(a) The facility must have in effect a written transfer agreement with one or more hospitals that reasonably assures that:      
        (1) Residents will be transferred from the facility to the hospital and ensured of timely admission to the hospital when transfer is medically appropriate as determined by the attending physician or, in an emergency situation, another practitioner in accordance with written facility policy.       
        (2) Providers will exchange medical and other information, including information required under §19.502(b)(4) of this chapter (relating to Transfer and Discharge in Medicaid-certified Facilities), needed for care and treatment of residents, and when the transferring facility deems it appropriate, for  determining whether such residents can receive appropriate services, receive services in a less restrictive setting than either the facility or the hospital, or reintegrate into the community.       
        (3) For Medicaid-certified facilities, the hospitals must be approved for participation under the Medicare and Medicaid programs.       
      (b) In addition, to ensure continuity of care, the transfer agreement must:      
        (1) provide for prompt diagnostic and other medical services;       
        (2) ensure accountability for a resident's personal effects at the time of transfer;       
        (3) specify the steps needed to transfer a resident in a prompt, safe and efficient manner; and       
        (4) provide for supplying, at the time of transfer, a summary of administrative, social, medical, and nursing information to the facility to which the resident is transferred.       
      (c) If the board or governing body for a long-term care facility and a hospital are the same, the controlling entity must have written procedures outlining how transfers will occur.     
      (d) The facility is considered to have a transfer agreement in effect if HHSC determines that the facility attempted in good faith to enter into an agreement with a hospital sufficiently close to the facility to make transfer feasible but could not, and it is in the public interest not to enforce this requirement. The facility must document in writing its good faith  effort to enter into an agreement.     
     Source Note:        The provisions of this §554.1915 adopted to be effective May 1, 1995, 20 TexReg 2393; amended to be effective March 24, 2020, 45 TexReg 2025; transferred effective January 15, 2021, as published in the Texas Register December 11, 2020, 45 TexReg 8871