TITLE 26. HEALTH AND HUMAN SERVICES

PART 1. HEALTH AND HUMAN SERVICES COMMISSION

CHAPTER 550. LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS

SUBCHAPTER F. INSPECTIONS AND VISITS

The executive commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §550.1301, concerning Inspections and Visits.

BACKGROUND AND PURPOSE

The purpose of the proposal is to update the rule to limit survey frequency from annually to every three years in alignment with current licensure renewal and inspection timeframe requirements in Texas Health and Safety Code §248A.053 and §248A.102. The changes reduce administrative and operational burdens for providers associated with annual inspections.

This proposal also deletes or updates obsolete references and clarifies existing language to improve overall readability.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §550.1301(a) and (b) clarifies language and improves readability. The edits to subsection (c) clarify that, except for visits outlined in subsection (e), HHSC does not announce inspections as well as investigations and visits described in subsection (a). The update to subsection (d) removes language referencing at least one licensing inspection annually because an inspection will now be conducted at least once every three years. The update to subsection (e) reorganizes the subsection for clarity and improved readability and includes restructuring paragraph (2) to new subsection (f).

FISCAL NOTE

Victoria Grady, Deputy Chief, Finance, has determined that for each year of the first five years that the rule will be in effect, there will be an estimated reduction in cost to state government as a result of enforcing and administering the rule as proposed. HHSC is unable to determine the reduction in costs because it is unknown how many providers will apply for a renewal license every three years. Enforcing or administering the rule does not have foreseeable implications relating to costs or revenues of local government.

GOVERNMENT GROWTH IMPACT STATEMENT

HHSC has determined that during the first five years that the rule will be in effect:

(1) the proposed rule will not create or eliminate a government program;

(2) implementation of the proposed rule will not affect the number of HHSC employee positions;

(3) implementation of the proposed rule will result in no assumed change in future legislative appropriations;

(4) the proposed rule will not affect fees paid to HHSC;

(5) the proposed rule will not create new regulations;

(6) the proposed rule will limit existing regulations;

(7) the proposed rule will not change the number of individuals subject to the rules; and

(8) the proposed rule will not affect the state's economy.

SMALL BUSINESS, MICRO-BUSINESS, AND RURAL COMMUNITY IMPACT ANALYSIS

Victoria Grady has also determined that there will be no adverse economic effect on small businesses, micro-businesses, or rural communities because there is no requirement to alter current business practices.

LOCAL EMPLOYMENT IMPACT

The proposed rule will not affect a local economy.

COSTS TO REGULATED PERSONS

Texas Government Code §2001.0045 does not apply to this rule because the rule does not impose a cost on regulated persons.

PUBLIC BENEFIT AND COSTS

Michelle Dionne-Vahalik, Deputy Executive Commissioner for Long-Term Care Regulation, has determined that for each year of the first five years the rule is in effect, the public benefit will be reducing administrative and operational burden on providers, allowing providers to focus resources on daily operations and care while HHSC maintains appropriate oversight.

Victoria Grady has also determined that for the first five years the rule is in effect, there are no anticipated economic costs to persons required to comply with the proposed rule because HHSC only extends survey timeframes, and there are no new fees or costs imposed on those required to comply.

TAKINGS IMPACT ASSESSMENT

HHSC has determined that the proposal does not restrict or limit an owner's right to the owner's property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking under Texas Government Code §2007.043.

PUBLIC COMMENT

Written comments on the proposal, including information related to the cost, benefit, or effect of the proposed rule, as well as any applicable data, research, or analysis, may be submitted to Rules Coordination Office, P.O. Box 13247, Mail Code 4102, Austin, Texas 78711-3247, or street address 4601 West Guadalupe Street, Austin, Texas 78751; or emailed to HHSRulesCoordinationOffice@hhs.texas.gov.

To be considered, comments must be submitted no later than 31 days after the date of this issue of the Texas Register. Comments must be (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered before 5:00 p.m. on the last working day of the comment period; or (3) emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When emailing comments, please indicate "Comments on Proposed Rule 26R045" in the subject line.

STATUTORY AUTHORITY

The amendment is authorized by Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies; and Texas Health and Safety Code §248A.101, which authorizes the executive commissioner of HHSC to adopt rules that are necessary to implement Chapter 248A, to protect the health and safety of the public, and to ensure the health, safety and comfort of the minors served.

The amendment implements Texas Government Code §524.0151 and Texas Health and Safety Code Chapter 248A.

§550.1301. Inspections and Visits.

(a) HHSC conducts [performs] inspections, follow-up visits, and compliance investigations. HHSC also investigates allegations [, investigations] of abuse, neglect, and exploitation. Any [, and] other contact visit may occur [visits] at a center as deemed appropriate or as required to determine a center's compliance with this chapter.

(b) An inspector or an inspection team [inspection] may conduct [be conducted by] an inspection or visit. The number of inspectors and other team members conducting an inspection or visit may depend [inspector or by a team depending] on the purpose of the inspection, the size of a center, and other factors.

(c) HHSC does not announce inspections, investigations, or visits described in subsection (a) of this section, except for visits outlined in subsection (e) of this section.

(d) HHSC conducts [at least one] unannounced licensing inspections at least once every three years from [inspection annually after issuance of] a license issue date.

(e) HHSC may visit a center for purposes other than the reasons described in subsection (a) of this section, including to assess or consult with staff on: [.]

(1) [HHSC may visit a center to consult with a center's staff to determine] how a center may update or expand the center's physical space; [may be expanded or upgraded or determine the progress of a center's construction or repairs, equipment installation or repairs, systems installation or repairs, or when conditions or emergencies arise, including fire, windstorm, or malfunctioning or nonfunctioning of electrical or mechanical systems.]

(f) [(2)] HHSC may announce visits that are not for a purpose described in subsection (a) of this section.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on July 27, 2026.

TRD-202603144

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: September 6, 2026

For further information, please call: (512) 438-3161