Current through Reg. 49, No. 38; September 20, 2024
(a) As defined by Texas Health and Safety
Code §
241.401, and
when used in this subchapter, the following words and terms have the following
meanings.
(1) "Acute hospital care at home
waiver program" means:
(A) the program
established by the Centers for Medicare and Medicaid Services under United
States Code Title 42 Section 1320b-5 that waives the requirements of
42 CFR Sections
482.23(b) and (b)(1);
and
(B) a successor program to the
program described by subparagraph (A) of this paragraph that is established by
the United States Congress or the Centers for Medicare & Medicaid
Services.
(2) "Hospital
at home program" means a program operated by a hospital to provide in a home
setting health care services that are considered to be acute hospital care for
purposes of the acute hospital care at home waiver program.
(b) Notwithstanding hospital
functions and services requirements in §
133.41 of this subchapter
(relating to Hospital Functions and Services) and hospital physical plant and
construction requirements in Subchapter I of this chapter (relating to Physical
Plant and Construction Requirements), a hospital may operate a hospital at home
program and treat an eligible patient at that patient's home if the hospital:
(1) obtains approval from the Centers for
Medicare & Medicaid Services (CMS) to participate in the acute hospital
care at home waiver program; and
(2) receives written approval from the Texas
Health and Human Services Commission (HHSC) to operate a hospital at home
program.
(c) To apply for
HHSC approval to operate a hospital at home program, an applicant shall submit
the following to HHSC:
(1) a complete
application to operate the program as indicated on the HHSC website;
(2) a nonrefundable application fee of
$350;
(3) a copy of the CMS
approval to participate in the acute hospital care at home waiver program;
and
(4) any additional information
requested by HHSC.
(d) A
hospital shall reapply for HHSC approval to operate the hospital's hospital at
home program when applying to renew the hospital's license under §
133.23 of this chapter (relating
to Application and Issuance of Renewal License).
(e) A hospital shall pay a nonrefundable
renewal application fee of $390 per 10 beds the hospital designates for the
hospital at home program in the renewal application. This fee is in addition to
the hospital's license renewal fee.
(f) When a hospital increases the number of
beds designated for its hospital at home program between license renewal
periods, the hospital shall notify HHSC and pay a nonrefundable fee of $390 per
block of 10 beds the hospital adds to their program.
(g) A hospital that is approved by HHSC to
operate a hospital at home program shall:
(1)
maintain CMS approval to participate in the acute hospital care at home waiver
program;
(2) comply with the CMS
acute hospital care at home waiver program requirements and all other
applicable statutes and regulations;
(3) develop, implement, and enforce policies
and procedures to ensure:
(A) the patient's
health and safety;
(B) the safety
of hospital staff entering the patient's home; and
(C) the safety of the patient's
home;
(4) ensure the
hospital's policies and procedures adopted under paragraph (3) of this
subsection at a minimum:
(A) require the
patient's home to:
(i) be located at a
physical address;
(ii) allow
hospital staff entry into the home as needed;
(iii) have animals separated securely away
from the patient care area while hospital staff is on site, except for service
animals as allowed by the Americans with Disabilities Act of 1990;
and
(iv) maintain a safe route from
the entrance and exit to the patient area within in the home;
(B) require the patient's home
maintain electricity, water, and wastewater service and identify how the
hospital addresses any disruptions in these services in an emergency;
and
(C) require the patient
maintain access to telephone service;
(5) obtain a patient's written and informed
consent to participate before the patient participates in the hospital's
hospital at home program, including notice that HHSC may request to accompany
hospital staff when entering the patient's home to ensure a hospital's
compliance with this rule; and
(6)
notify HHSC in writing no later than five business days if the hospital:
(A) chooses to no longer operate a hospital
at home program; or
(B) loses CMS
approval to participate in the acute hospital care at home waiver
program.
(h) At
any time, HHSC may withdraw its approval for a hospital to operate a hospital
at home program if HHSC finds a threat to patient health or safety. Any patient
being treated under the hospital at home program at the time HHSC withdraws its
approval shall be safely relocated as soon as practicable and according to the
hospital's policies and procedures.
(i) To the extent this section may conflict
with a requirement in §
133.21(c)(4)(B) or
(C) of this chapter (relating to General),
this section controls.
