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