TITLE 26. HEALTH AND HUMAN SERVICES
PART 1. HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 511. LIMITED SERVICES RURAL HOSPITALS
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §511.2, concerning Definitions, and §511.12, concerning Application and Issuance of Initial License; and new §511.79, concerning Workplace Violence Prevention.
Amended §511.2 and §511.12, and new §511.79, are adopted without changes to the proposed text as published in the June 6, 2025, issue of the Texas Register (50 TexReg 3416). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The new section is necessary to implement Senate Bill (SB) 240, 88th Legislature, Regular Session, 2023. SB 240 added new Texas Health and Safety Code (THSC) Chapter 331 which requires certain facilities, including limited services rural hospitals, to establish a workplace violence prevention committee or authorize an existing facility committee to develop the workplace violence prevention plan. THSC Chapter 331 also requires facilities to adopt, implement, and enforce a written workplace violence prevention policy and plan and to respond to workplace violence incidents.
The new section requires limited services rural hospitals to establish a workplace violence prevention committee or authorize an existing facility committee to develop the workplace violence prevention plan. The new section specifies the required membership for a committee. The new section requires a hospital to adopt, implement, and enforce a written workplace violence prevention policy and plan to protect health care providers and employees from violent behavior and threats of violent behavior occurring at the hospital. The new section requires the committee to annually evaluate the written workplace violence prevention plan and report the results of the evaluation to the hospital's governing body. The new section requires each hospital to make a copy of the hospital's workplace violence prevention plan available to each hospital health care provider or employee while providing protection from the release of information in the plan that would pose a security threat if made public.
The new section establishes minimum requirements for a hospital to respond to workplace violence incidents and creates protections for individuals with respect to reporting incidents of workplace violence.
The amended sections are necessary to add a definition of the term "facility" to the chapter and to correct a cross reference for the qualified rural hospital definition.
COMMENTS
The 31-day comment period ended July 7, 2025.
During this period, HHSC received comments regarding the proposed rules from two individuals. A summary of comments relating to the rules and HHSC responses follows.
Comment: A commenter suggested revising §511.79 to require the workplace violence prevention committee to include a person employed by local law enforcement if no limited service rural hospital employee who provides security services is available.
Response: HHSC declines to revise the rules as suggested because the rules are consistent with THSC §331.002(b).
Comment: A commenter expressed support of §511.79 because it helps protect healthcare workers, especially in underserved rural communities.
Response: HHSC acknowledges this comment.
SUBCHAPTER
A.
STATUTORY AUTHORITY
The amendment section is adopted under 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; THSC §241.302, which provides that the executive commissioner of HHSC shall adopt rules to establish minimum standards for limited services rural hospitals; and THSC Chapter 331, which requires licensed hospitals to adopt a workplace violence prevention policy and adopt and implement a workplace violence prevention plan in accordance with that chapter.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on September 19, 2025.
TRD-202503312
Karen Ray
Chief Counsel
Health and Human Services Commission
Effective date: October 9, 2025
Proposal publication date: June 6, 2025
For further information, please call: (512) 834-4591
SUBCHAPTER
B.
STATUTORY AUTHORITY
The amendment section is adopted under 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; THSC §241.302, which provides that the executive commissioner of HHSC shall adopt rules to establish minimum standards for limited services rural hospitals; and THSC Chapter 331, which requires licensed hospitals to adopt a workplace violence prevention policy and adopt and implement a workplace violence prevention plan in accordance with that chapter.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on September 19, 2025.
TRD-202503313
Karen Ray
Chief Counsel
Health and Human Services Commission
Effective date: October 9, 2025
Proposal publication date: June 6, 2025
For further information, please call: (512) 834-4591
SUBCHAPTER
C.
STATUTORY AUTHORITY
The new section is adopted under 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; THSC §241.302, which provides that the executive commissioner of HHSC shall adopt rules to establish minimum standards for limited services rural hospitals; and THSC Chapter 331, which requires licensed hospitals to adopt a workplace violence prevention policy and adopt and implement a workplace violence prevention plan in accordance with that chapter.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on September 19, 2025.
TRD-202503314
Karen Ray
Chief Counsel
Health and Human Services Commission
Effective date: October 9, 2025
Proposal publication date: June 6, 2025
For further information, please call: (512) 834-4591