Bill Text: TX SB1085 | 2019-2020 | 86th Legislature | Introduced


Bill Title: Relating to the licensing and regulation of hospitals in this state; increasing the amount of administrative penalties assessed or imposed against certain hospitals; authorizing the imposition of a fee.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced) 2019-03-07 - Referred to Health & Human Services [SB1085 Detail]

Download: Texas-2019-SB1085-Introduced.html
  86R1655 JCG-D
 
  By: Kolkhorst S.B. No. 1085
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the licensing and regulation of hospitals in this
  state; increasing the amount of administrative penalties assessed
  or imposed against certain hospitals; authorizing the imposition of
  a fee.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 241.022(b), Health and Safety Code, is
  amended to read as follows:
         (b)  The application must contain:
               (1)  the name and social security number of the sole
  proprietor, if the applicant is a sole proprietor;
               (2)  the name and social security number of each
  general partner who is an individual, if the applicant is a
  partnership;
               (3)  the name and social security number of any
  individual who has an ownership interest of more than five [25]
  percent in the corporation, if the applicant is a corporation; and
               (4)  any other information that the department may
  reasonably require.
         SECTION 2.  Subchapter B, Chapter 241, Health and Safety
  Code, is amended by adding Section 241.0221 to read as follows:
         Sec. 241.0221.  CRIMINAL HISTORY BACKGROUND CHECK FOR
  LICENSE APPLICANTS. (a)  This section does not apply to a
  governmental unit required to obtain a license under this chapter.
         (b)  The department shall conduct a criminal history
  background check on each applicant for a license under this chapter
  and, if the applicant is a partnership or corporation, each
  individual named in the application under Section 241.022(b).
         (c)  The executive commissioner by rule shall:
               (1)  determine the manner by which an applicant or
  individual is required to submit information for purposes of a
  criminal history background check under this section; and
               (2)  establish criteria for determining whether an
  applicant is eligible for a license under this chapter based on the
  criminal history background check conducted under this section.
         (d)  The department may enter into an agreement with the
  Department of Public Safety to conduct the criminal history
  background check required under this section.
         SECTION 3.  Subchapter B, Chapter 241, Health and Safety
  Code, is amended by adding Section 241.0261 to read as follows:
         Sec. 241.0261.  INFORMATION SHARING WITH OFFICE OF INSPECTOR
  GENERAL. (a)  The department in accordance with department rules
  may share with the office of inspector general of the commission
  information relating to an applicant for a hospital license under
  this chapter or a hospital license holder.
         (b)  Any information shared by the department under this
  section with the office of inspector general of the commission that
  is confidential under Section 241.051 must remain confidential and
  is not subject to disclosure under Chapter 552, Government Code.
         (c)  The executive commissioner shall adopt the rules
  necessary to implement this section.
         SECTION 4.  Section 241.051, Health and Safety Code, is
  amended by amending Subsection (a) and adding Subsections (a-1),
  (a-2), and (a-3) to read as follows:
         (a)  The department shall conduct an [may make any]
  inspection of each hospital licensed under this chapter as provided
  by Subsections (a-1) and (a-2), and the department may make any
  inspection, survey, or investigation [that] it considers
  necessary.  A representative of the department may enter the
  premises of a hospital at any reasonable time to make an inspection,
  a survey, or an investigation to assure compliance with or prevent a
  violation of this chapter, the rules adopted under this chapter, an
  order or special order of the commissioner, a special license
  provision, a court order granting injunctive relief, or other
  enforcement procedures.  The department shall maintain the
  confidentiality of hospital records as applicable under state or
  federal law.
         (a-1)  The department shall adopt a schedule for the
  inspection of each hospital licensed under this chapter so that 10
  percent of the hospitals, or as near as possible to 10 percent, are
  scheduled to be inspected each year. In scheduling a hospital for
  inspection under this subsection, the department must consider an
  accreditation, validation, or other full survey and must prioritize
  the inspection of hospitals in accordance with risk factors the
  department considers important, including:
               (1)  the date on which a hospital was last inspected;
               (2)  the number of deficiencies noted during the
  previous inspection of a hospital; and
               (3)  the number of complaints received regarding a
  hospital.
         (a-2)  Notwithstanding Subsection (a-1), the department
  shall inspect a hospital licensed under this chapter at least once
  every three years if the hospital:
               (1)  is not accredited by an accreditation body that is
  approved by the Centers for Medicare and Medicaid Services; or
               (2)  does not meet the conditions of participation for
  certification under Title XVIII of the Social Security Act (42
  U.S.C. Section 1395 et seq.).
         (a-3)  The department may request a copy of a hospital's
  latest accreditation survey at any time. The hospital shall comply
  with the department's request.
         SECTION 5.  Subchapter C, Chapter 241, Health and Safety
  Code, is amended by adding Section 241.0532 to read as follows:
         Sec. 241.0532.  EMERGENCY SUSPENSION. (a)  The department
  may issue an emergency order to suspend a license issued under this
  chapter if the department has reasonable cause to believe that the
  conduct of a license holder creates an immediate danger to public
  health and safety. An emergency suspension is effective
  immediately without a hearing on notice to the license holder.
         (b)  Before issuing an emergency order to suspend a license
  under Subsection (a), the department must provide the license
  holder the opportunity to respond to the department's findings.
         (c)  After the issuance of an emergency order under this
  section, on written request of the license holder to the department
  for a hearing, the department shall refer the matter to the State
  Office of Administrative Hearings.  An administrative law judge of
  the office shall conduct a hearing not earlier than the 10th day or
  later than the 30th day after the date the hearing request is
  received by the department to determine if the emergency suspension
  is to be continued, modified, or rescinded.
         (d)  The hearing and any appeal are governed by the
  department's rules for a contested case hearing and Chapter 2001,
  Government Code.
         SECTION 6.  Section 241.059, Health and Safety Code, is
  amended by amending Subsections (b) and (c) and adding Subsections
  (c-1), (c-2), and (c-3) to read as follows:
         (b)  In determining the amount of the penalty, the department
  shall consider:
               (1)  the hospital's previous violations;
               (2)  the seriousness of the violation;
               (3)  any threat to the health, safety, or rights of the
  hospital's patients;
               (4)  the demonstrated good faith of the hospital; [and]
               (5)  the effect of the penalty on the hospital's ability
  to continue to provide services; and
               (6)  such other matters as justice may require.
         (c)  A [The] penalty assessed under this section may not
  exceed:
               (1)  $10,000 [$1,000] for each violation, if the
  hospital is a rural hospital with 75 beds or fewer; or
               (2)  $25,000 for each violation for all other
  hospitals.
         (c-1)  Notwithstanding Subsection (c), [except that] the
  penalty for a violation of Section 166.004 shall be $500.
         (c-2)  Each day of a continuing violation, other than a
  violation of Section 166.004, may be considered a separate
  violation.
         (c-3)  In this section, "rural hospital" means a hospital
  that:
               (1)  is designated as a critical access hospital under
  and in compliance with 42 U.S.C. Section 1395i-4;
               (2)  is classified as a rural referral center under 42
  U.S.C. Section 1395ww(d)(5)(C)(i);
               (3)  is a sole community hospital, as defined by 42
  U.S.C. Section 1395ww(d)(5)(D)(iii); or
               (4)  is located in a county with a population of 60,000
  or less.
         SECTION 7.  Chapter 241, Health and Safety Code, is amended
  by adding Subchapters D and D-1 to read as follows:
  SUBCHAPTER D.  TRUSTEES FOR HOSPITALS
         Sec. 241.081.  INVOLUNTARY APPOINTMENT. (a)  The
  department may request the attorney general to bring an action in
  the name and on behalf of the state for the appointment of a trustee
  to operate a hospital if:
               (1)  the hospital is operating without a license;
               (2)  the department has suspended or revoked the
  hospital's license;
               (3)  license suspension or revocation procedures
  against the hospital are pending and the department determines that
  an immediate danger to public health and safety exists;
               (4)  the department determines that an emergency exists
  that presents an immediate danger to public health and safety; or
               (5)  the hospital is closing and arrangements for
  relocation of the patients to other licensed institutions have not
  been made before closure.
         (b)  A trustee appointed under Subsection (a)(5) may only
  ensure an orderly and safe relocation of the hospital's patients as
  quickly as possible.
         (c)  After a hearing, a court shall appoint a trustee to take
  charge of a hospital if the court finds that involuntary
  appointment of a trustee is necessary.
         (d)  The court shall appoint as trustee an individual whose
  background includes institutional medical administration.
         (e)  Venue for an action brought under this section is in
  Travis County.
         (f)  A court having jurisdiction of a judicial review of the
  matter may not order arbitration, whether on the motion of any party
  or on the court's own motion, to resolve the legal issues of a
  dispute involving the:
               (1)  appointment of a trustee under this section; or
               (2)  conduct with respect to which the appointment of a
  trustee is sought.
         Sec. 241.082.  QUALIFICATIONS OF TRUSTEES. (a)  A court may
  appoint a person to serve as a trustee under this subchapter only if
  the proposed trustee can demonstrate to the court that the proposed
  trustee will be:
               (1)  present at the hospital as required to perform the
  duties of a trustee; and
               (2)  available on call to appropriate staff at the
  hospital, the department, and the court as necessary during the
  time the trustee is not present at the hospital.
         (b)  A trustee shall report to the court in the event that the
  trustee is unable to satisfy the requirements of Subsection (a)(1)
  or (2).
         (c)  On the motion of any party or on the court's own motion,
  the court may replace a trustee who is unable to satisfy the
  requirements of Subsection (a)(1) or (2).
         (d)  A trustee's charges must separately identify personal
  hours worked for which compensation is claimed. A trustee's claim
  for personal compensation may include only compensation for
  activities related to the trusteeship and performed in or on behalf
  of the hospital.
         Sec. 241.083.  COMPENSATION; RELEASE OF FUNDS. (a)  A
  trustee appointed under this subchapter is entitled to reasonable
  compensation as determined by the court. On the motion of any
  party, the court shall review the reasonableness of the trustee's
  compensation. The court shall reduce the amount if the court
  determines that the compensation is not reasonable.
         (b)  The trustee may petition the court to order the release
  to the trustee of any payment owed the trustee for care and services
  provided to the patients if the payment has been withheld,
  including a payment withheld by the commission at the
  recommendation of the department.
         (c)  Withheld payments may include payments withheld by a
  governmental agency or other entity during the appointment of the
  trustee, such as payments:
               (1)  for Medicaid, Medicare, or insurance;
               (2)  by another third party; or
               (3)  for medical expenses borne by the patient.
         (d)  Payments withheld under 42 C.F.R. Section 455.23 or
  Section 531.102(g), Government Code, are not subject to release
  under this section.
         Sec. 241.084.  COMMUNICATIONS BY TRUSTEE. (a)  Except as
  provided by Subsection (b), a trustee appointed under this
  subchapter shall provide periodic reports to the department and the
  governing body of the hospital regarding:
               (1)  the status of the hospital following the emergency
  order to suspend the hospital's license and during the period the
  hospital is operated by the trustee; and
               (2)  each activity performed by the trustee on behalf
  of the hospital.
         (b)  A trustee is not required to report to the governing
  body of the hospital any information that may limit or impair the
  authority or activities of the trustee.
         Sec. 241.085.  EXEMPTION. This subchapter does not apply to
  a hospital owned, operated, or leased by a governmental entity.
  SUBCHAPTER D-1.  HOSPITAL PERPETUAL CARE ACCOUNT; FEE
         Sec. 241.091.  HOSPITAL PERPETUAL CARE ACCOUNT. (a)  The
  hospital perpetual care account is a dedicated account in the
  general revenue fund.
         (b)  The account consists of:
               (1)  fees deposited to the credit of the account under
  this subchapter; and
               (2)  money transferred or appropriated to the account
  by the legislature.
         (c)  The executive commissioner shall administer the
  account. Money in the account may be used only to pay for
  department costs associated with:
               (1)  the storage of medical records by the department;
  and
               (2)  any court-ordered appointment of a trustee to
  operate a hospital as provided under Section 241.081, including the
  payment of reasonable compensation to the trustee under Section
  241.083.
         Sec. 241.092.  HOSPITAL PERPETUAL CARE FEE. (a)  The
  executive commissioner may impose and the department may collect a
  fee from each hospital in an amount necessary to maintain a balance
  of $5 million in the hospital perpetual care account at all times.
         (b)  The fee imposed under this section shall be deposited to
  the credit of the hospital perpetual care account.
         (c)  The department shall suspend collection of the fee for
  the duration of a period during which the balance of the hospital
  perpetual care account is $5 million or more.
         SECTION 8.  (a) The executive commissioner of the Health and
  Human Services Commission shall adopt the rules required by Chapter
  241, Health and Safety Code, as amended by this Act, not later than
  May 1, 2020.
         (b)  The changes in law made by this Act apply only to an
  application submitted under Section 241.022, Health and Safety
  Code, as amended by this Act, or the assessment or imposition of an
  administrative penalty under Section 241.059, Health and Safety
  Code, as amended by this Act, for a violation that occurs on or
  after the effective date of this Act. An application submitted
  under Section 241.022 before the effective date of this Act or the
  assessment or imposition of an administrative penalty under Section
  241.059 for a violation that occurs before the effective date of
  this Act is governed by the law in effect on the date the
  application was submitted or the violation occurred, and that law
  is continued in effect for that purpose.
         (c)  Notwithstanding Section 6(e)(2)(B), Chapter 615 (S.B.
  1367), Acts of the 83rd Legislature, Regular Session, 2013, on
  January 1, 2020, the comptroller of public accounts shall transfer
  $5 million from the fund established under Subchapter F, Chapter
  1508, Insurance Code, to the hospital perpetual care account
  established under Section 241.091, Health and Safety Code, as added
  by this Act.
         SECTION 9.  Section 241.0221, Health and Safety Code, as
  added by this Act, applies only to an application for an original
  license submitted on or after the effective date of this Act. An
  application submitted before that date is governed by the law in
  effect on the date the application was submitted, and the former law
  is continued in effect for that purpose.
         SECTION 10.  As soon as practicable after the effective date
  of this Act, the executive commissioner of the Health and Human
  Services Commission shall adopt rules necessary to implement
  Section 241.0221, Health and Safety Code, as added by this Act.
         SECTION 11.  This Act takes effect immediately if it
  receives a vote of two-thirds of all the members elected to each
  house, as provided by Section 39, Article III, Texas Constitution.
  If this Act does not receive the vote necessary for immediate
  effect, this Act takes effect September 1, 2019.
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