(a) Physical plant waiver. On the request of the facility, the department may grant a waiver or modification for certain provisions of the physical plant and environment that, in the opinion of the department, would be impractical for the facility to meet. Waivers will not be granted for fire safety requirements required by the National Fire Protection Association (NFPA). The facility's written request must specify the specific provision for which waiver is requested.     
      (b) Facility operation waiver. On the request of the facility, the department may grant a waiver or approve a variation for certain provisions of facility operation that, in the opinion of the department, would be impractical or inappropriate for the facility to meet. The facility's  written request must specify the specific provision for which waiver is requested.     
      (c) Consideration. In considering the waiver or modification request, the department shall consider information submitted by the facility and whether the waiver or modification:      
        (1) will adversely affect the health and safety of the facility patients, employees, or the general public;       
        (2) if not granted, would impose an unreasonable hardship on the facility in providing adequate care for patients;       
        (3) will facilitate the creation or operation of the facility; and       
        (4) is appropriate when balanced against the best interests of the individuals served or to be served by the facility.       
      (d) Supporting documentation. The department may request written documentation from the facility to support the waiver or modification including, but not limited to:      
        (1) a statement addressing each of the criteria in subsection (c) of this section;       
        (2) evidence of approval by the local building and fire authorities;       
        (3) evidence of provisions in the Act or this chapter which will mitigate any adverse effect of the waiver or modification; and       
        (4) evidence of any mitigating act in excess of the Act or this chapter which will be used by the hospital to offset any adverse effect of the waiver or modification.       
      (e) Written  recommendation. The director shall submit a written recommendation for granting or denying the waiver to the commissioner of health (commissioner).     
      (f) 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.     
      (g) 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.     
      (h) File documentation. The licensing file for the facility maintained by the Texas Department of Health shall contain a copy of the request, the written recommendation of the director, and the order of the commissioner. The facility shall  also maintain a copy of the order.     
     Source Note:        The provisions of this §506.51 adopted to be effective July 25, 2004, 29 TexReg 6911; transferred effective June 1, 2019, as published in the Texas Register May 17, 2019, 44 TexReg 2467