(a) The Texas Health and Human Services Commission (HHSC) shall send written notice of license expiration to a limited services rural hospital (LSRH) at least 60 calendar days before the expiration date of the license. If the LSRH has not received notice, it is the LSRH's duty to notify HHSC and request a renewal notice.     
      (b) The LSRH shall submit the following to HHSC before the license expiration date:      
        (1) a complete and accurate application;       
        (2) a copy of two fire inspections that are conducted and approved by an individual certified by the Texas Commission on Fire Protection to conduct fire inspections and meet the requirements of §511.141 of this chapter (relating to Fire Prevention and Protection), one from within the last 12 months and one from the year before, as the LSRH must obtain an approved fire inspection annually;       
        (3) the renewal license fee; and       
        (4) if the applicant is accredited by a Centers for Medicare & Medicaid Services-approved organization, a copy of documentation from the accrediting body showing the current accreditation status of the hospital.       
      (c) HHSC may conduct an inspection before issuing a renewal license in accordance with §511.112 of this chapter (relating to Inspections).     
      (d) Subject to subsection (g) of this section, HHSC shall issue a renewal license to an LSRH that meets the requirements for a license.     
      (e) Renewal licenses will be valid for two years from the previous expiration date.     
      (f) If an LSRH fails to submit the application, documents, and fee by the expiration date of the LSRH's license, HHSC shall notify the LSRH that it must cease operation and immediately return the license to HHSC. If the LSRH intends to provide services after the expiration date of the license, HHSC may require the LSRH to apply for a license under §511.12 of this subchapter (relating to Application and Issuance of Initial License).     
      (g) Denial of a renewal license shall be governed by §511.121 of this chapter (relating to Enforcement).     
     Source Note:        The provisions of this §511.13 adopted to be effective October 5, 2023, 48 TexReg 5668