Current through Reg. 49, No. 52; December 27, 2024
(a) In addition to
providing emergency services and observation care, a limited services rural
hospital (LSRH) may provide outpatient and medical health diagnostic and
therapeutic items and services that are commonly furnished in a physician's
office or at another entry point into the health care delivery system that
include: radiology, laboratory, outpatient rehabilitation, surgical, maternal
health, and behavioral health services. If an LSRH provides additional
outpatient and medical health diagnostic and therapeutic items and services,
the LSRH shall comply with the requirements of this section.
(b) The outpatient and medical health
diagnostic and therapeutic items and services the LSRH provides shall:
(1) align with the health needs of the
community served by the LSRH; and
(2) be appropriately organized and meet the
needs of the patients in accordance with acceptable standards of
practice.
(c) The LSRH
shall:
(1) provide items and services based on
nationally recognized guidelines and standards of practice;
(2) have a system in place for referral from
the LSRH to different levels of care, including follow-up care, as
appropriate;
(3) have effective
communication systems in place between the LSRH and the patient (or responsible
individual) and their family, ensuring that the LSRH is responsive to their
needs and preferences;
(4) have
established relationships with hospitals that have the resources and capacity
available to deliver care that is beyond the scope of care delivered at the
LSRH; and
(5) have personnel
providing these services who meet the requirements in subsection (d) of this
section.
(d) The LSRH
shall meet the following personnel requirements for outpatient services.
(1) The LSRH shall assign one or more
individuals to be responsible for outpatient services.
(2) The LSRH shall have appropriate
professional and nonprofessional personnel available at each location where
outpatient services are offered, based on the scope and complexity of
outpatient services.
(3) For any
specialty services offered at the LSRH, the LSRH shall have a physician,
advanced practice registered nurse, or physician assistant providing services
with experience and training in the specialty service area and in accordance
with their scope of practice.
(e) Outpatient medical and health services
shall be ordered by a practitioner who is:
(1)
responsible for the care of the patient for whom the practitioner is ordering
the services;
(2) licensed in the
state of Texas;
(3) acting within
their scope of practice under state law;
(4) authorized, in accordance with state law
and policies adopted by the medical staff; and
(5) approved by the governing body, to order
the applicable outpatient services and either:
(A) appointed to the LSRH's medical staff and
who have been granted privileges to order the applicable outpatient services;
or
(B) not appointed to the medical
staff, but who satisfy the requirements for authorization by the medical staff
and the LSRH for ordering the applicable outpatient services for their
patients.
