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A BILL TO BE ENTITLED
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AN ACT
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relating to a state plan and requirements for nursing facilities to |
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provide care for persons with Alzheimer's disease and related |
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disorders. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Effective September 1, 2031, Section 242.032(c), |
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Health and Safety Code, is amended to read as follows: |
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(c) The applicant or license holder must furnish evidence to |
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affirmatively establish the applicant's or license holder's ability |
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to comply with: |
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(1) minimum standards of medical care, nursing care, |
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and financial condition; [and] |
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(2) standards for the specialized care and treatment |
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of persons with Alzheimer's disease and related disorders; and |
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(3) any other applicable state or federal standard. |
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SECTION 2. Effective September 1, 2031, Section 242.037, |
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Health and Safety Code, is amended by amending Subsection (e) and |
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adding Subsection (f-1) to read as follows: |
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(e) In addition to standards or rules required by other |
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provisions of this chapter, the executive commissioner shall adopt |
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and publish and the department shall enforce minimum standards |
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relating to: |
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(1) the construction of an institution, including |
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plumbing, heating, lighting, ventilation, and other housing |
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conditions, to ensure the residents' health, safety, comfort, and |
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protection from fire hazard; |
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(2) the regulation of the number and qualification of |
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all personnel, including management and nursing personnel, |
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responsible for any part of the care given to the residents; |
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(3) requirements for in-service education of all |
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employees who have any contact with the residents; |
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(4) [training on the care of persons with Alzheimer's |
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disease and related disorders for employees who work with those |
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persons; |
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[(5)] sanitary and related conditions in an |
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institution and its surroundings, including water supply, sewage |
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disposal, food handling, and general hygiene in order to ensure the |
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residents' health, safety, and comfort; |
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(5) [(6)] the nutritional needs of each resident |
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according to good nutritional practice or the recommendations of |
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the physician attending the resident; |
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(6) [(7)] equipment essential to the residents' health |
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and welfare; |
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(7) [(8)] the use and administration of medication in |
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conformity with applicable law and rules; |
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(8) [(9)] care and treatment of residents and any |
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other matter related to resident health, safety, and welfare; |
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(9) [(10)] licensure of institutions; and |
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(10) [(11)] implementation of this chapter. |
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(f-1) The executive commissioner shall adopt, publish, and |
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enforce standards for the specialized care and treatment of persons |
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with Alzheimer's disease and related disorders, including training |
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requirements for nursing facility employees who provide that |
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specialized care or treatment. The executive commissioner by rule |
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shall adopt and modify as necessary to conform to changes in medical |
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practice a definition of "Alzheimer's disease and related |
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disorders," and may adopt by reference a definition published in a |
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generally accepted clinical resource for medical professionals. |
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The commission may periodically modify the standards as the |
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executive commissioner determines appropriate. |
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SECTION 3. The heading to Section 242.040, Health and |
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Safety Code, is amended to read as follows: |
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Sec. 242.040. CERTIFICATION REQUIREMENTS TO PROVIDE [OF |
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INSTITUTIONS THAT] CARE FOR PERSONS WITH ALZHEIMER'S DISEASE AND |
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RELATED DISORDERS. |
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SECTION 4. Section 242.040, Health and Safety Code, is |
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amended by amending Subsections (a), (b), (c), (e), and (f) and |
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adding Subsections (b-1) and (b-2) to read as follows: |
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(a) The commission [department] shall establish a system |
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for certifying nursing facilities [institutions] that meet |
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standards adopted by the executive commissioner concerning the |
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specialized care and treatment of persons with Alzheimer's disease |
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and related disorders. The commission may periodically modify the |
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system and standards as the executive commissioner determines |
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appropriate. |
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(b) A nursing facility may not [An institution is not |
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required to be certified under this section in order to] provide |
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care and treatment for [of] persons with Alzheimer's disease and |
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related disorders unless the facility holds a certification issued |
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under this section. |
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(b-1) Notwithstanding Subsection (b) and subject to |
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Subsection (b-2), a nursing facility is not required to hold a |
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certification issued under this section to provide care and |
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treatment for persons with Alzheimer's disease and related |
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disorders before January 1, 2031. |
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(b-2) A nursing facility that is initially licensed under |
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this chapter on or after January 1, 2023, must hold a certification |
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issued under this section to provide care and treatment for persons |
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with Alzheimer's disease and related disorders. |
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(c) The executive commissioner by rule shall [may] adopt |
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standards for the specialized care and treatment of persons with |
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Alzheimer's disease and related disorders and provide procedures |
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for nursing facilities [institutions] applying for certification |
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under this section. The rules must provide for a three-year |
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certification period. |
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(e) A nursing facility [An institution] may not advertise or |
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otherwise communicate that the facility [institution] is certified |
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by the commission [department] to provide specialized care for |
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persons with Alzheimer's disease or related disorders unless the |
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facility [institution] is certified under this section. |
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(f) The executive commissioner by rule shall adopt a system |
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under which an appropriate number of certifications issued by the |
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commission [department] expire on staggered dates occurring in each |
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three-year period. If the expiration date of a certification |
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changes as a result of this subsection, the commission [department] |
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shall prorate the certification fee relating to that certification |
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as appropriate. To the extent possible, the system must align the |
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expiration date for a nursing facility's certification under this |
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section with the expiration date for the facility's license under |
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this chapter. |
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SECTION 5. Subchapter B, Chapter 242, Health and Safety |
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Code, is amended by adding Section 242.0405 to read as follows: |
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Sec. 242.0405. STATE PLAN FOR CERTIFICATION OF NURSING |
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FACILITIES TO PROVIDE CARE FOR PERSONS WITH ALZHEIMER'S DISEASE AND |
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RELATED DISORDERS. (a) The commission shall develop a state plan |
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to certify each nursing facility in this state under Section |
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242.040 to provide care and treatment for persons with Alzheimer's |
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disease and related disorders by January 1, 2031, and after that |
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date require as part of licensure under this chapter that the |
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facilities comply with the standards formerly required for |
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certification under Section 242.040. The executive commissioner |
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must approve the state plan and shall adopt rules for implementing |
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the approved state plan. |
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(b) In developing the state plan, the commission shall: |
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(1) conduct a study on certifying each nursing |
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facility in this state under Section 242.040 by January 1, 2031; and |
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(2) determine and consider in implementing the state |
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plan the: |
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(A) costs and challenges; |
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(B) legal and technical issues; and |
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(C) scheduling factors and time considerations. |
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(c) The state plan must require that: |
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(1) at least 10 percent of the total number of nursing |
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facilities in this state be certified under Section 242.040 by |
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January 1, 2023; |
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(2) at least 25 percent of the total number of |
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facilities in this state be certified under Section 242.040 by |
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January 1, 2025; |
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(3) at least 50 percent of the total number of |
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facilities in this state be certified under Section 242.040 by |
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January 1, 2027; |
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(4) at least 75 percent of the total number of |
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facilities in this state be certified under Section 242.040 by |
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January 1, 2029; and |
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(5) each facility in this state as part of the |
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facility's license qualification meets the standards for |
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certification under Section 242.040 by January 1, 2031. |
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(d) The state plan may provide for reimbursement to nursing |
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facilities that become certified under Section 242.040 in amounts |
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based on the following schedule: |
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(1) for a facility that is certified by January 1, |
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2023, the state plan may provide for 100 percent reimbursement of |
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the certification costs; |
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(2) for a facility that is certified by January 1, |
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2025, the state plan may reimburse the facility in an amount not to |
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exceed 75 percent reimbursement of the certification costs; |
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(3) for a facility that is certified by January 1, |
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2027, the state plan may reimburse the facility in an amount not to |
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exceed 50 percent reimbursement of the certification costs; and |
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(4) for a facility that is certified by January 1, |
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2029, the state plan may reimburse the facility in an amount not to |
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exceed 25 percent reimbursement of the certification costs. |
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(e) The commission may use existing resources and solicit |
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and accept gifts, grants, and donations from any source to |
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implement the state plan. |
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(f) This section expires September 1, 2033. |
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SECTION 6. Section 242.202, Health and Safety Code, is |
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amended by amending Subsection (d) and adding Subsection (d-1) to |
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read as follows: |
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(d) The disclosure statement must contain the following |
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categories of information: |
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(1) the nursing facility's [institution's] philosophy |
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of care; |
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(2) [whether the institution is certified under |
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Section 242.040 for the provision of specialized care and treatment |
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of residents with Alzheimer's disease and related disorders; |
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[(3)] the preadmission, admission, and discharge |
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process; |
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(3) [(4)] resident assessment, care planning, and |
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implementation of the care plan; |
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(4) [(5)] staffing patterns, such as |
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resident-to-staff ratios, and staff training; |
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(5) [(6)] the physical environment of the facility |
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[institution]; |
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(6) [(7)] resident activities; |
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(7) [(8)] program costs; |
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(8) [(9)] systems for evaluation of the facility's |
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[institution's] programs for residents; |
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(9) [(10)] family involvement in resident care; and |
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(10) [(11)] the toll-free telephone number maintained |
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by the department for acceptance of complaints against the facility |
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[institution]. |
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(d-1) Before January 1, 2031, the disclosure statement must |
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also include a statement on whether the nursing facility is |
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certified under Section 242.040 for the provision of specialized |
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care and treatment of residents with Alzheimer's disease and |
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related disorders. This subsection expires September 1, 2031. |
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SECTION 7. Effective September 1, 2031, the following |
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provisions of the Health and Safety Code are repealed: |
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(1) Section 242.040; |
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(2) Section 242.041; and |
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(3) Section 242.201. |
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SECTION 8. Not later than September 1, 2022, the Health and |
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Human Services Commission shall develop, and the executive |
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commissioner of the commission shall approve and adopt, rules for |
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implementing the state plan required by Section 242.0405, Health |
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and Safety Code, as added by this Act. |
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SECTION 9. As soon as practicable after the effective date |
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of this Act, the executive commissioner of the Health and Human |
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Services Commission shall adopt the rules necessary to implement |
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the changes in law made by this Act. |
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SECTION 10. Except as otherwise provided by this Act, this |
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Act takes effect September 1, 2021. |