(a) Request for a waiver. A hospital may submit a written request to the director for a waiver or modification of a particular provision of the Texas Hospital Licensing Act (Act) or a minimum standard in this chapter, except fire safety requirements. The written request shall specify the section(s) of the Act or this chapter for which a waiver is requested.     
      (b) Waiver request requirements. In requesting the waiver, the hospital must address each of the following points and provide documentation as necessary to support their position. The hospital 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 it was determined that granting the waiver would not adversely impact the hospital's participation in the federal Medicare program or accreditation by a Centers for Medicare and Medicaid Services-approved organization;       
        (3) describe how not granting the waiver would impose an unreasonable hardship on the hospital in providing adequate care for patients;       
        (4) describe how the waiver would facilitate the creation or operation of the hospital; 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 hospital.       
      (c) Supporting documentation. The hospital should submit supporting documentation with the waiver request. The department may request additional written documentation from the hospital to support the waiver or modification.     
      (d) Written recommendation. The director shall submit a written recommendation for granting or denying the waiver to the commissioner of state health services (commissioner).     
      (e) Granting order. If the director recommends that the waiver or modification be granted, the commissioner may issue a written order granting the waiver or modification.     
      (f) Denial of order. If the director recommends that the waiver or modification be denied, the commissioner may issue a written order denying the waiver or modification.     
      (g) File documentation. The licensing file for the hospital maintained by the Department of State Health Services shall contain a copy of the request, any supporting documents which were provided, the written recommendation of the director, and the order. The hospital is to maintain the original order in their permanent records.     
     Source Note:        The provisions of this §133.81 adopted to be effective June 21, 2007, 32 TexReg 3587