Amend SB 1839 (senate engrossment) as follows:
(1) Following SECTION 7.02 of the bill (page 29, between
lines 8 and 9), insert the following new SECTION, appropriately
numbered:
SECTION 7.___. Amend Subtitle B, Title 4, Health and Safety
Code, by adding Chapter 255 to read as follows:
CHAPTER 255. QUALITY ASSURANCE EARLY WARNING SYSTEM FOR
LONG-TERM CARE FACILITIES; RAPID RESPONSE TEAMS
Sec. 255.001. DEFINITIONS. In this chapter:
(1) "Department" means the Texas Department of Human
Services.
(2) "Long-term care facility" means a nursing
institution, an assisted living facility, or an intermediate care
facility for the mentally retarded licensed under Chapter 242, 247,
or 252, or certified under Chapter 32, Human Resources Code.
(3) "Quality-of-care monitor" means a registered
nurse, pharmacist, or nutritionist who:
(A) is employed by the department;
(B) is trained and experienced in long-term care
facility regulation, standards of practice in long-term care, and
evaluation of patient care; and
(C) functions independently of other divisions
of the department.
Sec. 255.002. EARLY WARNING SYSTEM. The department shall
establish an early warning system to detect conditions that could
be detrimental to the health, safety, and welfare of residents. The
early warning system shall include analysis of financial and
quality-of-care indicators that would predict the need for the
department to take action.
Sec. 255.003. QUALITY-OF-CARE MONITORS. (a) The department
shall establish regional offices with one or more quality-of-care
monitors, based on the number of long-term care facilities in the
region, to monitor the facilities in the region on a regular,
unannounced, aperiodic basis, including nights, evenings, weekends,
and holidays.
(b) Priority for monitoring visits shall be given to
long-term care facilities with a history of patient care
deficiencies.
(c) Quality-of-care monitors may not be deployed by the
department as a part of the regional survey team in the conduct of
routine, scheduled surveys.
(d) A quality-of-care monitor may not interfere with,
impede, or otherwise adversely affect the performance of the duties
of a surveyor, inspector, or investigator of the department.
(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.
(f) The quality-of-care monitor shall include in an
assessment visit:
(1) observation of the care and services rendered to
residents; and
(2) formal and informal interviews with residents,
family members, facility staff, resident guests, volunteers, other
regulatory staff, and representatives of a human rights advocacy
committee.
(g) The identity of a resident or a family member of a
resident interviewed by a quality-of-care monitor as provided by
Subsection (f)(2) shall remain confidential and may not be
disclosed to any person under any other provision of this section.
(h) The findings of a monitoring visit, both positive and
negative, shall be provided orally and in writing to the long-term
care facility administrator or, in the absence of the facility
administrator, to the administrator on duty or the director of
nursing.
(i) The quality-of-care monitor may recommend to the
long-term care facility administrator procedural and policy changes
and staff training to improve the care or quality of life of
facility residents.
(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 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.
Sec. 255.004. RAPID RESPONSE TEAMS. (a) The department
shall create rapid response teams composed of health care experts
that can visit long-term care facilities identified through the
department's early warning system.
(b) Rapid response teams may visit long-term care facilities
that request the department's assistance. A visit under this
subsection may not occur before the 60th day after the date of an
exit interview following an annual or follow-up survey or
inspection.
(c) The rapid response teams may not be deployed for the
purpose of helping a long-term care facility prepare for a regular
inspection or survey conducted under Chapter 242, 247, or 252 or in
accordance with Chapter 32, Human Resources Code.
(2) In SECTION 7.02 of the bill:
(A) In the recital, strike "531.056, 531.057,"
and substitute "531.056" (page 23, line 22).
(B) Strike added Section 531.057, Government
Code (page 24, lines 24-26, page 25, lines 1-26, page 26, lines
1-26, page 27, lines 1-26, and page 28, line 1).
(3) In SECTION 7.04 of the bill, strike "531.056, 531.057,"
and substitute "531.056" (page 30, line 19).
(4) Following SECTION 7.04 of the bill, (page 30, between
lines 20 and 21) insert the following new SECTION, appropriately
numbered:
SECTION 7.___. Not later than January 1, 2002, the Texas
Board of Human Services shall adopt any rules necessary to
implement Chapter 255, Health and Safety Code, as added by this
article.
(5) In SECTION 7.06 of the bill:
(A) Strike "(a)" (page 30, line 25).
(B) Strike Subsection (b)(page 32, lines 2-5).
(6) Renumber SECTIONS of Article 7 of the bill accordingly.
(7) In SECTION 11.01 of the bill, in Subdivision (7) (page
44, lines 11-13), strike "Section 531.057, Government" and
substitute "Chapter 255, Health and Safety".