By Hilderbran                                         H.B. No. 2645
       74R6488 DLF-D
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to licensing standards for certain nursing facilities and
    1-3  penalties that may be assessed against those facilities.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Section 242.002(6), Health and Safety Code, is
    1-6  amended to read as follows:
    1-7              (6)  "Institution" means<:>
    1-8                    <(A)>  an establishment that<:>
    1-9                          <(i)>  furnishes, in one or more
   1-10  facilities, food, <and> shelter, and medical services to four or
   1-11  more persons under the supervision of a physician <who are
   1-12  unrelated to the proprietor of the establishment; and>
   1-13                          <(ii)  provides minor treatment under the
   1-14  direction and supervision of a physician licensed by the Texas
   1-15  State Board of Medical Examiners, or other services that meet some
   1-16  need beyond the basic provision of food, shelter, and laundry; or>
   1-17                    <(B)  a foster care type residential facility
   1-18  that provides room and board to fewer than five persons who:>
   1-19                          <(i)  are not related within the second
   1-20  degree of consanguinity or affinity, as determined under Article
   1-21  5996h, Revised Statutes, to the proprietor; and>
   1-22                          <(ii)  because of their physical or mental
   1-23  limitation, or both, require a level of care and services suitable
   1-24  to their needs that contributes to their health, comfort, and
    2-1  welfare>.
    2-2        SECTION 2.  Section 242.003, Health and Safety Code, is
    2-3  amended to read as follows:
    2-4        Sec. 242.003.  EXEMPTIONS.  <(a)>  Except as otherwise
    2-5  provided, this chapter does not apply to:
    2-6              (1)  a hotel or other similar place that furnishes only
    2-7  food, lodging, or both, to its guests;
    2-8              (2)  a hospital;
    2-9              (3)  an establishment conducted by or for the adherents
   2-10  of a well-recognized church or religious denomination for the
   2-11  purpose of providing facilities for the care or treatment of the
   2-12  sick who depend exclusively on prayer or spiritual means for
   2-13  healing, without the use of any drug or material remedy, if the
   2-14  establishment complies with safety, sanitary, and quarantine laws
   2-15  and rules;
   2-16              (4)  an establishment that furnishes, in addition to
   2-17  food, shelter, and laundry, only baths and massages;
   2-18              (5)  an institution operated by a person licensed by
   2-19  the Texas Board of Chiropractic Examiners;
   2-20              (6)  a facility that:
   2-21                    (A)  primarily engages in training, habilitation,
   2-22  rehabilitation, or education of clients or residents;
   2-23                    (B)  is operated under the jurisdiction of a
   2-24  state or federal agency, including the Texas Rehabilitation
   2-25  Commission, Texas Department of Mental Health and Mental
   2-26  Retardation, Texas Department of Human Services, Texas Commission
   2-27  for the Blind, Texas Commission on Alcohol and Drug Abuse,
    3-1  institutional division of the Texas Department of Criminal Justice,
    3-2  and the Veteran's Administration; and
    3-3                    (C)  is certified through inspection or
    3-4  evaluation as meeting the standards established by the state or
    3-5  federal agency; and
    3-6              (7)  a foster care type residential facility that
    3-7  <serves fewer than five persons and> operates under rules adopted
    3-8  by the Texas Department of Human Services.
    3-9        <(b)  An institution described by Section 242.002(6)(C) is
   3-10  subject to licensing under this chapter only if written application
   3-11  is made for participation in the intermediate care program under
   3-12  federal law.>
   3-13        SECTION 3.  Section 242.037, Health and Safety Code, is
   3-14  amended to read as follows:
   3-15        Sec. 242.037.  MINIMUM STANDARDS.  (a)  The board may adopt,
   3-16  publish, and enforce minimum standards relating to:
   3-17              (1)  the construction of an institution, including
   3-18  plumbing, heating, lighting, ventilation, and other housing
   3-19  conditions, to ensure the residents' health, safety, comfort, and
   3-20  protection from fire hazard;
   3-21              (2)  the regulation of the number and qualification of
   3-22  all personnel, including management and nursing personnel,
   3-23  responsible for any part of the care given to the residents;
   3-24              (3)  requirements for in-service education of all
   3-25  employees who have any contact with the residents;
   3-26              (4)  training on the care of persons with Alzheimer's
   3-27  disease and related disorders for employees who work with those
    4-1  persons;
    4-2              (5)  sanitary and related conditions in an institution
    4-3  and its surroundings, including water supply, sewage disposal, food
    4-4  handling, and general hygiene in order to ensure the residents'
    4-5  health, safety, and comfort;
    4-6              (6)  the dietary needs of each resident according to
    4-7  good nutritional practice or the recommendations of the physician
    4-8  attending the resident;
    4-9              (7)  equipment essential to the residents' health and
   4-10  welfare; and
   4-11              (8)  the use and administration of medication in
   4-12  conformity with applicable law and rules.
   4-13        (b)  Notwithstanding Section 222.0255(b), an institution that
   4-14  is certified as being in compliance with each standard of
   4-15  participation in the state Medicaid program that relates to the
   4-16  same subject matter as a minimum standard established under
   4-17  Subsection (a) is not required to satisfy the minimum standard
   4-18  established under that subsection.
   4-19        SECTION 4.  Section 242.066(a), Health and Safety Code, is
   4-20  amended to read as follows:
   4-21        (a)  The department may assess an administrative <a civil>
   4-22  penalty against a person who violates this chapter or a rule or
   4-23  order adopted or license issued under this chapter.
   4-24        SECTION 5.  Section 242.068(d), Health and Safety Code, is
   4-25  amended to read as follows:
   4-26        (d)  Based on the findings of fact and recommendations of the
   4-27  hearing examiner, the commissioner of health by order may find:
    5-1              (1)  a violation has occurred and assess an
    5-2  administrative <a civil> penalty; or
    5-3              (2)  a violation has not occurred.
    5-4        SECTION 6.  Section 242.069, Health and Safety Code, is
    5-5  amended by amending Subsection (a) and adding Subsection (g) to
    5-6  read as follows:
    5-7        (a)  The commissioner of health shall give notice of the
    5-8  decision taken under Section 242.068(d) to the person charged.  If
    5-9  the commissioner finds that a violation has occurred and has
   5-10  assessed an administrative <a civil> penalty, the commissioner
   5-11  shall give written notice to the person charged of the findings,
   5-12  the amount of the penalty, and the person's right to judicial
   5-13  review of the order.
   5-14        (g)  An administrative penalty collected under this section
   5-15  shall be deposited to the credit of the nursing and convalescent
   5-16  home trust fund established under Section 242.096.
   5-17        SECTION 7.  Subchapter C, Chapter 242, Health and Safety
   5-18  Code, is amended by adding Section 242.071 to read as follows:
   5-19        Sec. 242.071.  EVIDENCE OF VIOLATION.  (a)  A finding by the
   5-20  department that an institution has violated this chapter or a rule
   5-21  adopted under this chapter, or the assessment or payment of an
   5-22  administrative penalty under this subchapter, is not admissible as
   5-23  evidence in a civil action to prove that the institution has
   5-24  committed a violation.
   5-25        (b)  This section does not apply in an enforcement action or
   5-26  related proceeding in which the state or an agency or political
   5-27  subdivision of the state is a party.
    6-1        SECTION 8.  Section 242.132(c), Health and Safety Code, is
    6-2  amended to read as follows:
    6-3        (c)  The criminal penalty provided by this section is in
    6-4  addition to any civil or administrative penalties for which the
    6-5  person may be liable.
    6-6        SECTION 9.  The importance of this legislation and the
    6-7  crowded condition of the calendars in both houses create an
    6-8  emergency and an imperative public necessity that the
    6-9  constitutional rule requiring bills to be read on three several
   6-10  days in each house be suspended, and this rule is hereby suspended,
   6-11  and that this Act take effect and be in force from and after its
   6-12  passage, and it is so enacted.