(a) A limited services rural hospital (LSRH) shall obtain a license before admitting patients.     
      (b) An applicant for an LSRH license shall submit a license application to the Texas Health and Human Services Commission (HHSC) in a form and manner prescribed by HHSC.     
      (c) An applicant shall submit a license application in accordance with §511.12 of this subchapter (relating to Application and Issuance of Initial License). The applicant shall retain copies of all application documents submitted to HHSC.     
      (d) During the licensing period, an LSRH shall comply with the other provisions of Texas Health and Safety Code Chapter 241 (relating to Hospitals), to the extent they do not conflict with Subchapter K (relating to Limited Services Rural Hospitals), and Code of Federal Regulations Title 42 Part 485 Subpart E (relating to Conditions of Participation: Rural Emergency Hospitals (REHs)) and this chapter.     
      (e) HHSC issues an LSRH license for the premises and person named in the application.      
        (1) An LSRH license shall not include off-site outpatient facilities.       
        (2) An LSRH may share a building with other licensed facilities.                  (A) The LSRH must be licensed separately from the other licensed facilities.                   (B) No identifiable part of the building may be dually licensed by more than one facility.                   (C) Each licensed facility in the building shall comply with the requirements of §511.165 of this chapter (relating to Building with Multiple Occupancies).         
        (3) A licensed LSRH shall not hold or pursue dual licensure as any other facility type.       
      (f) An LSRH shall prominently and conspicuously display the LSRH license in a public area of the licensed premises that is readily visible to patients, employees, and visitors.     
      (g) An LSRH shall not alter the LSRH license.     
      (h) An LSRH license is nontransferable. The LSRH shall comply with the provisions of §511.15 of this subchapter (relating to Change of Ownership) in the event of a change in the ownership of an LSRH.     
      (i) An LSRH shall notify HHSC in writing and in accordance with HHSC instructions, of any changes affecting the LSRH's license before the change occurs. Changes may include:      
        (1) addition or deletion of services indicated on the license application; or       
        (2) any construction, renovation, or modification of the hospital buildings.       
      (j) An LSRH shall notify HHSC, in writing and in accordance with HHSC instructions, at the time of the occurrence of any of the following:      
        (1) cessation of operation of the LSRH, whether temporary or permanent;       
        (2) change in certification or accreditation status;       
        (3) change in the LSRH name, telephone number, or administrator; or       
        (4) change in the emergency contact name or emergency contact phone number.       
      (k) A written notice of cessation of operation under subsection (j)(1) of this section shall include the location where the LSRH will store medical records and the identity and telephone number of the custodian of the medical records.     
     Source Note:        The provisions of this §511.11 adopted to be effective October 5, 2023, 48 TexReg 5668