(a) A facility shall report the following incident(s) to the department within ten working days:(1) death of a dialysis patient, which occurs in the facility, at home, or in a hospital;(2) hospital transfers;(3) conversion of staff or a patient to hepatitis B surface antigen (HbsAg) positive;(4) involuntary transfer or discharge of a patient; and(5) a fire in the facility.(b) An incident listed in subsection (a) of this section shall be reported to the Facility Licensing Group, Regulatory Licensing Unit, Department of State Health Services, Mail Code 2835, P.O. Box 149347, Austin, TX 78714-9347. The incident report shall be on a form provided by the department and include the information requested on the form. The facility may reproduce the form as needed to maintain an adequate supply.