(a) Purpose. This section provides the criteria and procedures the department uses to determine a nonprofit hospital's or hospital system's eligibility for limited liability certification by the department.
(b) Authority. This section is authorized by Health and Safety Code, §311.0456 (§311.0456), which requires the department to receive, determine eligibility, and certify limited liability status for nonprofit hospitals or hospital systems that meet the requirements of these sections.
(c) Definitions. Terms used in this subchapter have the following meanings, unless the context clearly indicates otherwise. Terms not defined have their common meanings.
  (1) Department--The Department of State Health Services.
  (2) Charity care--Is defined in Health and Safety Code, §311.031(2).
  (3) Net patient revenue--Is defined in Health and Safety Code, §311.042(8).
(d) Eligible Entities. This section applies to a nonprofit hospital and hospital system that:
  (1) meets the definition of nonprofit hospital in the Health and Safety Code, §311.042(9)(A); or
  (2) is a corporation certified by the Texas Medical Board as a nonprofit organization under Occupations Code, §162.001, whose sole member is a qualifying hospital or hospital system.
(e) Certification Criteria. A nonprofit hospital or hospital system that satisfies the eligibility criteria under this section must additionally meet the following certification criteria:
  (1) provide charity care in an amount equal to or at least 8% of net patient revenue during the most recent fiscal year of the hospital or system; and
  (2) provide at least 40% of the total charity care provided in the county in which the hospital is located.
    (A) Charity care for purposes of this section is determined by the department by checking the report submitted by the hospital or system under the Health and Safety Code, §311.033 and the statement of community benefits and charity care submitted by the nonprofit hospital or hospital system under Health and Safety Code, §311.045.
    (B) If a report under §311.033 is not available for all hospitals in a county in which a nonprofit hospital meeting the requirement in paragraph (1) of this subsection is requesting certification, the department shall determine the eligibility of the hospital or hospital system using other sources of verified charity care information available at the time of certification.
(f) Mandatory Submission Deadline. Not later than May 31 of each year for which certification is sought, a nonprofit hospital or hospital system must submit a written request for certification stating that the hospital or system is eligible for certification. Reports submitted after May 31 of each reporting year will not be considered for certification, and exceptions to the deadline will not be granted.
(g) Duties of the Department. The department will determine whether a hospital or hospital system is an eligible entity and meets the certification criteria not later than December 31 of the year in which the department receives the request.
(h) Effective Date of Certification. A certification issued under this section to a nonprofit hospital or hospital system takes effect on December 31 of that year for which certification is issued and expires on the anniversary of that date.
(i) Effect of Certification. Section 311.0456 describes the effect of certification on liability for noneconomic damages.

Source Note: The provisions of this §13.41 adopted to be effective December 4, 2007, 32 TexReg 8827