(a) An applicant may request that HHSC issue, before conducting an on-site health inspection, an initial license for a Type A or Type B facility. The applicant must request the license by submitting a form prescribed by HHSC via the online portal.
(b) If an applicant makes a request in accordance with subsection (a) of this section, HHSC determines the applicant is in good standing, and the applicant complies with subsection (d) of this section, the applicant is not required to admit a resident to the facility or have the on-site health inspection described in §553.23(f) of this subchapter (relating to Initial License Application Procedures and Requirements) before HHSC issues an initial license.
(c) For purposes of this section, an applicant is in good standing if:
  (1) one of the following conditions is met:
    (A) the applicant has operated or been a controlling person of a licensed Type A or Type B facility in Texas for at least six consecutive years; or
    (B) the applicant has not held a license for a Type A or Type B facility, but a controlling person of the applicant has operated or been a controlling person of a licensed Type A or Type B facility in Texas for at least six consecutive years; and
  (2) each licensed facility operated by the applicant or the controlling person described in paragraph (1)(A) or (B) of this subsection:
    (A) has not had a violation of a licensing rule:
      (i) that:
        (I) resulted in actual harm to a resident, which is defined as a negative outcome that compromises the resident's physical, mental or emotional well-being; or
        (II) posed an immediate threat of harm causing or likely to cause serious injury, impairment, or death to a resident; and
      (ii) that:
        (I) the facility did not challenge;
        (II) was affirmed; or
        (III) is pending a final determination; and
    (B) has not had a sanction imposed by HHSC against the facility during the six years before the date an application is submitted that resulted in:
      (i) a civil penalty;
      (ii) an administrative penalty;
      (iii) an injunction;
      (iv) the denial, suspension, or revocation of a license; or
      (v) an emergency closure.
(d) An applicant that makes a request in accordance with subsection (a) of this section must:
  (1) submit to HHSC via the online portal:
    (A) the applicant's policies and procedures;
    (B) evidence that the applicant has complied with §553.257(b) of this chapter (relating to Human Resources); and
    (C) documentation that the applicant's employees have the credentials described in §553.253 of this chapter (relating to Employee Qualifications and Training); and
  (2) comply with §553.23(d) of this subchapter and §553.17 of this subchapter (relating to Criteria for Licensing).
(e) HHSC issues an initial license to an applicant that makes a request in accordance with subsection (a) of this section if HHSC determines that an applicant:
  (1) is in good standing;
  (2) has submitted information in accordance with subsection (d)(1) of this section that complies with this chapter; and
  (3) is in compliance with applicable NFPA 101 and other physical plant requirements of Subchapter D of this chapter (relating to Facility Construction), including meeting the requirements of a Life Safety Code (LSC) inspection within 120 days after the date HHSC staff conduct the initial LSC inspection.
(f) HHSC staff conduct an on-site health inspection within 90 days after the date HHSC issues a license in accordance with subsection (e) of this section. The on-site health inspection includes HHSC observation of the facility's provision of care to at least one resident.
(g) Until a facility that is issued an initial license under this section meets the requirements of the on-site health inspection described in subsection (f) of this section, the facility must attach a written addendum to the disclosure statement required by §553.259(c)(1) of this chapter (relating to Admission Policies and Procedures) as notice to a resident or a prospective resident that the facility has not met the requirements of the on-site health inspection. At a minimum, the addendum must state that:
  (1) the facility has not met the requirements of an initial on-site health inspection for a license; and
  (2) HHSC staff conduct an on-site health inspection for licensure within 90 days after the date the license is issued.

Source Note: The provisions of this §553.25 adopted to be effective August 31, 2021, 46 TexReg 5017