Texas 2019 - 86th Regular

Texas Senate Bill SB1085 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	86R1655 JCG-D
2	2	By: Kolkhorst S.B. No. 1085
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the licensing and regulation of hospitals in this
8	8	state; increasing the amount of administrative penalties assessed
9	9	or imposed against certain hospitals; authorizing the imposition of
10	10	a fee.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Section 241.022(b), Health and Safety Code, is
13	13	amended to read as follows:
14	14	(b) The application must contain:
15	15	(1) the name and social security number of the sole
16	16	proprietor, if the applicant is a sole proprietor;
17	17	(2) the name and social security number of each
18	18	general partner who is an individual, if the applicant is a
19	19	partnership;
20	20	(3) the name and social security number of any
21	21	individual who has an ownership interest of more than five [25]
22	22	percent in the corporation, if the applicant is a corporation; and
23	23	(4) any other information that the department may
24	24	reasonably require.
25	25	SECTION 2. Subchapter B, Chapter 241, Health and Safety
26	26	Code, is amended by adding Section 241.0221 to read as follows:
27	27	Sec. 241.0221. CRIMINAL HISTORY BACKGROUND CHECK FOR
28	28	LICENSE APPLICANTS. (a) This section does not apply to a
29	29	governmental unit required to obtain a license under this chapter.
30	30	(b) The department shall conduct a criminal history
31	31	background check on each applicant for a license under this chapter
32	32	and, if the applicant is a partnership or corporation, each
33	33	individual named in the application under Section 241.022(b).
34	34	(c) The executive commissioner by rule shall:
35	35	(1) determine the manner by which an applicant or
36	36	individual is required to submit information for purposes of a
37	37	criminal history background check under this section; and
38	38	(2) establish criteria for determining whether an
39	39	applicant is eligible for a license under this chapter based on the
40	40	criminal history background check conducted under this section.
41	41	(d) The department may enter into an agreement with the
42	42	Department of Public Safety to conduct the criminal history
43	43	background check required under this section.
44	44	SECTION 3. Subchapter B, Chapter 241, Health and Safety
45	45	Code, is amended by adding Section 241.0261 to read as follows:
46	46	Sec. 241.0261. INFORMATION SHARING WITH OFFICE OF INSPECTOR
47	47	GENERAL. (a) The department in accordance with department rules
48	48	may share with the office of inspector general of the commission
49	49	information relating to an applicant for a hospital license under
50	50	this chapter or a hospital license holder.
51	51	(b) Any information shared by the department under this
52	52	section with the office of inspector general of the commission that
53	53	is confidential under Section 241.051 must remain confidential and
54	54	is not subject to disclosure under Chapter 552, Government Code.
55	55	(c) The executive commissioner shall adopt the rules
56	56	necessary to implement this section.
57	57	SECTION 4. Section 241.051, Health and Safety Code, is
58	58	amended by amending Subsection (a) and adding Subsections (a-1),
59	59	(a-2), and (a-3) to read as follows:
60	60	(a) The department shall conduct an [may make any]
61	61	inspection of each hospital licensed under this chapter as provided
62	62	by Subsections (a-1) and (a-2), and the department may make any
63	63	inspection, survey, or investigation [that] it considers
64	64	necessary. A representative of the department may enter the
65	65	premises of a hospital at any reasonable time to make an inspection,
66	66	a survey, or an investigation to assure compliance with or prevent a
67	67	violation of this chapter, the rules adopted under this chapter, an
68	68	order or special order of the commissioner, a special license
69	69	provision, a court order granting injunctive relief, or other
70	70	enforcement procedures. The department shall maintain the
71	71	confidentiality of hospital records as applicable under state or
72	72	federal law.
73	73	(a-1) The department shall adopt a schedule for the
74	74	inspection of each hospital licensed under this chapter so that 10
75	75	percent of the hospitals, or as near as possible to 10 percent, are
76	76	scheduled to be inspected each year. In scheduling a hospital for
77	77	inspection under this subsection, the department must consider an
78	78	accreditation, validation, or other full survey and must prioritize
79	79	the inspection of hospitals in accordance with risk factors the
80	80	department considers important, including:
81	81	(1) the date on which a hospital was last inspected;
82	82	(2) the number of deficiencies noted during the
83	83	previous inspection of a hospital; and
84	84	(3) the number of complaints received regarding a
85	85	hospital.
86	86	(a-2) Notwithstanding Subsection (a-1), the department
87	87	shall inspect a hospital licensed under this chapter at least once
88	88	every three years if the hospital:
89	89	(1) is not accredited by an accreditation body that is
90	90	approved by the Centers for Medicare and Medicaid Services; or
91	91	(2) does not meet the conditions of participation for
92	92	certification under Title XVIII of the Social Security Act (42
93	93	U.S.C. Section 1395 et seq.).
94	94	(a-3) The department may request a copy of a hospital's
95	95	latest accreditation survey at any time. The hospital shall comply
96	96	with the department's request.
97	97	SECTION 5. Subchapter C, Chapter 241, Health and Safety
98	98	Code, is amended by adding Section 241.0532 to read as follows:
99	99	Sec. 241.0532. EMERGENCY SUSPENSION. (a) The department
100	100	may issue an emergency order to suspend a license issued under this
101	101	chapter if the department has reasonable cause to believe that the
102	102	conduct of a license holder creates an immediate danger to public
103	103	health and safety. An emergency suspension is effective
104	104	immediately without a hearing on notice to the license holder.
105	105	(b) Before issuing an emergency order to suspend a license
106	106	under Subsection (a), the department must provide the license
107	107	holder the opportunity to respond to the department's findings.
108	108	(c) After the issuance of an emergency order under this
109	109	section, on written request of the license holder to the department
110	110	for a hearing, the department shall refer the matter to the State
111	111	Office of Administrative Hearings. An administrative law judge of
112	112	the office shall conduct a hearing not earlier than the 10th day or
113	113	later than the 30th day after the date the hearing request is
114	114	received by the department to determine if the emergency suspension
115	115	is to be continued, modified, or rescinded.
116	116	(d) The hearing and any appeal are governed by the
117	117	department's rules for a contested case hearing and Chapter 2001,
118	118	Government Code.
119	119	SECTION 6. Section 241.059, Health and Safety Code, is
120	120	amended by amending Subsections (b) and (c) and adding Subsections
121	121	(c-1), (c-2), and (c-3) to read as follows:
122	122	(b) In determining the amount of the penalty, the department
123	123	shall consider:
124	124	(1) the hospital's previous violations;
125	125	(2) the seriousness of the violation;
126	126	(3) any threat to the health, safety, or rights of the
127	127	hospital's patients;
128	128	(4) the demonstrated good faith of the hospital; [and]
129	129	(5) the effect of the penalty on the hospital's ability
130	130	to continue to provide services; and
131	131	(6) such other matters as justice may require.
132	132	(c) A [The] penalty assessed under this section may not
133	133	exceed:
134	134	(1) $10,000 [$1,000] for each violation, if the
135	135	hospital is a rural hospital with 75 beds or fewer; or
136	136	(2) $25,000 for each violation for all other
137	137	hospitals.
138	138	(c-1) Notwithstanding Subsection (c), [except that] the
139	139	penalty for a violation of Section 166.004 shall be $500.
140	140	(c-2) Each day of a continuing violation, other than a
141	141	violation of Section 166.004, may be considered a separate
142	142	violation.
143	143	(c-3) In this section, "rural hospital" means a hospital
144	144	that:
145	145	(1) is designated as a critical access hospital under
146	146	and in compliance with 42 U.S.C. Section 1395i-4;
147	147	(2) is classified as a rural referral center under 42
148	148	U.S.C. Section 1395ww(d)(5)(C)(i);
149	149	(3) is a sole community hospital, as defined by 42
150	150	U.S.C. Section 1395ww(d)(5)(D)(iii); or
151	151	(4) is located in a county with a population of 60,000
152	152	or less.
153	153	SECTION 7. Chapter 241, Health and Safety Code, is amended
154	154	by adding Subchapters D and D-1 to read as follows:
155	155	SUBCHAPTER D. TRUSTEES FOR HOSPITALS
156	156	Sec. 241.081. INVOLUNTARY APPOINTMENT. (a) The
157	157	department may request the attorney general to bring an action in
158	158	the name and on behalf of the state for the appointment of a trustee
159	159	to operate a hospital if:
160	160	(1) the hospital is operating without a license;
161	161	(2) the department has suspended or revoked the
162	162	hospital's license;
163	163	(3) license suspension or revocation procedures
164	164	against the hospital are pending and the department determines that
165	165	an immediate danger to public health and safety exists;
166	166	(4) the department determines that an emergency exists
167	167	that presents an immediate danger to public health and safety; or
168	168	(5) the hospital is closing and arrangements for
169	169	relocation of the patients to other licensed institutions have not
170	170	been made before closure.
171	171	(b) A trustee appointed under Subsection (a)(5) may only
172	172	ensure an orderly and safe relocation of the hospital's patients as
173	173	quickly as possible.
174	174	(c) After a hearing, a court shall appoint a trustee to take
175	175	charge of a hospital if the court finds that involuntary
176	176	appointment of a trustee is necessary.
177	177	(d) The court shall appoint as trustee an individual whose
178	178	background includes institutional medical administration.
179	179	(e) Venue for an action brought under this section is in
180	180	Travis County.
181	181	(f) A court having jurisdiction of a judicial review of the
182	182	matter may not order arbitration, whether on the motion of any party
183	183	or on the court's own motion, to resolve the legal issues of a
184	184	dispute involving the:
185	185	(1) appointment of a trustee under this section; or
186	186	(2) conduct with respect to which the appointment of a
187	187	trustee is sought.
188	188	Sec. 241.082. QUALIFICATIONS OF TRUSTEES. (a) A court may
189	189	appoint a person to serve as a trustee under this subchapter only if
190	190	the proposed trustee can demonstrate to the court that the proposed
191	191	trustee will be:
192	192	(1) present at the hospital as required to perform the
193	193	duties of a trustee; and
194	194	(2) available on call to appropriate staff at the
195	195	hospital, the department, and the court as necessary during the
196	196	time the trustee is not present at the hospital.
197	197	(b) A trustee shall report to the court in the event that the
198	198	trustee is unable to satisfy the requirements of Subsection (a)(1)
199	199	or (2).
200	200	(c) On the motion of any party or on the court's own motion,
201	201	the court may replace a trustee who is unable to satisfy the
202	202	requirements of Subsection (a)(1) or (2).
203	203	(d) A trustee's charges must separately identify personal
204	204	hours worked for which compensation is claimed. A trustee's claim
205	205	for personal compensation may include only compensation for
206	206	activities related to the trusteeship and performed in or on behalf
207	207	of the hospital.
208	208	Sec. 241.083. COMPENSATION; RELEASE OF FUNDS. (a) A
209	209	trustee appointed under this subchapter is entitled to reasonable
210	210	compensation as determined by the court. On the motion of any
211	211	party, the court shall review the reasonableness of the trustee's
212	212	compensation. The court shall reduce the amount if the court
213	213	determines that the compensation is not reasonable.
214	214	(b) The trustee may petition the court to order the release
215	215	to the trustee of any payment owed the trustee for care and services
216	216	provided to the patients if the payment has been withheld,
217	217	including a payment withheld by the commission at the
218	218	recommendation of the department.
219	219	(c) Withheld payments may include payments withheld by a
220	220	governmental agency or other entity during the appointment of the
221	221	trustee, such as payments:
222	222	(1) for Medicaid, Medicare, or insurance;
223	223	(2) by another third party; or
224	224	(3) for medical expenses borne by the patient.
225	225	(d) Payments withheld under 42 C.F.R. Section 455.23 or
226	226	Section 531.102(g), Government Code, are not subject to release
227	227	under this section.
228	228	Sec. 241.084. COMMUNICATIONS BY TRUSTEE. (a) Except as
229	229	provided by Subsection (b), a trustee appointed under this
230	230	subchapter shall provide periodic reports to the department and the
231	231	governing body of the hospital regarding:
232	232	(1) the status of the hospital following the emergency
233	233	order to suspend the hospital's license and during the period the
234	234	hospital is operated by the trustee; and
235	235	(2) each activity performed by the trustee on behalf
236	236	of the hospital.
237	237	(b) A trustee is not required to report to the governing
238	238	body of the hospital any information that may limit or impair the
239	239	authority or activities of the trustee.
240	240	Sec. 241.085. EXEMPTION. This subchapter does not apply to
241	241	a hospital owned, operated, or leased by a governmental entity.
242	242	SUBCHAPTER D-1. HOSPITAL PERPETUAL CARE ACCOUNT; FEE
243	243	Sec. 241.091. HOSPITAL PERPETUAL CARE ACCOUNT. (a) The
244	244	hospital perpetual care account is a dedicated account in the
245	245	general revenue fund.
246	246	(b) The account consists of:
247	247	(1) fees deposited to the credit of the account under
248	248	this subchapter; and
249	249	(2) money transferred or appropriated to the account
250	250	by the legislature.
251	251	(c) The executive commissioner shall administer the
252	252	account. Money in the account may be used only to pay for
253	253	department costs associated with:
254	254	(1) the storage of medical records by the department;
255	255	and
256	256	(2) any court-ordered appointment of a trustee to
257	257	operate a hospital as provided under Section 241.081, including the
258	258	payment of reasonable compensation to the trustee under Section
259	259	241.083.
260	260	Sec. 241.092. HOSPITAL PERPETUAL CARE FEE. (a) The
261	261	executive commissioner may impose and the department may collect a
262	262	fee from each hospital in an amount necessary to maintain a balance
263	263	of $5 million in the hospital perpetual care account at all times.
264	264	(b) The fee imposed under this section shall be deposited to
265	265	the credit of the hospital perpetual care account.
266	266	(c) The department shall suspend collection of the fee for
267	267	the duration of a period during which the balance of the hospital
268	268	perpetual care account is $5 million or more.
269	269	SECTION 8. (a) The executive commissioner of the Health and
270	270	Human Services Commission shall adopt the rules required by Chapter
271	271	241, Health and Safety Code, as amended by this Act, not later than
272	272	May 1, 2020.
273	273	(b) The changes in law made by this Act apply only to an
274	274	application submitted under Section 241.022, Health and Safety
275	275	Code, as amended by this Act, or the assessment or imposition of an
276	276	administrative penalty under Section 241.059, Health and Safety
277	277	Code, as amended by this Act, for a violation that occurs on or
278	278	after the effective date of this Act. An application submitted
279	279	under Section 241.022 before the effective date of this Act or the
280	280	assessment or imposition of an administrative penalty under Section
281	281	241.059 for a violation that occurs before the effective date of
282	282	this Act is governed by the law in effect on the date the
283	283	application was submitted or the violation occurred, and that law
284	284	is continued in effect for that purpose.
285	285	(c) Notwithstanding Section 6(e)(2)(B), Chapter 615 (S.B.
286	286	1367), Acts of the 83rd Legislature, Regular Session, 2013, on
287	287	January 1, 2020, the comptroller of public accounts shall transfer
288	288	$5 million from the fund established under Subchapter F, Chapter
289	289	1508, Insurance Code, to the hospital perpetual care account
290	290	established under Section 241.091, Health and Safety Code, as added
291	291	by this Act.
292	292	SECTION 9. Section 241.0221, Health and Safety Code, as
293	293	added by this Act, applies only to an application for an original
294	294	license submitted on or after the effective date of this Act. An
295	295	application submitted before that date is governed by the law in
296	296	effect on the date the application was submitted, and the former law
297	297	is continued in effect for that purpose.
298	298	SECTION 10. As soon as practicable after the effective date
299	299	of this Act, the executive commissioner of the Health and Human
300	300	Services Commission shall adopt rules necessary to implement
301	301	Section 241.0221, Health and Safety Code, as added by this Act.
302	302	SECTION 11. This Act takes effect immediately if it
303	303	receives a vote of two-thirds of all the members elected to each
304	304	house, as provided by Section 39, Article III, Texas Constitution.
305	305	If this Act does not receive the vote necessary for immediate
306	306	effect, this Act takes effect September 1, 2019.