to believe

that the hospital has violated provisions of the licensing law,

rules adopted under the licensing law, special license

conditions, or orders of the commissioner of health; provided,

however, that the department shall coordinate with the federal

Health Care Financing Administration and its agents responsible

for the inspection of hospitals to determine compliance with the

conditions of participation under Title XVIII of the Social

Security Act (42 U.S.C. Section 1395 et seq.), so as to avoid

duplicate investigations.

(b) The department shall by rule establish a procedure for the

acceptance and timely review of complaints received from

hospitals concerning the objectivity, training, and

qualifications of the persons conducting the inspection.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 64, eff. Sept. 1,

1991; Acts 1993, 73rd Leg., ch. 584, Sec. 17, eff. Sept. 1, 1993.

Sec. 222.027. PHYSICIAN ON SURVEY TEAM. The Texas Department of

Health shall ensure that a licensed physician involved in direct

patient care as defined by the Texas State Board of Medical

Examiners is included on a survey team sent under Title XVIII of

the Social Security Act (42 U.S.C. Section 1395 et seq.) when

surveying the quality of services provided by physicians in

hospitals.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 63, eff. Sept. 1,

1991.

SUBCHAPTER C. SURVEYS OF INTERMEDIATE CARE FACILITIES FOR

MENTALLY RETARDED

Sec. 222.041. DEFINITIONS. In this subchapter:

(1) "Board" means the Texas Board of Human Services.

(2) "Commissioner" means the commissioner of human services.

(3) "Department" means the Texas Department of Human Services.

(4) "ICF-MR" means the medical assistance program serving

persons receiving care in intermediate care facilities for

mentally retarded persons.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 65, eff. Sept. 1,

1991. Amended by Acts 1995, 74th Leg., ch. 76, Sec. 8.080, eff.

Sept. 1, 1995.

Sec. 222.042. LICENSING OF ICF-MR BEDS AND FACILITIES. The

department may not license or approve as meeting licensing

standards new ICF-MR beds or the expansion of an existing ICF-MR

facility unless the new beds or the expansion was included in the

plan approved by the Health and Human Services Commission in

accordance with Section 533.062.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 65, eff. Sept. 1,

1991. Amended by Acts 1993, 73rd Leg., ch. 646, Sec. 1, eff. Aug.

30, 1993; Acts 1993, 73rd Leg., ch. 747, Sec. 26, eff. Sept. 1,

1993.

Sec. 222.043. REVIEW OF ICF-MR SURVEYS. (a) The board by rule

shall establish policies and procedures as prescribed by this

section to conduct an informal review of ICF-MR surveys when the

survey findings are disputed by the provider. The board shall

provide that the procedure may be used only if the deficiencies

cited in the survey report do not pose an imminent threat of

danger to the health or safety of a resident.

(b) The department shall designate at least one employee to

conduct on a full-time basis the review provided by this section.

The person must be impartial and may not be directly involved in

or supervise any initial or recertification surveys. The person

may participate in or direct follow-up surveys for quality

assurance purposes only at the discretion of the commissioner or

the commissioner's designated representative or under Chapter

242.

current knowledge of applicable federal laws and survey

processes. The employee reports directly to the commissioner or

the commissioner's designated representative.

(d) If a provider disputes the findings of a survey team or

files a complaint relating to the conduct of the survey, the

employee designated under Subsection (b) shall conduct an

informal review as soon as possible, but before the 45th day

after the date of receiving the request for a review or the

expiration of the period during which the provider is required to

correct the alleged deficiency, whichever is sooner.

(e) The employee conducting the review shall sustain, alter, or

reverse the original findings of the survey team after consulting

with the commissioner or the commissioner's designated

representative.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 65, eff. Sept. 1,

1991. Amended by Acts 1995, 74th Leg., ch. 76, Sec. 8.081, eff.

Sept. 1, 1995.

Sec. 222.044. FOLLOW-UP SURVEYS. (a) The department shall

conduct follow-up surveys of ICF-MR facilities to:

(1) evaluate and monitor the findings of the certification or

licensing survey teams; and

(2) ensure consistency in deficiencies cited and in punitive

actions recommended throughout the state.

(b) A provider shall correct any additional deficiency cited by

the department. The department may not impose an additional

punitive action for the deficiency unless the provider fails to

correct the deficiency within the period during which the

provider is required to correct the deficiency.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 65, eff. Sept. 1,

1991. Amended by Acts 1995, 74th Leg., ch. 76, Sec. 8.082, eff.

Sept. 1, 1995.

Sec. 222.046. SURVEYS OF ICF-MR FACILITIES. (a) The department

shall ensure that each survey team sent to survey an ICF-MR

facility includes a qualified mental retardation professional, as

that term is defined by federal law.

(b) The department shall require that each survey team sent to

survey an ICF-MR facility conduct a final interview with the

provider to ensure that the survey team informs the provider of

the survey findings and that the survey team has requested the

necessary information from the provider. The survey team shall

allow the provider to record the interview. The provider shall

immediately give the survey team a copy of any recording.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 65, eff. Sept. 1,

1991.

State Codes and Statutes

State Codes and Statutes

State Codes and Statutes

State Codes and Statutes

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