Hospitals - Special Hospitals

As defined by Texas Health and Safety Code Section 241.003, a special hospital is an establishment that meets all the following criteria:

  • Offers services, facilities, and beds for use for more than 24 hours for two or more unrelated individuals who are regularly admitted, treated, and discharged and who require services more intensive than room, board, personal services, and general nursing care
  • Has:
    • Clinical laboratory facilities, diagnostic x-ray facilities, treatment facilities, or other definitive medical treatment
    • A medical staff in regular attendance
  • Maintains records of the clinical work performed for each patient

Texas Health and Safety Code Chapter 241 establishes the state licensing requirements for special hospitals. Under state law, HHSC is responsible for the licensing and regulation of special hospitals in Texas, and the Regulatory Services Division within HHSC carries out these duties.

HHSC adopts rules for special hospitals including establishing standards for:

  • Licensing procedures and fees
  • License denial, probation, suspension, and revocation
  • Requirements for staffing by physicians and nurses
  • Hospital services relating to patient care
  • Fire prevention, safety, and sanitation requirements in hospitals
  • Patient care and a patient bill of rights
  • Compliance with other state and federal laws affecting the health, safety, and rights of hospital patients
  • Inspection, investigation, and enforcement procedures

Laws and Rules

Texas Laws

Rules and Regulations

Senate Bill 1137 Hospital Price Transparency Information

Find or Verify a License


An applicant seeking a special hospital license must submit a completed application, license fee, and other applicable documents to HHSC. The Health Facility Licensing Unit will not process an application until after HHSC Accounts Receivable receives and posts the license fee.

Refer to the application or instructions linked in this section for specific requirements.

HHSC must review and approve all required application materials received before issuing a license to an applicant.

Initial Licensure Applications

Change of Ownership Applications

Relocation Applications

Renewal Licensure Applications

Supporting Forms and Documents

Architectural Review Information and Forms

Refer to the Architectural Information page.

Complaint and Incident Submission Information

Inspection Components

HHSC conducts health compliance on-site inspections to determine compliance with the provisions of the Health and Safety Code and associated rules listed in the Laws and Rules section of this page. During the inspection, HHSC staff generally perform the following activities:

  • Conduct an entrance and an exit conference with applicable facility personnel
  • Explain the inspection process and answer questions
  • Review clinical records
  • Review facility and personnel records
  • Review facility policies and procedures
  • Review quality assurance activities
  • Interview staff
  • Assess the facility’s compliance with applicable statutes and rules
  • Discuss final inspection findings with applicable facility personnel

Enforcement Actions

Human Trafficking Resources

Ethics or Medical Committee Reporting

Texas Health and Safety Code Chapter 166, Subchapter B, Section 166.054, as added by 88(R) HB 3162, requires health care facilities to report information regarding ethics or medical committee processes when an attending physician refuses to honor an advance directive or health care decision made by or on behalf of a patient who is determined to be incompetent or is otherwise mentally or physically incapable of communication. Facilities must submit a report no later than the 180th day after the facility notifies the person responsible for the patient's health care decision in writing regarding the review process as required by Section 166.046(b), as amended by 88(R) HB 3162.

The following form is required to be submitted by the facility to the HHSC Office of Data, Analytics, and Performance:

For assistance completing the online forms, for technical support, or to provide feedback on the user experience, email Ethics or Medical Committee Reporting.

For questions regarding regulatory reporting requirements, email Health Care Regulation

Provider Certification

The Secretary of the United States Department of Health and Human Services directs state health agencies or other appropriate agencies to determine whether health care entities meet federal standards. This helping function is termed "provider certification."

Health Care Regulation staff are responsible for providing certification oversight on behalf of CMS for special hospitals.

For more information on the certification process, refer to our Centers for Medicare and Medicaid Services Information page, or contact your regional office (PDF).

Critical Access Hospital

CAHs are a type of hospital that may be grated a special federal designation when they meet one or more of the following eligibility criteria:

  • Currently-participating Medicare hospitals
  • Hospitals that ceased operations on or after November 29, 1989
  • Health clinics or centers (as defined by the State) that previously operated as a hospital before being downsized to a health clinic or center

Refer to the Centers for Medicaid and Medicare Services' website for information on obtaining Medicare certification, and refer to the CMS Critical Access Hospitals page for more information on CAHs. The Texas State Office of Rural Health maintains a list of CAHs in Texas.


Hospitals may be accredited.

Clinical Laboratory Improvement Amendments Information

Refer to our CLIA information page. For more information on CLIA, contact your regional office (PDF).

Contact Information

For Healthcare Regulation contact information, visit our Contact Us Page.

Health Care Facility Enforcement

Phone: 512-438-5439 
Fax: 512-438-3697 
Mailing Address
Texas Health and Human Services Commission 
Regulatory Services Division 
Health Care Facility Enforcement, MC 1866 
P.O. Box 149347 
Austin, TX 78714-9347

Open Records Requests

Texas Health and Human Services is committed to providing full access to public information. For information on how to submit an open records request, visit the Open Records Policy and Procedures webpage.