Relating to a periodic comprehensive performance audit of certain operations of hospital districts located in populous counties.

HB 5023 requires hospital districts in populous counties to undergo a comprehensive performance audit at least once every five years. The audit must evaluate district management, financial controls, vendor contracts, and compliance with laws, and assess whether management follows national hospital standards. Districts must provide a written report of findings and recommendations to the commissioners court and post it on their public website if one exists. The commissioners court must then hold a public hearing on the audit results. This bill directly affects hospital districts in populous counties, mandating regular oversight of their operations.