1-1           By:  Cain                                        S.B. No. 422

 1-2           (In the Senate - Filed February 3, 1997; February 5, 1997,

 1-3     read first time and referred to Committee on Health and Human

 1-4     Services; February 20, 1997, reported adversely, with favorable

 1-5     Committee Substitute by the following vote:  Yeas 10, Nays 0;

 1-6     February 20, 1997, sent to printer.)

 1-7     COMMITTEE SUBSTITUTE FOR S.B. No. 422                   By:  Nelson

 1-8                            A BILL TO BE ENTITLED

 1-9                                   AN ACT

1-10     relating to the licensure of a hospital with multiple premises

1-11     under a single license and the provision of certain services by

1-12     licensed hospitals.

1-13           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

1-14           SECTION 1.  Section 241.003, Health and Safety Code, is

1-15     amended to read as follows:

1-16           Sec. 241.003.  DEFINITIONS.  In this chapter:

1-17                 (1)  "Board" means the Texas Board of Health.

1-18                 (2)  "Comprehensive medical rehabilitation hospital"

1-19     means a general hospital that specializes in providing medical

1-20     rehabilitation services, including surgery and related ancillary

1-21     services.

1-22                 (3)  "Council" means the Hospital Licensing Advisory

1-23     Council.

1-24                 (4) [(3)]  "Department" means the Texas Department of

1-25     Health.

1-26                 (5) [(4)]  "General hospital" means an establishment

1-27     that:

1-28                       (A)  offers services, facilities, and beds for

1-29     use for more than 24 hours for two or more unrelated individuals

1-30     requiring diagnosis, treatment, or care for illness, injury,

1-31     deformity, abnormality, or pregnancy; and

1-32                       (B)  regularly maintains, at a minimum, clinical

1-33     laboratory services, diagnostic X-ray services, treatment

1-34     facilities including surgery or obstetrical care or both, and other

1-35     definitive medical or surgical treatment of similar extent.

1-36                 (6) [(5)]  "Governmental unit" means a political

1-37     subdivision of the state, including a hospital district, county, or

1-38     municipality, and any department, division, board, or other agency

1-39     of a political subdivision.

1-40                 (7) [(6)]  "Hospital" includes a general hospital and a

1-41     special hospital.

1-42                 (8) [(7)]  "Medical staff" means a physician or group

1-43     of physicians and a podiatrist or group of podiatrists who by

1-44     action of the governing body of a hospital are privileged to work

1-45     in and use the facilities of a hospital for or in connection with

1-46     the observation, care, diagnosis, or treatment of an individual who

1-47     is, or may be, suffering from a mental or physical disease or

1-48     disorder or a physical deformity or injury.

1-49                 (9)  "Pediatric and adolescent hospital" means a

1-50     general hospital that specializes in providing services to children

1-51     and adolescents, including surgery and related ancillary services.

1-52                 (10) [(8)]  "Person" means an individual, firm,

1-53     partnership, corporation, association, or joint stock company, and

1-54     includes a receiver, trustee, assignee, or other similar

1-55     representative of those entities.

1-56                 (11) [(9)]  "Physician" means a physician licensed by

1-57     the Texas State Board of Medical Examiners.

1-58                 (12) [(10)]  "Podiatrist" means a podiatrist licensed

1-59     by the Texas State Board of Podiatric Medical Examiners.

1-60                 (13)  "Premises" means:

1-61                       (A)  a single building where inpatients receive

1-62     hospital services; or

1-63                       (B)  multiple buildings where inpatients receive

1-64     hospital services, provided that the following criteria are met:

 2-1                             (i)  all inpatient buildings and inpatient

 2-2     services are subject to the control and direction of the governing

 2-3     body of the hospital;

 2-4                             (ii)  all inpatient buildings are no more

 2-5     than 30 minutes travel time apart;

 2-6                             (iii)  there is integration of the

 2-7     organized medical staff of the hospital;

 2-8                             (iv)  there is a single chief executive

 2-9     officer who reports directly to the governing body and through whom

2-10     all administrative authority flows and who exercises control and

2-11     surveillance over all administrative activities of the hospital;

2-12                             (v)  there is a single chief medical

2-13     officer who reports directly to the governing body and who is

2-14     responsible for all medical staff activities of the hospital; and

2-15                             (vi)  each building that is geographically

2-16     separate from other buildings contains at least one nursing unit

2-17     for inpatients, unless providing only diagnostic or laboratory

2-18     services, or a combination thereof, in the building for hospital

2-19     inpatients.

2-20                 (14) [(11)]  "Special hospital" means an establishment

2-21     that:

2-22                       (A)  offers services, facilities, and beds for

2-23     use for more than 24 hours for two or more unrelated individuals

2-24     who are regularly admitted, treated, and discharged and who require

2-25     services more intensive than room, board, personal services, and

2-26     general nursing care;

2-27                       (B)  has clinical laboratory facilities,

2-28     diagnostic X-ray facilities, treatment facilities, or other

2-29     definitive medical treatment;

2-30                       (C)  has a medical staff in regular attendance;

2-31     and

2-32                       (D)  maintains records of the clinical work

2-33     performed for each patient.

2-34           SECTION 2.  Section 241.022, Health and Safety Code, is

2-35     amended by adding Subsection (f) to read as follows:

2-36           (f)  A hospital shall not include in its license application

2-37     its offsite outpatient services.

2-38           SECTION 3.  Section 241.026, Health and Safety Code, is

2-39     amended by adding Subsection (f) to read as follows:

2-40           (f)  A comprehensive medical rehabilitation hospital or a

2-41     pediatric and adolescent hospital shall have an emergency treatment

2-42     room but is not required to have an emergency department.

2-43           SECTION 4.  The importance of this legislation and the

2-44     crowded condition of the calendars in both houses create an

2-45     emergency and an imperative public necessity that the

2-46     constitutional rule requiring bills to be read on three several

2-47     days in each house be suspended, and this rule is hereby suspended,

2-48     and that this Act take effect and be in force from and after its

2-49     passage, and it is so enacted.

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