(a) A branch office operates as a part of the parent agency and must comply with the same regulations as the parent agency. The parent agency is responsible for ensuring that its branches comply with licensing standards.
(b) A branch office providing licensed and certified home health services must comply with the standards for certified agencies in §558.402 of this chapter (relating to Standards Specific to Licensed and Certified Home Health Services).
(c) The service area of a branch office must be located within the parent agency's service area.
  (1) A branch office must not provide services outside its licensed service area.
  (2) A branch office must maintain adequate staff to provide services and to supervise the provision of services within the service area.
  (3) A branch office may expand its service area at any time during the licensure period.
    (A) Unless exempted under subparagraph (B) of the paragraph, a branch office must submit to HHSC a written notice to expand its service area at least 30 days before the expansion. The notice must include:
      (i) revised boundaries of the branch office's original service area;
      (ii) the effective date of the expansion; and
      (iii) an updated list of management and supervisory personnel (including names), if changes are made.
    (B) An agency is exempt from the 30-day written notice requirement under subparagraph (A) of this paragraph if HHSC determines an emergency exists that would impact client health and safety. An agency must notify HHSC immediately of a possible emergency. HHSC determines if an exemption can be granted.
  (4) A branch office may reduce its service area at any time during the licensure period by sending HHSC written notification of the reduction, revised boundaries of the branch office's original service area, and the effective date of the reduction.
(d) A parent agency and a branch office providing home health or personal assistance services must meet the following requirements:
  (1) The parent agency administrator or alternate administrator, or supervising nurse or alternate supervising nurse, must conduct an on-site supervisory visit to the branch office at least monthly. The parent agency may visit the branch office more frequently considering the size of the service area and the scope of services provided by the parent agency. The supervisory visits must be documented and include the date of the visit, the content of the consultation, the individuals in attendance, and the recommendations of the staff.
  (2) The original active clinical record must be kept at the branch office.
  (3) The parent agency must approve all branch office policies and procedures. This approval must be documented and filed in the parent and branch offices.
(e) HHSC issues or renews a branch office license for applicants who meet the requirements of this section.
  (1) Issuance or renewal of a branch office license is contingent upon compliance with the Statute and this chapter by the parent agency and branch office.
  (2) HHSC may take enforcement action against a parent agency license for a branch office's failure to comply with the Statute or this chapter in accordance with Subchapter F of this chapter (relating to Enforcement).
  (3) Revocation, suspension, denial, or surrender of a parent agency license will result in the same revocation, suspension, denial, or surrender of a branch office license for all branch office licenses of the parent agency.
(f) A branch office may offer fewer health services or categories than the parent office but may not offer health services or categories that are not also offered by the parent agency.

Source Note: The provisions of this §558.321 adopted to be effective February 1, 2002, 26 TexReg 9159; amended to be effective June 1, 2006, 31 TexReg 1455; 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