(a) In this section and § 251.017, “emergency” means an incident likely to threaten the health, welfare, or safety of end stage renal disease facility patients or staff or the public, including a fire, equipment failure, power outage, flood, interruption in utility service, medical emergency, or natural or other disaster.
(b) Each end stage renal disease facility shall adopt a written emergency preparedness and contingency operations plan to address the provision of care during an emergency. The plan must:
(1) be updated annually and approved by the facility’s leadership each time the plan is updated;
(2) include procedures for notifying each of the following entities as soon as practicable regarding the closure or reduction in hours of operation of the facility due to an emergency:
(A) the department;
(B) each hospital with which the facility has a transfer agreement;
(C) the trauma service area regional advisory council that serves the geographic area in which the facility is located; and
(D) each applicable local emergency management agency;
(3) except as provided by Subsection (d), require the facility to execute a contract with another end stage renal disease facility located within a 100-mile radius of the facility stipulating that the other end stage renal disease facility will provide dialysis treatment to facility patients who are unable to receive scheduled dialysis treatment due to the facility’s closure or reduction in hours; and
(4) include a documented patient communications plan that includes procedures for notifying a patient when that patient’s scheduled dialysis treatment is interrupted.

(c) As part of the emergency preparedness and contingency operations plan adopted under Subsection (b), each end stage renal disease facility shall develop and the facility’s leadership must approve a continuity of care plan for the provision of dialysis treatment to facility patients during an emergency. The facility must provide a copy of the plan to each patient before providing or scheduling dialysis treatment. The plan must include:
(1) procedures for distributing written materials to facility patients that specifically describe the facility’s emergency preparedness and contingency operations plan adopted under Subsection (b); and
(2) detailed procedures, based on the facility’s patient population, on the facility’s contingency plans, including transportation options, for patients to access dialysis treatment at each end stage renal disease facility with which the facility has an agreement or made advance preparations to ensure that the facility’s patients have the option to receive dialysis treatment.
(d) An end stage renal disease facility is not required to contract with another end stage renal disease facility under Subsection (b)(3) if:
(1) no other end stage renal disease facility is located within a 100-mile radius of the facility; and
(2) the facility obtains written approval from the department exempting the facility from that requirement.
(e) On request, an end stage renal disease facility shall provide the facility’s emergency preparedness and contingency operations plan adopted under Subsection (b) to:
(1) the department;
(2) each hospital with which the facility has a transfer agreement;
(3) the trauma service area regional advisory council that serves the geographic area in which the facility is located; and
(4) each applicable local emergency management agency.
(f) Each end stage renal disease facility shall provide annual training to facility staff on the facility’s emergency preparedness and contingency operations plan under this section.
(g) Each end stage renal disease facility shall annually contact a local and state disaster management representative, an emergency operations center, and a trauma service area regional advisory council to:
(1) request comments on whether the emergency preparedness and contingency operations plan adopted by the facility under Subsection (b) should be modified; and
(2) ensure that local agencies, regional agencies, state agencies, and hospitals are aware of the facility, the facility’s policy on provision of life-saving treatment, the facility’s patient population and potential transportation needs, and the anticipated number of patients affected.