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Amend CSHB 2292 in ARTICLE 2 of the bill by inserting the 
following new SECTION, appropriately numbered, and renumbering 
subsequent sections of the article accordingly:
	SECTION ____.  (a)  Section 242.047, Health and Safety Code, 
is amended to read as follows:
	Sec. 242.047.  ACCREDITATION REVIEW TO SATISFY [INSTEAD OF] 
INSPECTION OR CERTIFICATION REQUIREMENTS.  (a)  The department 
shall accept an annual accreditation review from the Joint 
Commission on Accreditation of Health Organizations for a nursing 
home instead of an inspection for renewal of a license under Section 
242.033 and in satisfaction of the requirements for certification 
by the department for participation in the medical assistance 
program under Chapter 32, Human Resources Code, and the federal 
Medicare program, but only if:
		(1)  the nursing home is accredited by the commission 
under the commission's long-term care standards;
		(2)  the commission maintains an annual inspection or 
review program that, for each nursing home, meets the department's 
applicable minimum standards as confirmed by the board;
		(3)  the commission conducts an annual on-site 
inspection or review of the home; [and]
		(4)  the nursing home submits to the department a copy 
of its annual accreditation review from the commission in addition 
to the application, fee, and any report required for renewal of a 
license or for certification, as applicable; and
		(5)  the department has:                                               
			(A)  determined whether a waiver or authorization 
from a federal agency is necessary under federal law, including for 
federal funding purposes, before the department accepts an annual 
accreditation review from the joint commission:
				(i)  instead of an inspection for license 
renewal purposes;        
				(ii)  as satisfying the requirements for 
certification by the department for participation in the medical 
assistance program; or
				(iii) as satisfying the requirements for 
certification by the department for participation in the federal 
Medicare program; and
			(B)  obtained any necessary federal waivers or 
authorizations.      
	(b)  The department shall coordinate its licensing and 
certification activities with the commission.
	(c)  The department and the commission shall sign a 
memorandum of agreement to implement this section.  The memorandum 
must provide that if all parties to the memorandum do not agree in 
the development, interpretation, and implementation of the 
memorandum, any area of dispute is to be resolved by the board.
	(d)  Except as specifically provided by this section, this
[This] section does not limit the department in performing any 
duties and inspections authorized by this chapter or under any 
contract relating to the medical assistance program under Chapter 
32, Human Resources Code, and Titles XVIII and XIX of the Social 
Security Act (42 U.S.C. Sections 1395 et seq. and 1396 et seq.), 
including authority to take appropriate action relating to an 
institution, such as closing the institution.
	(e)  This section does not require a nursing home to obtain 
accreditation from the commission.
	(b)  Not later than October 1, 2003, the Texas Department of 
Human Services shall:
		(1)  determine whether a waiver or authorization from a 
federal agency is necessary under federal law, including for 
federal funding purposes, before the department may accept an 
annual accreditation review from the Joint Commission on 
Accreditation of Health Organizations for a nursing home:
			(A)  instead of an inspection for purposes of 
renewing a nursing home license under Chapter 242, Health and 
Safety Code;
			(B)  as satisfying the requirements for 
certification by the department for participation in the medical 
assistance program under Chapter 32, Human Resources Code; and
			(C)  as satisfying the requirements for 
certification by the department for participation in the federal 
Medicare program; and
		(2)  if the department determines that a waiver or 
authorization is necessary, request any required waivers or 
authorizations that the department may possibly obtain under 
federal law.
	(c)  Not later than December 1, 2003, the Texas Department of 
Human Services shall report its progress under Subsection (b) of 
this section to the governor and to the presiding officer of each 
house of the legislature.