(a) Administrator qualifications.
  (1) For an agency licensed to provide licensed home health services, licensed and certified home health services, or hospice services, the administrator and the alternate administrator must:
    (A) be a licensed physician, RN, licensed social worker, licensed therapist, or licensed nursing home administrator with at least one year of management or supervisory experience in a health-related setting, such as:
      (i) a home and community support services agency;
      (ii) a hospital;
      (iii) a nursing facility;
      (iv) a hospice;
      (v) an outpatient rehabilitation center;
      (vi) a psychiatric facility;
      (vii) an intermediate care facility for individuals with an intellectual disability or related conditions; or
      (viii) a licensed health care delivery setting providing services for individuals with functional disabilities; or
    (B) have a high school diploma or a general equivalency degree (GED) with at least two years of management or supervisory experience in a health-related setting, such as:
      (i) a home and community support services agency;
      (ii) a hospital;
      (iii) a nursing facility;
      (iv) a hospice;
      (v) an outpatient rehabilitation center;
      (vi) a psychiatric facility;
      (vii) an intermediate care facility for individuals with an intellectual disability or related conditions; or
      (viii) a licensed health care delivery setting providing services for individuals with functional disabilities.
  (2) For an agency licensed to provide hospice services, in addition to the qualifications listed in paragraph (1)(A) or (B) of this subsection, the administrator and the alternate administrator must:
    (A) be a hospice employee; and
    (B) have any additional education and experience required by the hospice's governing body, as specified in the agency's job description.
  (3) For an agency licensed to provide only personal assistance services, the administrator and the alternate administrator must meet at least one of the following qualifications:
    (A) have a high school diploma or a GED with at least one year of experience or training in caring for individuals with functional disabilities;
    (B) have completed two years of full-time study at an accredited college or university in a health-related field; or
    (C) meet the qualifications listed in paragraph (1)(A) or (B) of this subsection.
(b) Administrator conditions.
  (1) An administrator and alternate administrator must be able to read, write, and comprehend English.
  (2) An administrator and alternate administrator designated as an administrator or alternate administrator for the first time on or after December 1, 2006, must meet the initial educational training requirements specified in §558.259 of this division (relating to Initial Educational Training in Administration of Agencies).
  (3) An administrator and alternate administrator designated as an administrator or alternate administrator before December 1, 2006, must meet the continuing education requirements specified in §558.260 of this division (relating to Continuing Education in Administration of Agencies).
  (4) A person is not eligible to be the administrator or alternate administrator of any agency if the person was the administrator of an agency cited with a violation that resulted in HHSC taking enforcement action against the agency while the person was the administrator of the cited agency.
    (A) This paragraph applies for 12 months after the date of the enforcement action.
    (B) For purposes of this paragraph, enforcement action means license revocation, suspension, emergency suspension of a license, denial of an application for a license, or the imposition of an injunction, but it does not include administrative or civil penalties.
    (C) If HHSC prevails in one enforcement action against the agency and proceeds with, but does not prevail in, another enforcement action based on some or all of the same violations, this paragraph does not apply.
  (5) An administrator and alternate administrator must not be convicted of an offense described in Chapter 560 of this title (relating to Denial or Refusal of License) during the time frames described in that chapter.
(c) Supervising nurse qualifications.
  (1) For an agency without a home dialysis designation, a supervising nurse and alternate supervising nurse must each:
    (A) be an RN licensed in Texas or in accordance with the Texas Board of Nursing rules for Nurse Licensure Compact (NLC); and
    (B) have at least one year of experience as an RN within the last 36 months.
  (2) For an agency with home dialysis designation, a supervising nurse and alternate supervising nurse must each:
    (A) be an RN licensed in Texas or in accordance with the Texas Board of Nursing rules, 22 TAC Chapter 220 for NLC, and:
      (i) have at least three years of current experience in hemodialysis; or
      (ii) have at least two years of experience as an RN and hold a current certification from a nationally recognized board in nephrology nursing or hemodialysis; or
    (B) be a nephrologist or physician with training or demonstrated experience in the care of ESRD clients.

Source Note: The provisions of this §558.244 adopted to be effective December 1, 2006, 31 TexReg 7368; amended to be effective May 1, 2008, 33 TexReg 1136; amended to be effective September 1, 2009, 34 TexReg 5139; amended to be effective October 1, 2013, 38 TexReg 6628; transferred effective May 1, 2019, as published in the April 12, 2019, issue of the Texas Register, 44 TexReg 1893; amended to be effective April 25, 2021, 46 TexReg 2427