The federal government shutdown hasn't derailed the nation's new health-insurance program. But it has suspended another crucial layer of protection for patients -- routine safety inspections of hospitals and nursing homes. And Texas is among the states hardest hit. Its nearly $1 million monthly appropriation ? the second largest next to California's ? to pay for such reviews remains frozen until Congress passes a new funding bill. But several forms of inspections designed to flag patient dangers or systemic problems can't proceed. They include "standard surveys," which are the annual inspections of nursing homes and hospitals, and "initial surveys" to gauge whether a care facility being proposed can receive Medicare funding.