1. (a) A facility shall notify the Texas Health and Human Services Commission (HHSC) in writing in accordance with HHSC instructions at least 30 calendar days before:

   1. (1) any construction;
   2. (2) addition, alteration, renovation, or remodeling;
   3. (3) equipment and finish upgrade;
   4. (4) conversion of a licensed or previously licensed facility to an ESRD license designation;
   5. (5) demolition;
   6. (6) retrofitting a function, such as changing end stage renal disease treatment modality or training station designations; or
   7. (7) change of services, including change in treatment modality, station type, and station number.

2. (b) A facility shall notify HHSC in writing and in accordance with HHSC instructions within 10 calendar days following:

   1. (1) a change in the facility name, mailing address, facility administrator email address, telephone number, or fax number;
   2. (2) a change of administrator; or
   3. (3) the facility ceasing operation.

3. (c) A facility shall request and receive HHSC written approval in accordance with HHSC instructions before changes in services or the number of stations.

   1. (1) The facility shall request HHSC approval at least 90 calendar days before the planned change and must receive HHSC approval before implementing the changes.
   2. (2) The change shall comply with Subchapter Z of this chapter (relating to Physical Plant and Construction Requirements).
   3. (3) For an additional service or increase in stations, HHSC may require the facility to provide evidence of appropriate staffing, policies and procedures, or any other documentation it determines is necessary to evaluate the request.
   4. (4) For an increase in stations, the facility shall also submit written evidence that the water treatment system is of sufficient size to accommodate the increase and maintain a safe water supply.
   5. (5) HHSC may conduct an on-site inspection before acting on the requested changes.
   6. (6) The facility shall comply with §507.12(a)(7) of this subchapter (relating to Application and Issuance of Initial License).
   7. (7) HHSC sends the facility written notice of HHSC approval or denial of the requested change.
   8. (8) All existing facilities increasing the number of in-center dialysis treatment stations shall have an isolation room, as specified in the current CMS Conditions for Coverage, or shall provide a waiver. Refer to isolation room requirements in Subchapter Z of this chapter.

Source Note:The provisions of this §507.16 adopted to be effective December 23, 2025, 50 TexReg 8289.