(a) HHSC may enter the premises of a facility at reasonable times and make an inspection necessary to issue a license or renew a license. HHSC inspection and survey personnel perform inspections and surveys, follow-up visits, complaint investigations, investigations of abuse or neglect, and other contact visits as required for carrying out the responsibilities of licensing.
(b) Generally, all inspections, surveys, complaint investigations, and other visits, whether routine or nonroutine, made for the purpose of determining the appropriateness of client care and day-to-day operations of a facility are unannounced. Any exceptions must be justified.
(c) Certain visits may be announced, including initial architectural inspections, visits to determine the progress of physical plant construction or repairs, equipment installation or repairs, systems installation or repairs, or conditions when certain emergencies arise, such as fire, windstorm, or malfunctioning or nonfunctioning of electrical or mechanical systems.
(d) Any person may request an inspection of a facility by notifying HHSC of an alleged violation of a licensing requirement. The complaint should be as detailed as possible and signed by the complainant; however, HHSC does investigate anonymous complaints. Unless a complaint is anonymous, HHSC responds to the complainant in writing but without the outcome of the investigation.
(e) If the complaint alleges abuse, neglect, or exploitation, HHSC performs an inspection as soon as feasible but not later than the 14th day after the date HHSC receives the complaint, unless after an investigation the complaint is found to be frivolous. If the complaint does not allege abuse, neglect, or exploitation, HHSC investigates the complaint not later than the 45th day after the date HHSC receives the complaint.
(f) The facility must make all its books, records, electronic records, and other documents maintained by or on behalf of a facility accessible to HHSC upon request.
  (1) HHSC is authorized to photocopy documents, photograph clients, and use any other available recording devices to preserve all relevant evidence of conditions found during an inspection, survey, or investigation.
  (2) Examples of records and documents that may be requested and photocopied or otherwise reproduced are client medical records, including nursing notes, pharmacy records, medication records, and prescribing practitioner's orders.
  (3) The facility may charge HHSC at a rate not to exceed the rate HHSC charges for copies. The procedure of copying is the responsibility of the director or his or her designee. If copying requires that the records be removed from the facility, a representative of the facility is expected to accompany the records and ensure their order and preservation.
  (4) HHSC protects the copies for privacy and confidentiality in accordance with recognized standards of medical records practice, applicable state laws, and HHSC policy.
  (5) If a facility maintains electronic records, it must have a mechanism for printing all documentation if a surveyor or investigator requests a printed copy.
(g) HHSC does not reveal the source of a complaint.
(h) HHSC inspects a facility at least once every two years after the initial inspection.

Source Note: The provisions of this §559.81 adopted to be effective August 31, 1993, 18 TexReg 2726; transferred effective September 1, 1993, as published in the Texas Register September 3, 1993, 18 TexReg 5885; amended to be effective January 1, 1995, 19 TexReg 9531; amended to be effective May 1, 1999, 24 TexReg 3100; amended to be effective November 1, 2000, 25 TexReg 10753; amended to be effective April 1, 2007, 32 TexReg 1749; amended to be effective October 29, 2018, 43 TexReg 7219; transferred effective January 15, 2021, as published in the Texas Register December 18, 2020, 45 TexReg 9249; amended to be effectiveJuly 10, 2024, 49 TexReg 4909