Amend CSHB 190 as follows:
      (1)  On page 60, line 13, strike "and (o)" and substitute
"(o), and (p)".
      (2)  On page 63, between lines 6 and 7, insert the following:
      (p)  In any circumstance in which a nursing facility would
otherwise be required to admit a resident transferred from another
facility, because of an emergency or otherwise, the nursing
facility may not admit a resident whose needs cannot be met through
service from the facility's staff or in cooperation with community
resources or other providers under contract.  If a nursing facility
refuses to admit a resident under this subsection, the nursing
facility shall provide a written statement of the reasons for the
refusal to the department within a period specified by department
rule. A nursing facility that fails to provide the written
statement, or that includes false or misleading information in the
statement, is subject to monetary penalties assessed in accordance
with this chapter.
      SECTION 2.02.  If before the Texas Department of Human
Services implements  Section 32.021(p), Human Resources Code, as
added by this Act, the  Health and Human  Services Commission
determines that a waiver  or  authorization from  a  federal
agency is necessary for implementation, the commission shall
request the  waiver or authorization and the Texas Department of
Human Services  shall delay implementing this Act  until the waiver
or authorization is granted.