By: Cain, Nelson S.B. No. 422
A BILL TO BE ENTITLED
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 medical
1-11 rehabilitation services, including surgery and related ancillary
1-12 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 241.022, Health and Safety Code, is
4-17 amended by adding Subsection (f) to read as follows:
4-18 (f) A hospital shall not include in its license application
4-19 its offsite outpatient services.
4-20 SECTION 3. Section 241.026, Health and Safety Code, is
4-21 amended by adding Subsection (f) to read as follows:
4-22 (f) A comprehensive medical rehabilitation hospital or a
4-23 pediatric and adolescent hospital shall have an emergency treatment
4-24 room but is not required to have an emergency department.
4-25 SECTION 4. The importance of this legislation and the
5-1 crowded condition of the calendars in both houses create an
5-2 emergency and an imperative public necessity that the
5-3 constitutional rule requiring bills to be read on three several
5-4 days in each house be suspended, and this rule is hereby suspended,
5-5 and that this Act take effect and be in force from and after its
5-6 passage, and it is so enacted.
5-7 COMMITTEE AMENDMENT NO. 1
5-8 Amend S.B. 422, SECTION 1, Sec. 241.003(2) as follows:
5-9 Insert the word "comprehensive" between the words "providing"
5-10 and "medical".
5-11 Amend SECTION 3 of S.B. 422 by amending Section 241.026(c),
5-12 Health and Safety Code, to read as follows:
5-13 (c) Upon the recommendation of the hospital licensing
5-14 director and the council, the board by order may waive or modify
5-15 the requirement of a particular provision of this Act or minimum
5-16 standard adopted by board rule under this section to [a particular
5-17 special hospital or] a particular general or special hospital
5-18 [serving a rural community] if the board determines that the waiver
5-19 or modification will facilitate the creation or operation of the
5-20 hospital and that the waiver or modification is in the best
5-21 interests of the individuals served or to be served by the
5-22 hospital.
5-23 Berlanga