1. (a) An agency with a license to provide hospice services may qualify for an alternate delivery site license if the parent agency:

   1. (1) is in substantial compliance with the statute and this chapter; and
   2. (2) has no enforcement action pending against its license.
2. (b) An agency may obtain an application for an ADS license on DADS website. If needed, an applicant can use information provided on DADS website to call DADS to obtain an application by mail. On the application, an agency may request to operate an inpatient unit at the alternate delivery site location.
3. (c) An agency must submit to DADS a complete and correct application and the required license fee specified in §97.3 of this chapter (relating to License Fees) for an ADS in accordance with instructions provided with the application. A complete and correct application includes all documents and information that DADS requests as part of the application process.
4. (d) After an agency submits an application for an ADS with an inpatient unit, the agency must contact the DADS Architectural Unit to request a Life Safety Code survey. Before DADS considers whether the application is complete, DADS must determine an agency's compliance with the Life Safety Code requirements in Subchapter H, Division 7 of this chapter (relating to Hospice Inpatient Units).

5. (e) DADS reviews an application for an ADS license to determine whether it is complete and correct.

   1. (1) DADS processes an application for an ADS license according to the time frames in §97.31 of this subchapter (relating to Time Frames for Processing and Issuing a License).
   2. (2) If an agency receives a written notice from DADS that some or all of the documents, information, or the license fee required by this section is missing or incomplete, the agency must submit the required information to DADS postmarked within 30 days after the date of the notice. If an agency fails to submit the required information postmarked within 30 days after the notice date, DADS considers the application for an ADS license incomplete and denies the application. If DADS denies the application, DADS does not refund the license fee.
6. (f) A designated survey office reviews an agency's application for an ADS license and makes a recommendation to DADS Home and Community Support Services Agencies licensing unit whether to approve or deny the application. The DADS licensing unit approves or denies the agency's application.

7. (g) If DADS denies an agency's application, DADS sends the agency a written notice:

   1. (1) informing the agency of its decision; and
   2. (2) providing the agency with an opportunity to appeal its decision through a formal hearing process as described in §97.601 of this chapter (relating to Enforcement Actions).
8. (h) After DADS issues a license for an ADS with an inpatient unit, the agency must, after providing inpatient services to a client, submit the Notification of Readiness for a Health Survey of a Hospice Inpatient Unit (DADS Form 2020-A), to the designated survey office. DADS conducts an initial licensure health survey to review the standards specified in Subchapter H, Division 7 of this chapter that a DADS Life Safety Code surveyor did not review during the initial Life Safety Code survey.
9. (i) An agency is not required to request an initial licensure health survey of an ADS with an inpatient unit if the agency is exempt from the health survey as specified in §97.503 of this chapter (relating to Exemption From a Survey). To demonstrate that it is exempt, the agency must send the accreditation documentation from JCAHO or CHAP to the DADS designated survey office within seven days after the agency receives the accreditation documentation.
10. (j) If an agency receives accreditation documentation from JCAHO or CHAP after the agency submits a written request to DADS for an initial licensure health survey, the agency may demonstrate that it is exempt from the survey by sending the accreditation documentation to the DADS designated survey office before DADS arrives at the agency to conduct an initial health survey.
11. (k) A Medicare-certified hospice agency must also submit a request to CMS for approval of an ADS, including an ADS with an inpatient unit. CMS approves or denies the request.
12. (l) An ADS license expires on the same date the parent agency's license expires. The agency may renew its ADS license with the parent agency's license.
13. (m) DADS mails an ADS license to the parent agency. The agency must post the ADS license in a conspicuous place on the licensed ADS premises.
14. (n) An ADS must comply with the statute and this chapter, including the applicable additional standards for hospice agencies in Subchapter H of this chapter (relating to Standards Specific to Agencies Licensed to Provide Hospice Services) and §97.322 of this chapter (relating to Standards for Alternate Delivery Sites). A Medicare-certified hospice agency's ADS must also comply with the applicable federal rules and regulations for hospice agencies in 42 CFR Part 418, Hospice Care.

Source Note:The provisions of this §558.29 adopted to be effective June 1, 2006, 31 TexReg 1455; amended to be effective October 1, 2013, 38 TexReg 6628; transferred effective May 1, 2019, as published in the April 12, 2019, issue of the Texas Register, 44 TexReg 1893.