- Clinical laboratory services
- Diagnostic x-ray services
- Treatment facilities including surgery or obstetrical care, or both
- Other definitive medical or surgical treatment of similar extent
Texas Health and Safety Code Chapter 241 establishes the state licensing requirements for general hospitals. Under state law, HHSC is responsible for the licensing and regulation of general hospitals in Texas, and the Regulatory Services Division within HHSC carries out these duties.
HHSC adopts rules for general 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
- Health and Safety Code Chapter 241, Hospitals
- Per Texas Health and Safety Code Section 241.154(e), a hospital 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 25 Part 1, Chapter 133, Hospital Licensing
- Medical Disclosure Laws and Rules
- Federal Regulations:
- Medicare/Medicaid State Operations Manual - Publication 100-07
- Appendix A - Survey Protocol, Regulations, and Interpretive Guidelines for Hospitals (PDF)
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
- View the accessible version of the Directory of General and Special Hospitals (Excel)
Licensing
An applicant seeking a general hospital 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 3228, Application for a License to Operate a General or Special Hospital
- Form 3229, Application for a License to Operate a Multiple Location General or Special Hospital
- Form 3230, Application for HHSC Approval to Operate a Hospital at Home Program
Change of Ownership Applications
- Change of Ownership Instructions (PDF)
- Form 3228, Application for a License to Operate a General or Special Hospital
- Form 3229, Application for a License to Operate a Multiple Location General or Special Hospital
- Form 3230, Application for HHSC Approval to Operate a Hospital at Home Program
Relocation Applications
- Form 3228, Application for a License to Operate a General or Special Hospital
- Form 3229, Application for a License to Operate a Multiple Location General or Special Hospital
- Form 3230, Application for HHSC Approval to Operate a Hospital at Home Program
Renewal Licensure Applications
- Form 3232, General or Special Hospital Renewal Application
- Form 3264, General and Special Hospital Multiple Location License Renewal Application
- Form 3230, Application for HHSC Approval to Operate a Hospital at Home Program
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)
- Form 3255, Fire Safety Survey Report for Hospitals and Crisis Stabilization Units (PDF)
- Hospital Closure Instructions (PDF)
- CMS Hospital Database Worksheet
- Form 3249, Hospital Waiver Request
- Form 3250, Hospital Statute and Rule Waiver Request Application for Facility Physical Plant and Construction Requirements
Architectural Review Information and Forms
Complaint and Incident Submission Information
- Incidents Submission Portal for Health Care Regulation Providers
- File a Complaint for a Health Facility
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
- Human Trafficking Required Signage Information (PDF)
- Human Trafficking Sign – English (PDF)
- Human Trafficking Sign – Spanish (PDF)
- HHSC Texas Human Trafficking Resource Center
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. 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 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.
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 DAP:
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 general hospitals.
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.
Accreditation
Hospitals may be accredited.
Clinical Laboratory Improvement Amendments Information
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 78714-9347Open 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 .
- Medicare/Medicaid State Operations Manual - Publication 100-07