AN ACT

 1-1     relating to the licensure of a hospital with multiple premises

 1-2     under a single license and the provision of certain services by

 1-3     licensed hospitals.

 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-5           SECTION 1.  Section 241.003, Health and Safety Code, is

 1-6     amended to read as follows:

 1-7           Sec. 241.003.  DEFINITIONS.  In this chapter:

 1-8                 (1)  "Board" means the Texas Board of Health.

 1-9                 (2)  "Comprehensive medical rehabilitation hospital"

1-10     means a general hospital that specializes in providing

1-11     comprehensive medical rehabilitation services, including surgery

1-12     and related ancillary services.

1-13                 (3)  "Council" means the Hospital Licensing Advisory

1-14     Council.

1-15                 (4) [(3)]  "Department" means the Texas Department of

1-16     Health.

1-17                 (5) [(4)]  "General hospital" means an establishment

1-18     that:

1-19                       (A)  offers services, facilities, and beds for

1-20     use for more than 24 hours for two or more unrelated individuals

1-21     requiring diagnosis, treatment, or care for illness, injury,

1-22     deformity, abnormality, or pregnancy; and

1-23                       (B)  regularly maintains, at a minimum, clinical

 2-1     laboratory services, diagnostic X-ray services, treatment

 2-2     facilities including surgery or obstetrical care or both, and other

 2-3     definitive medical or surgical treatment of similar extent.

 2-4                 (6) [(5)]  "Governmental unit" means a political

 2-5     subdivision of the state, including a hospital district, county, or

 2-6     municipality, and any department, division, board, or other agency

 2-7     of a political subdivision.

 2-8                 (7) [(6)]  "Hospital" includes a general hospital and a

 2-9     special hospital.

2-10                 (8) [(7)]  "Medical staff" means a physician or group

2-11     of physicians and a podiatrist or group of podiatrists who by

2-12     action of the governing body of a hospital are privileged to work

2-13     in and use the facilities of a hospital for or in connection with

2-14     the observation, care, diagnosis, or treatment of an individual who

2-15     is, or may be, suffering from a mental or physical disease or

2-16     disorder or a physical deformity or injury.

2-17                 (9)  "Pediatric and adolescent hospital" means a

2-18     general hospital that specializes in providing services to children

2-19     and adolescents, including surgery and related ancillary services.

2-20                 (10) [(8)]  "Person" means an individual, firm,

2-21     partnership, corporation, association, or joint stock company, and

2-22     includes a receiver, trustee, assignee, or other similar

2-23     representative of those entities.

2-24                 (11) [(9)]  "Physician" means a physician licensed by

2-25     the Texas State Board of Medical Examiners.

 3-1                 (12) [(10)]  "Podiatrist" means a podiatrist licensed

 3-2     by the Texas State Board of Podiatric Medical Examiners.

 3-3                 (13)  "Premises" means:

 3-4                       (A)  a single building where inpatients receive

 3-5     hospital services; or

 3-6                       (B)  multiple buildings where inpatients receive

 3-7     hospital services, provided that the following criteria are met:

 3-8                             (i)  all inpatient buildings and inpatient

 3-9     services are subject to the control and direction of the governing

3-10     body of the hospital;

3-11                             (ii)  all inpatient buildings are within a

3-12     30-mile radius of the main address of the licensee;

3-13                             (iii)  there is integration of the

3-14     organized medical staff of the hospital;

3-15                             (iv)  there is a single chief executive

3-16     officer who reports directly to the governing body and through whom

3-17     all administrative authority flows and who exercises control and

3-18     surveillance over all administrative activities of the hospital;

3-19                             (v)  there is a single chief medical

3-20     officer who reports directly to the governing body and who is

3-21     responsible for all medical staff activities of the hospital; and

3-22                             (vi)  each building that is geographically

3-23     separate from other buildings contains at least one nursing unit

3-24     for inpatients, unless providing only diagnostic or laboratory

3-25     services, or a combination thereof, in the building for hospital

 4-1     inpatients.

 4-2                 (14) [(11)]  "Special hospital" means an establishment

 4-3     that:

 4-4                       (A)  offers services, facilities, and beds for

 4-5     use for more than 24 hours for two or more unrelated individuals

 4-6     who are regularly admitted, treated, and discharged and who require

 4-7     services more intensive than room, board, personal services, and

 4-8     general nursing care;

 4-9                       (B)  has clinical laboratory facilities,

4-10     diagnostic X-ray facilities, treatment facilities, or other

4-11     definitive medical treatment;

4-12                       (C)  has a medical staff in regular attendance;

4-13     and

4-14                       (D)  maintains records of the clinical work

4-15     performed for each patient.

4-16           SECTION 2.  Section 241.026, Health and Safety Code, is

4-17     amended by amending Subsection (c) and adding Subsection (f) to

4-18     read as follows:

4-19           (c)  Upon the recommendation of the hospital licensing

4-20     director and the council, the board by order may waive or modify

4-21     the requirement of a particular provision of this Act or minimum

4-22     standard [requirement] adopted by board rule under this section to

4-23     [a particular special hospital or] a particular general or special

4-24     hospital [serving a rural community] if the board determines that

4-25     the waiver or modification will facilitate the creation or

 5-1     operation of the hospital and that the waiver or modification is in

 5-2     the best interests of the individuals served or to be served by the

 5-3     hospital.

 5-4           (f)  A comprehensive medical rehabilitation hospital or a

 5-5     pediatric and adolescent hospital shall have an emergency treatment

 5-6     room but is not required to have an emergency department.

 5-7           SECTION 3.  The importance of this legislation and the

 5-8     crowded condition of the calendars in both houses create an

 5-9     emergency and an imperative public necessity that the

5-10     constitutional rule requiring bills to be read on three several

5-11     days in each house be suspended, and this rule is hereby suspended,

5-12     and that this Act take effect and be in force from and after its

5-13     passage, and it is so enacted.

                                                                S.B. No. 422

         _______________________________     _______________________________

             President of the Senate              Speaker of the House

               I hereby certify that S.B. No. 422 passed the Senate on

         March 10, 1997, by a viva-voce vote and that the Senate concurred

         in House amendments on April 23, 1997, by the following vote:

         Yeas 31, Nays 0.

                                             _______________________________

                                                 Secretary of the Senate

               I hereby certify that S.B. No. 422 passed the House, with

         amendments, on April 18, 1997, by the following vote:  Yeas 142,

         Nays 0, two present not voting.

                                             _______________________________

                                                 Chief Clerk of the House

         Approved:

         _______________________________

                     Date

         _______________________________

                   Governor