Limited Services Rural Hospitals | Texas Health and Human Services

As defined by Texas Health and Safety Code Section 241.301 and Texas Administrative Code Title 26 Section 511.2 a limited services rural hospital is a general or special hospital that is or was licensed under Texas Health and Safety Code under Chapter 241 and that:

is:
- located in a rural area, as defined by:
  - Texas Health and Human Services Commission rule; or
  - 42 U.S.C. Section 1395ww(d)(2)(D), or
- designated by the Centers for Medicare & Medicaid Services as a critical access hospital, rural referral center, or sole community hospital, and
otherwise meets the requirements to be designated as a rural emergency hospital under Code of Federal Regulations Title 42 Part 485, Subpart E.

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

HHSC adopts rules for LSRHs including establishing standards for:

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

Laws and Rules

Texas Laws

Health and Safety Code Chapter 241, Subchapter K, Limited Services Rural Hospital
Per Texas Health and Safety Code Section 241.154(e), an LSRH must adjust the fee for providing health care information under Section 241.154 based on the most recent changes to the consumer price index as published by the Bureau of Labor Statistics of the United States Department of Labor that measures the average changes in prices of goods and services purchased by urban wage earners and clerical workers' families and single workers living alone.

Rules and Regulations

Senate Bill 1137 Hospital Price Transparency Information

Find or Verify a License

Verify a facility license by searching the Online Licensing System
View the accessible version of the Directory of Limited Services Rural Hospitals (Excel)

Licensing

An applicant seeking an LSRH license must submit a complete 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

Form 3240, Application for a License to Operate a Limited Services Rural Hospital

Change of Ownership Applications

Relocation Applications

Form 3240, Application for a License to Operate a Limited Services Rural Hospital

Supporting Forms and Documents

Architectural Review Information and Forms

Read about the Architectural Review process, application, forms and other information.

Complaint and Incident Submission

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

Human Trafficking Resources

Abortion Reporting

As defined by Texas Health and Safety Code Section 245.002, an abortion facility is a place where abortions are performed.

Texas Health and Safety Code Chapters 245 and 171 require abortion facilities and physicians that provide abortion services to report to HHSC certain information about abortion procedures the provider performs. HHSC must follow strict confidentiality provisions in the law regarding any information about an abortion facility. The law does allow HHSC to release statistical information reported to HHSC by abortion providers. HHSC Office of Data, Analytics, and Performance (DAP) compiles this statistical information and publishes it on the Induced Termination of Pregnancy Statistics page.

Abortion Reporting Forms

The following forms are required to be submitted by the physician to DAP:

The following form is required to be submitted by the facility to DAP:

Abortion Complications Reporting Form

Email Health Care Regulation Policies and Rules with questions regarding the statutory and regulatory abortion reporting requirements.

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

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 LSRHs.

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

Accreditation

LSRHs may be accredited.

Clinical Laboratory Improvement Amendments

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

Contact Information

Health Care Regulation Contact Information

For Health Care Regulation contact information, visit our Contact Us page.

Health Care Facility Enforcement

Phone: 512-438-5439
Fax: 512-438-3697
Email: Health.Facilities.Enforcement@hhsc.state.tx.us
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. Open Records Policy and Procedures has information on how to submit an open records request.