(a) The Texas Health and Human Services Commission (HHSC) may suspend a facility's license or order an immediate closing of part of the facility if:
  (1) HHSC finds that the facility is operating in violation of the licensure rules; and
  (2) the violation creates an immediate threat to the health and safety of a resident.
(b) The order suspending a license or closing a part of a facility under this section is immediately effective on the date the license holder receives written notice or a later date specified in the order.
(c) The order suspending a license or ordering an immediate closing of a part of the facility is valid for ten days after the effective date of the order.
(d) When an emergency suspension has been ordered and the conditions in the facility indicate that residents need to be relocated, a facility must ensure:
  (1) A resident's rights or freedom of choice in selecting treatment facilities will be respected.
  (2) If a facility or part thereof is closed, the following rules apply.
    (A) HHSC will notify the local health department director, city or county health authority, and representatives of the appropriate state agencies of the closure.
    (B) Facility staff must notify each resident's legally authorized representative (LAR) and attending physician, advising them of the action in process.
    (C) The resident or the resident's LAR will have an opportunity to designate a preference for a specific facility or for other arrangements.
    (D) HHSC must contact the local intellectual and developmental disability authority (LIDDA) to arrange for resident relocation to other facilities in the area in accordance with the resident's preference. A facility chosen for relocation must be in good standing with HHSC and, if certified under Titles XVIII and XIX of the Social Security Act, must be in good standing under its contract. The facility chosen must be able to meet the needs of the resident.
    (E) If absolutely necessary, to prevent transport over substantial distances, HHSC will grant a waiver to a receiving facility to temporarily exceed its licensed capacity, provided the health and safety of residents is not compromised and the facility can meet the increased demands for direct care personnel and dietary services. A facility may exceed its licensed capacity under these circumstances, monitored by HHSC staff, until residents can be transferred to a permanent location.
    (F) With each resident transferred, the following reports, records, and supplies must be transmitted to the receiving institution:
      (i) a copy of the current physician's orders for medication, treatment, diet, and special services required;
      (ii) personal information, such as name and address of next of kin or LAR; attending physician; Medicare and Medicaid identification number; Social Security number; and other identification information as deemed necessary and available;
      (iii) all medication dispensed in the name of the resident for which physician's orders are current. The medication must be inventoried and transferred with the resident. Medications past an expiration date or discontinued by physician order must be inventoried for disposition in accordance with state law;
      (iv) the resident's personal belongings, clothing, and toilet articles. An inventory of personal property and valuables must be made by the closing facility; and
      (v) resident trust fund accounts maintained by the closing facility. All items must be properly inventoried, and receipts obtained for audit purposes by the appropriate state agency.
    (G) If the closed facility is allowed to reopen within 90 days, the relocated residents will have the first right to return to the facility. Relocated residents may choose to return, may stay in the receiving facility (if the facility is not exceeding its licensed capacity), or choose any other accommodations.
    (H) Any resident's return to the facility must be treated as a new admission, including exchange of medical information, medications, and completion of required forms.
(e) A licensee whose facility is closed under this section is entitled to request an administrative hearing in accordance with 1 TAC §357.484 (relating to Request for a Hearing), but a hearing request does not suspend the effectiveness of the order.

Source Note: The provisions of this §551.234 adopted to be effective May 1, 1995, 20 TexReg 1659; amended to be effective February 1, 1999, 23 TexReg 11829; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1883; amended to be effective February 24, 2022, 47 TexReg 787