Texas 2015 - 84th Regular

Texas Senate Bill SB424 Compare Versions

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Version 2 (New)

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1	1	84R22061 MEW-D
2	2	By: Schwertner, et al. S.B. No. 424
3	3	(Zerwas)
4	4	Substitute the following for S.B. No. 424: No.
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the licensing and regulation of hospitals in this
10	10	state; increasing the amount of administrative penalties assessed
11	11	or imposed against certain hospitals; authorizing the imposition of
12	12	a fee.
13	13	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
14	14	SECTION 1. Section 241.022(b), Health and Safety Code, is
15	15	amended to read as follows:
16	16	(b) The application must contain:
17	17	(1) the name and social security number of the sole
18	18	proprietor, if the applicant is a sole proprietor;
19	19	(2) the name and social security number of each
20	20	general partner who is an individual, if the applicant is a
21	21	partnership;
22	22	(3) the name and social security number of any
23	23	individual who has an ownership interest of more than five [25]
24	24	percent in the corporation, if the applicant is a corporation; and
25	25	(4) any other information that the department may
26	26	reasonably require.
27	27	SECTION 2. Subchapter B, Chapter 241, Health and Safety
28	28	Code, is amended by adding Section 241.0261 to read as follows:
29	29	Sec. 241.0261. INFORMATION SHARING WITH OFFICE OF INSPECTOR
30	30	GENERAL. (a) The department in accordance with department rules
31	31	may share with the office of inspector general of the Health and
32	32	Human Services Commission information relating to an applicant for
33	33	a hospital license under this chapter or a hospital license holder.
34	34	(b) Any information shared by the department under this
35	35	section with the office of inspector general of the Health and Human
36	36	Services Commission that is confidential under Section 241.051 must
37	37	remain confidential and is not subject to disclosure under Chapter
38	38	552, Government Code.
39	39	(c) The executive commissioner of the Health and Human
40	40	Services Commission shall adopt the rules necessary to implement
41	41	this section.
42	42	SECTION 3. Section 241.051, Health and Safety Code, is
43	43	amended by amending Subsection (a), as amended by S.B. No. 219, Acts
44	44	of the 84th Legislature, Regular Session, 2015, and adding
45	45	Subsections (a-1), (a-2), and (a-3) to read as follows:
46	46	(a) The department shall conduct an [may make any]
47	47	inspection of each hospital licensed under this chapter as provided
48	48	by Subsections (a-1) and (a-2), and the department may make any
49	49	inspection, survey, or investigation [that] it considers
50	50	necessary. A representative of the department may enter the
51	51	premises of a hospital at any reasonable time to make an inspection,
52	52	a survey, or an investigation to assure compliance with or prevent a
53	53	violation of this chapter, the rules adopted under this chapter, an
54	54	order or special order of the commissioner, a special license
55	55	provision, a court order granting injunctive relief, or other
56	56	enforcement procedures. The department shall maintain the
57	57	confidentiality of hospital records as applicable under state or
58	58	federal law.
59	59	(a-1) The department shall adopt a schedule for the
60	60	inspection of each hospital licensed under this chapter so that 10
61	61	percent of the hospitals, or as near as possible to 10 percent, are
62	62	scheduled to be inspected each year. In scheduling a hospital for
63	63	inspection under this subsection, the department must consider an
64	64	accreditation, validation, or other full survey and must prioritize
65	65	the inspection of hospitals in accordance with risk factors the
66	66	department considers important, including:
67	67	(1) the date on which a hospital was last inspected;
68	68	(2) the number of deficiencies noted during the
69	69	previous inspection of a hospital; and
70	70	(3) the number of complaints received regarding a
71	71	hospital.
72	72	(a-2) Notwithstanding Subsection (a-1), the department
73	73	shall inspect a hospital licensed under this chapter at least once
74	74	every three years if the hospital:
75	75	(1) is not accredited by an accreditation body that is
76	76	approved by the Centers for Medicare and Medicaid Services; or
77	77	(2) does not meet the conditions of participation for
78	78	certification under Title XVIII of the Social Security Act (42
79	79	U.S.C. Section 1395 et seq.).
80	80	(a-3) The department may request a copy of a hospital's
81	81	latest accreditation survey at any time. The hospital shall comply
82	82	with the department's request.
83	83	SECTION 4. Subchapter C, Chapter 241, Health and Safety
84	84	Code, is amended by adding Section 241.0532 to read as follows:
85	85	Sec. 241.0532. EMERGENCY SUSPENSION. (a) The department
86	86	may issue an emergency order to suspend a license issued under this
87	87	chapter if the department has reasonable cause to believe that the
88	88	conduct of a license holder creates an immediate danger to public
89	89	health and safety. An emergency suspension is effective
90	90	immediately without a hearing on notice to the license holder.
91	91	(b) Before issuing an emergency order to suspend a license
92	92	under Subsection (a), the department must provide the license
93	93	holder the opportunity to respond to the department's findings.
94	94	(c) After the issuance of an emergency order under this
95	95	section, on written request of the license holder to the department
96	96	for a hearing, the department shall refer the matter to the State
97	97	Office of Administrative Hearings. An administrative law judge of
98	98	the office shall conduct a hearing not earlier than the 10th day or
99	99	later than the 30th day after the date the hearing request is
100	100	received by the department to determine if the emergency suspension
101	101	is to be continued, modified, or rescinded.
102	102	(d) The hearing and any appeal are governed by the
103	103	department's rules for a contested case hearing and Chapter 2001,
104	104	Government Code.
105	105	SECTION 5. Section 241.059, Health and Safety Code, is
106	106	amended by amending Subsection (b), as amended by S.B. No. 219, Acts
107	107	of the 84th Legislature, Regular Session, 2015, amending Subsection
108	108	(c), and adding Subsections (c-1), (c-2), and (c-3) to read as
109	109	follows:
110	110	(b) In determining the amount of the penalty, the department
111	111	shall consider:
112	112	(1) the hospital's previous violations;
113	113	(2) the seriousness of the violation;
114	114	(3) any threat to the health, safety, or rights of the
115	115	hospital's patients;
116	116	(4) the demonstrated good faith of the hospital; [and]
117	117	(5) the effect of the penalty on the hospital's ability
118	118	to continue to provide services; and
119	119	(6) such other matters as justice may require.
120	120	(c) A [The] penalty assessed under this section may not
121	121	exceed:
122	122	(1) $10,000 [$1,000] for each violation, if the
123	123	hospital is a rural hospital with 75 beds or fewer; or
124	124	(2) $25,000 for each violation for all other
125	125	hospitals.
126	126	(c-1) Notwithstanding Subsection (c), [except that] the
127	127	penalty for a violation of Section 166.004 shall be $500.
128	128	(c-2) Each day of a continuing violation, other than a
129	129	violation of Section 166.004, may be considered a separate
130	130	violation.
131	131	(c-3) In this section, "rural hospital" means a hospital
132	132	that:
133	133	(1) is designated as a critical access hospital under
134	134	and in compliance with 42 U.S.C. Section 1395i-4;
135	135	(2) is classified as a rural referral center under 42
136	136	U.S.C. Section 1395ww(d)(5)(C)(i);
137	137	(3) is a sole community hospital, as defined by 42
138	138	U.S.C. Section 1395ww(d)(5)(D)(iii); or
139	139	(4) is located in a county with a population of 60,000
140	140	or less.
141	141	SECTION 6. Chapter 241, Health and Safety Code, is amended
142	142	by adding Subchapters D and D-1 to read as follows:
143	143	SUBCHAPTER D. TRUSTEES FOR HOSPITALS
144	144	Sec. 241.081. INVOLUNTARY APPOINTMENT. (a) The department
145	145	may request the attorney general to bring an action in the name and
146	146	on behalf of the state for the appointment of a trustee to operate a
147	147	hospital if:
148	148	(1) the hospital is operating without a license;
149	149	(2) the department has suspended or revoked the
150	150	hospital's license;
151	151	(3) license suspension or revocation procedures
152	152	against the hospital are pending and the department determines that
153	153	an immediate danger to public health and safety exists;
154	154	(4) the department determines that an emergency exists
155	155	that presents an immediate danger to public health and safety; or
156	156	(5) the hospital is closing and arrangements for
157	157	relocation of the patients to other licensed institutions have not
158	158	been made before closure.
159	159	(b) A trustee appointed under Subsection (a)(5) may only
160	160	ensure an orderly and safe relocation of the hospital's patients as
161	161	quickly as possible.
162	162	(c) After a hearing, a court shall appoint a trustee to take
163	163	charge of a hospital if the court finds that involuntary
164	164	appointment of a trustee is necessary.
165	165	(d) The court shall appoint as trustee an individual whose
166	166	background includes institutional medical administration.
167	167	(e) Venue for an action brought under this section is in
168	168	Travis County.
169	169	(f) A court having jurisdiction of a judicial review of the
170	170	matter may not order arbitration, whether on the motion of any party
171	171	or on the court's own motion, to resolve the legal issues of a
172	172	dispute involving the:
173	173	(1) appointment of a trustee under this section; or
174	174	(2) conduct with respect to which the appointment of a
175	175	trustee is sought.
176	176	Sec. 241.082. QUALIFICATIONS OF TRUSTEES. (a) A court may
177	177	appoint a person to serve as a trustee under this subchapter only if
178	178	the proposed trustee can demonstrate to the court that the proposed
179	179	trustee will be:
180	180	(1) present at the hospital as required to perform the
181	181	duties of a trustee; and
182	182	(2) available on call to appropriate staff at the
183	183	hospital, the department, and the court as necessary during the
184	184	time the trustee is not present at the hospital.
185	185	(b) A trustee shall report to the court in the event that the
186	186	trustee is unable to satisfy the requirements of Subsection (a)(1)
187	187	or (2).
188	188	(c) On the motion of any party or on the court's own motion,
189	189	the court may replace a trustee who is unable to satisfy the
190	190	requirements of Subsection (a)(1) or (2).
191	191	(d) A trustee's charges must separately identify personal
192	192	hours worked for which compensation is claimed. A trustee's claim
193	193	for personal compensation may include only compensation for
194	194	activities related to the trusteeship and performed in or on behalf
195	195	of the hospital.
196	196	Sec. 241.083. COMPENSATION; RELEASE OF FUNDS. (a) A
197	197	trustee appointed under this subchapter is entitled to reasonable
198	198	compensation as determined by the court. On the motion of any
199	199	party, the court shall review the reasonableness of the trustee's
200	200	compensation. The court shall reduce the amount if the court
201	201	determines that the compensation is not reasonable.
202	202	(b) The trustee may petition the court to order the release
203	203	to the trustee of any payment owed the trustee for care and services
204	204	provided to the patients if the payment has been withheld,
205	205	including a payment withheld by the Health and Human Services
206	206	Commission at the recommendation of the department.
207	207	(c) Withheld payments may include payments withheld by a
208	208	governmental agency or other entity during the appointment of the
209	209	trustee, such as payments:
210	210	(1) for Medicaid, Medicare, or insurance;
211	211	(2) by another third party; or
212	212	(3) for medical expenses borne by the patient.
213	213	Sec. 241.084. COMMUNICATIONS BY TRUSTEE. (a) Except as
214	214	provided by Subsection (b), a trustee appointed under this
215	215	subchapter shall provide periodic reports to the department and the
216	216	governing body of the hospital regarding:
217	217	(1) the status of the hospital following the emergency
218	218	order to suspend the hospital's license and during the period the
219	219	hospital is operated by the trustee; and
220	220	(2) each activity performed by the trustee on behalf
221	221	of the hospital.
222	222	(b) A trustee is not required to report to the governing
223	223	body of the hospital any information that may limit or impair the
224	224	authority or activities of the trustee.
225	225	Sec. 241.085. EXEMPTION. This subchapter does not apply to
226	226	a hospital owned, operated, or leased by a governmental entity.
227	227	SUBCHAPTER D-1. HOSPITAL PERPETUAL CARE ACCOUNT; FEE
228	228	Sec. 241.091. HOSPITAL PERPETUAL CARE ACCOUNT. (a) The
229	229	hospital perpetual care account is a dedicated account in the
230	230	general revenue fund.
231	231	(b) The account consists of:
232	232	(1) fees deposited to the credit of the account under
233	233	this subchapter; and
234	234	(2) money transferred or appropriated to the account
235	235	by the legislature.
236	236	(c) The executive commissioner of the Health and Human
237	237	Services Commission shall administer the account. Money in the
238	238	account may be used only to pay for department costs associated
239	239	with:
240	240	(1) the storage of medical records by the department;
241	241	and
242	242	(2) any court-ordered appointment of a trustee to
243	243	operate a hospital as provided under Section 241.081, including the
244	244	payment of reasonable compensation to the trustee under Section
245	245	241.083.
246	246	Sec. 241.092. HOSPITAL PERPETUAL CARE FEE. (a) The
247	247	executive commissioner of the Health and Human Services Commission
248	248	may impose and the department may collect a fee from each hospital
249	249	in an amount necessary to maintain a balance of $5 million in the
250	250	hospital perpetual care account at all times.
251	251	(b) The fee imposed under this section shall be deposited to
252	252	the credit of the hospital perpetual care account.
253	253	(c) The department shall suspend collection of the fee for
254	254	the duration of a period during which the balance of the hospital
255	255	perpetual care account is $5 million or more.
256	256	SECTION 7. (a) The executive commissioner of the Health and
257	257	Human Services Commission shall adopt the rules required by Chapter
258	258	241, Health and Safety Code, as amended by this Act, not later than
259	259	May 1, 2016.
260	260	(b) The changes in law made by this Act apply only to an
261	261	application submitted under Section 241.022, Health and Safety
262	262	Code, as amended by this Act, or the assessment or imposition of an
263	263	administrative penalty under Section 241.059, Health and Safety
264	264	Code, as amended by this Act, for a violation that occurs on or
265	265	after the effective date of this Act. An application submitted
266	266	under Section 241.022 before the effective date of this Act or the
267	267	assessment or imposition of an administrative penalty under Section
268	268	241.059 for a violation that occurs before the effective date of
269	269	this Act is governed by the law in effect on the date the
270	270	application was submitted or the violation occurred, and that law
271	271	is continued in effect for that purpose.
272	272	(c) Notwithstanding Section 6(e)(2)(B), Chapter 615 (S.B.
273	273	1367), Acts of the 83rd Legislature, Regular Session, 2013, on
274	274	January 1, 2016, the commissioner of insurance shall transfer $5
275	275	million from the fund established under Subchapter F, Chapter 1508,
276	276	Insurance Code, to the hospital perpetual care account established
277	277	under Section 241.091, Health and Safety Code, as added by this Act.
278	278	SECTION 8. This Act takes effect immediately if it receives
279	279	a vote of two-thirds of all the members elected to each house, as
280	280	provided by Section 39, Article III, Texas Constitution. If this
281	281	Act does not receive the vote necessary for immediate effect, this
282	282	Act takes effect September 1, 2015.