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:
- 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
- located in a rural area, as defined by:
- 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
- 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
- Texas Administrative Code Title 26 Part 1, Chapter 511, Limited Services Rural Hospitals
- Medical Disclosure Laws and Rules
- Federal Regulations:
Senate Bill 1137 Hospital Price Transparency Information
- Hospital Price Transparency Online Reporting Form
- Hospital Price Transparency (SB 1137) Required Information (PDF)
- Senate Bill 1137 Hospital Price Transparency Frequently Asked Questions (FAQ) (PDF)
- Hospital Price Transparency Recorded Webinar
- Hospital Price Transparency Recorded Webinar PowerPoint Slides (PDF)
Find or Verify a License
Verify a facility license by searching the Online Licensing System
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
Change of Ownership Applications
- Change of Ownership Instructions (PDF)
- Form 3240, Application for a License to Operate a Limited Services Rural Hospital
Supporting Forms and Documents
- Disclosure and Consent Forms for Medical and Surgical Procedures
- ER Handout for Psychiatric Patients (PDF)
- ER Handout for Psychiatric Patients- Spanish (PDF)
Architectural Review Information and Forms
Refer to the Architectural Information page.
Complaint and Incident Submission Information
- Incidents Submission Portal for Health Care Regulation Providers
- File a Complaint for a Health Facility
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
- HB 2552 Background Information (PDF)
- Human Trafficking Sign – English (PDF)
- Human Trafficking Sign – Spanish (PDF)
- Texas Human Trafficking Resource Center
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. The HHSC Office of Data, Analytics, and Performance (DAP) compiles this statistical information and publishes it on HHSC’s Induced Termination of Pregnancy Statistics webpage.
Abortion Reporting Forms
The following forms are required to be submitted by the physician to DAP:
- Induced Abortion Report Form
- Medical Emergency Abortion Incident Reporting Form
- Third Trimester Induced Abortion Certification Form
- Abortion Complications Reporting Form
The following form is required to be submitted by the facility to DAP:
Contact Health Care Regulation’s Policies and Rules Unit 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.
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).
LSRHs may be accredited.
Clinical Laboratory Improvement Amendments Information
Health Care Regulation Contact Information
For Health Care Regulation contact information, visit our Contact Us page.
Health Care Facility Enforcement
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.
- DSHS Commissioner’s COVID-19 Testing Letter to Hospitals (PDF)
- DSHS Hospital Data Reporting Instructions (PDF)
- Health Care Facilities Regulation Guidance Letters
- Information for Survivors of Sexual Assault - Non-SAFE-Ready Facility - English (PDF)
- Information for Survivors of Sexual Assault - Non-SAFE-Ready Facility - Spanish (PDF)
- Information for Survivors of Sexual Assault - SAFE-Ready Facility - English (PDF)
- Information for Survivors of Sexual Assault - SAFE-Ready Facility - Spanish (PDF)