TX HHS Form 3566. LSRH License Renewal Application

The TX HHS Form 3566, LSRH License Renewal Application, is a crucial document for Rural Hospitals seeking to renew their license. This form helps solve the problem of ensuring that rural hospitals meet the necessary requirements and standards to continue operating. The application is typically used by rural hospitals in Texas, which must provide specific services such as emergency care, laboratory testing, radiologic imaging, and pharmaceutical services.

The form requires key information from the applicant, including LSRH name, license number, and CMS certification number. It also asks about ownership structure, physician involvement, and additional medical services offered. The application includes sections for providing required services, such as emergency department beds, and listing any other health services provided by the hospital.

By completing this form, rural hospitals demonstrate their compliance with Texas regulations and standards. Key features of the form include the requirement for specific services, conditions for ownership and physician involvement, and procedures for reporting additional medical services. This application is an essential tool for rural hospitals seeking to maintain their license and continue providing vital healthcare services to their communities.

• The TX HHS Form 3566 is used by Rural Hospitals in Texas seeking to renew their license.
• The form requires information on LSRH name, license number, CMS certification number, ownership structure, physician involvement, and additional medical services offered.
• The application includes sections for providing required services, such as emergency department beds, and listing any other health services provided by the hospital.