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AN ACT
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relating to certain violations committed by long-term care |
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facilities, including violations that constitute the abuse and |
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neglect of residents. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. (a) It is the intent of the legislature that |
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Section 242.061, Health and Safety Code, as amended by this |
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section, establish a ceiling or maximum number of violations |
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related to the abuse and neglect of a resident that a facility can |
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commit before the executive commissioner is required to revoke the |
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facility's license. The changes in law made by this section are not |
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intended to limit or diminish the department's permissive authority |
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to revoke a license under Chapter 242, Health and Safety Code. |
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(b) Section 242.061, Health and Safety Code, is amended by |
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amending Subsection (a) and adding Subsections (a-1), (a-2), (a-3), |
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(c-1), (e), and (e-1) to read as follows: |
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(a) In this section: |
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(1) "Abuse" has the meaning assigned by Section |
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260A.001. |
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(2) "Immediate threat to health and safety" means a |
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situation in which immediate corrective action is necessary because |
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the facility's noncompliance with one or more requirements has |
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caused, or is likely to cause, serious injury, harm, impairment, or |
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death to a resident. |
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(3) "Neglect" has the meaning assigned by Section |
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260A.001. |
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(a-1) The department, after providing notice and |
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opportunity for a hearing to the applicant or license holder, may |
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deny, suspend, or revoke a license if the department finds that the |
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applicant, the license holder, or any other person described by |
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Section 242.032(d) has: |
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(1) violated this chapter or a rule, standard, or |
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order adopted or license issued under this chapter in either a |
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repeated or substantial manner; |
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(2) committed any act described by Sections |
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242.066(a)(2)-(6); or |
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(3) failed to comply with Section 242.074. |
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(a-2) Except as provided by Subsection (a-3) or (e-1), the |
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executive commissioner shall revoke a license under Subsection |
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(a-1) if the department finds that: |
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(1) the license holder has committed three violations |
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described by Subsection (a-1), within a 24-month period, that |
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constitute an immediate threat to health and safety related to the |
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abuse or neglect of a resident; and |
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(2) each of the violations described by Subdivision |
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(1) is reported in connection with a separate survey, inspection, |
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or investigation visit that occurred on separate entrance and exit |
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dates. |
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(a-3) The executive commissioner may not revoke a license |
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under Subsection (a-2) due to a violation described by Subsection |
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(a-2)(1), if: |
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(1) the violation and the determination of immediate |
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threat to health and safety are not included on the written list of |
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violations left with the facility at the time of the initial exit |
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conference under Section 242.0445(b) for a survey, inspection, or |
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investigation; |
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(2) the violation is not included on the final |
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statement of violations described by Section 242.0445; or |
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(3) the violation has been reviewed under the informal |
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dispute resolution process established by Section 531.058, |
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Government Code, and a determination was made that: |
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(A) the violation should be removed from the |
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license holder's record; or |
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(B) the violation is reduced in severity so that |
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the violation is no longer cited as an immediate threat to health |
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and safety related to the abuse or neglect of a resident. |
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(c-1) In the case of revocation of a license under |
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Subsection (a-2), to ensure the health and safety of residents of |
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the institution, the department may: |
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(1) request the appointment of a trustee to operate |
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the institution under Subchapter D; |
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(2) assist with obtaining a new operator for the |
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institution; or |
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(3) assist with the relocation of residents to another |
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institution. |
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(e) The executive commissioner may stay a license |
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revocation required by Subsection (a-2) if the executive |
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commissioner determines that the stay would not jeopardize the |
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health and safety of the residents of the facility or place the |
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residents at risk of abuse or neglect. The executive commissioner |
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by rule shall establish criteria under which a license revocation |
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may be stayed under this subsection. The executive commissioner |
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shall follow negotiated rulemaking procedures prescribed by |
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Chapter 2008, Government Code, for the adoption of rules |
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establishing the criteria. The criteria established must permit |
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the executive commissioner to stay a license revocation of a |
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nursing facility for which the department has deployed a rapid |
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response team under Section 255.004, if the facility has cooperated |
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with the rapid response team and demonstrated improvement in |
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quality of care, as determined by the rapid response team. |
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(e-1) The executive commissioner may stay a license |
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revocation required by Subsection (a-2) for a veterans home, as |
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defined by Section 164.002, Natural Resources Code, if the |
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Veterans' Land Board contracts with a different entity to operate |
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the veterans home than the entity that operated the home during the |
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period in which the violations described by Subsection (a-2) |
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occurred. |
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SECTION 2. Section 242.0615(a), Health and Safety Code, is |
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amended to read as follows: |
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(a) The department, after providing notice and opportunity |
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for a hearing, may exclude a person from eligibility for a license |
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under this chapter if the person or any person described by Section |
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242.032(d) has substantially failed to comply with this chapter and |
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the rules adopted under this chapter. The authority granted by this |
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subsection is in addition to the authority to deny issuance of a |
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license under Section 242.061(a-1) [242.061(a)]. |
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SECTION 3. Section 255.003, Health and Safety Code, is |
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amended by amending Subsections (b), (e), and (j) and adding |
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Subsections (b-1) and (i-1) to read as follows: |
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(b) Monitoring [Priority for monitoring] visits shall be |
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given to long-term care facilities: |
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(1) with a history of patient care deficiencies; or |
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(2) that are identified as medium risk through the |
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department's early warning system. |
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(b-1) A long-term care facility may request a monitoring |
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visit under this section. |
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(e) Quality-of-care monitors shall assess: |
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(1) the overall quality of life in the long-term care |
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facility; and |
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(2) specific conditions in the facility directly |
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related to patient care, including conditions identified through |
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the long-term care facility's quality measure reports based on |
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Minimum Data Set Resident Assessments. |
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(i-1) The department shall schedule a follow-up visit not |
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later than the 45th day after the date of an initial monitoring |
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visit conducted under this section. |
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(j) Conditions observed by the quality-of-care monitor that |
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create an immediate threat to the health or safety of a resident |
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shall be reported immediately to the long-term care facility |
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administrator, to the regional office supervisor for appropriate |
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action, and, as appropriate or as required by law, to law |
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enforcement, adult protective services, other divisions of the |
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department, or other responsible agencies. |
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SECTION 4. Section 255.004, Health and Safety Code, is |
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amended by amending Subsection (a) and adding Subsections (a-1) and |
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(a-2) to read as follows: |
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(a) In this section: |
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(1) "Abuse" has the meaning assigned by Section |
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260A.001. |
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(2) "Immediate threat to health and safety" means a |
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situation in which immediate corrective action is necessary because |
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the facility's noncompliance with one or more requirements has |
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caused, or is likely to cause, serious injury, harm, impairment, or |
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death to a resident. |
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(3) "Neglect" has the meaning assigned by Section |
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260A.001. |
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(a-1) The department shall create rapid response teams |
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composed of health care experts that can visit a long-term care |
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facility that: |
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(1) is [facilities] identified as high risk through |
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the department's early warning system; or |
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(2) if the long-term care facility is a nursing |
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institution, has committed three violations described by Section |
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242.061(a-1), within a 24-month period, that constitute an |
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immediate threat to health and safety related to the abuse or |
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neglect of a resident. |
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(a-2) A long-term care facility shall cooperate with a rapid |
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response team deployed under this section to improve the quality of |
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care provided at the facility. |
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SECTION 5. Section 531.058, Government Code, is amended by |
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adding Subsection (a-1) to read as follows: |
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(a-1) As part of the informal dispute resolution process |
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established under this section, the commission shall contract with |
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an appropriate disinterested person who is a nonprofit organization |
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to adjudicate disputes between an institution or facility licensed |
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under Chapter 242, Health and Safety Code, and the Department of |
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Aging and Disability Services concerning a statement of violations |
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prepared by the department in connection with a survey conducted by |
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the department of the institution or facility. Section 2009.053 |
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does not apply to the selection of an appropriate disinterested |
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person under this subsection. The person with whom the commission |
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contracts shall adjudicate all disputes described by this |
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subsection. |
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SECTION 6. (a) As soon as possible after the effective |
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date of this Act, the Department of Aging and Disability Services or |
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the Health and Human Services Commission, as appropriate, shall |
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apply for any waiver or other authorization from a federal agency |
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that is necessary to implement this Act. The department and |
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commission may delay implementing this Act until the waiver or |
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authorization is granted. |
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(b) As soon as practicable after the effective date of this |
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Act: |
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(1) the executive commissioner of the Health and Human |
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Services Commission shall adopt the rules necessary to implement |
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Section 531.058(a-1), Government Code, as added by this Act; and |
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(2) the Department of Aging and Disability Services |
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and the Health and Human Services Commission shall, as appropriate, |
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revise or enter into a memorandum of understanding as required by a |
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federal agency that is necessary to implement Section 531.058(a-1), |
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Government Code, as added by this Act. |
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SECTION 7. Sections 242.061(a-2) and (a-3), Health and |
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Safety Code, as added by this Act, apply only to a violation |
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committed on or after September 1, 2016. A violation committed |
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before September 1, 2016, is governed by the law in effect on the |
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date the violation was committed, and the former law is continued in |
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effect for that purpose. For purposes of this section, a violation |
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was committed before September 1, 2016, if any element of the |
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violation occurred before that date. |
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SECTION 8. (a) Except as provided by Subsection (b) of |
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this section, this Act takes effect immediately if it receives a |
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vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2015. |
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(b) Sections 242.061(a-2) and (a-3), Health and Safety |
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Code, as added by this Act, take effect September 1, 2016. |
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______________________________ |
______________________________ |
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President of the Senate |
Speaker of the House |
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I hereby certify that S.B. No. 304 passed the Senate on |
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March 30, 2015, by the following vote: Yeas 30, Nays 0; and that |
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the Senate concurred in House amendment on May 28, 2015, by the |
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following vote: Yeas 31, Nays 0. |
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______________________________ |
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Secretary of the Senate |
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I hereby certify that S.B. No. 304 passed the House, with |
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amendment, on May 23, 2015, by the following vote: Yeas 138, |
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Nays 1, one present not voting. |
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______________________________ |
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Chief Clerk of the House |
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Approved: |
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______________________________ |
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Date |
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______________________________ |
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Governor |