85R9048 JG-D
	By: Schwertner	S.B. No. 932

	A BILL TO BE ENTITLED
	AN ACT
	relating to the licensing of, the executive commissioner of the
	Health and Human Services Commission's duties with respect to, and
	the administrative penalties for certain long-term care
	facilities.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Sections 531.058(a) and (a-1), Government Code,
	are amended to read as follows:
	(a)  The executive commissioner by rule shall establish an
	informal dispute resolution process in accordance with this
	section.  The process must provide for adjudication by an
	appropriate disinterested person of disputes relating to a proposed
	enforcement action or related proceeding of the commission under
	Section 32.021(d), Human Resources Code, or the Department of Aging
	and Disability Services or its successor agency under Chapter 242,
	247, or 252, Health and Safety Code. The informal dispute
	resolution process must require:
	(1)  an institution or facility to request informal
	dispute resolution not later than the 10th calendar day after
	notification by the commission or department, as applicable, of the
	violation of a standard or standards; and
	(2)  the commission to complete the process not later
	than:
	(A)  the 30th calendar day after receipt of a
	request from an institution or facility, other than an assisted
	living facility, for informal dispute resolution; or
	(B)  the 90th calendar day after receipt of a
	request from an assisted living facility for informal dispute
	resolution.
	(a-1)  As part of the informal dispute resolution process
	established under this section, the commission shall contract with
	an appropriate disinterested person who is a nonprofit organization
	to adjudicate disputes between an institution or facility licensed
	under Chapter 242 or 247, Health and Safety Code, and the Department
	of Aging and Disability Services or its successor agency concerning
	a statement of violations prepared by the department in connection
	with a survey conducted by the department of the institution or
	facility. Section 2009.053 does not apply to the selection of an
	appropriate disinterested person under this subsection. The person
	with whom the commission contracts shall adjudicate all disputes
	described by this subsection.
	SECTION 2.  Subchapter B, Chapter 531, Government Code, is
	amended by adding Section 531.0585 to read as follows:
	Sec. 531.0585.  ISSUANCE OF MATERIALS TO CERTAIN LONG-TERM
	CARE FACILITIES. The executive commissioner shall review the
	commission's methods for issuing informational letters, policy
	updates, policy clarifications, and other related materials to an
	entity licensed under Chapter 103, Human Resources Code, or Chapter
	242, 247, 248A, or 252, Health and Safety Code, and develop and
	implement more efficient methods to issue those materials as
	appropriate.
	SECTION 3.  Section 242.066, Health and Safety Code, is
	amended by amending Subsections (a) and (e) and adding Subsection
	(i) to read as follows:
	(a)  The commission [department] may assess an
	administrative penalty against a person who:
	(1)  violates this chapter or a rule, standard, or
	order adopted or license issued under this chapter;
	(2)  makes a false statement, that the person knows or
	should know is false, of a material fact:
	(A)  on an application for issuance or renewal of
	a license or in an attachment to the application; or
	(B)  with respect to a matter under investigation
	by the commission [department];
	(3)  refuses to allow a representative of the
	commission [department] to inspect:
	(A)  a book, record, or file required to be
	maintained by an institution; or
	(B)  any portion of the premises of an
	institution;
	(4)  wilfully interferes with the work of a
	representative of the commission [department] or the enforcement of
	this chapter;
	(5)  wilfully interferes with a representative of the
	commission [department] preserving evidence of a violation of this
	chapter or a rule, standard, or order adopted or license issued
	under this chapter;
	(6)  fails to pay a penalty assessed by the commission
	[department] under this chapter not later than the 10th day after
	the date the assessment of the penalty becomes final; or
	(7)  fails to notify the commission [department] of a
	change of ownership before the effective date of the change of
	ownership.
	(e)  In determining the amount of a penalty, the commission
	[department] shall consider any matter that justice may require,
	including:
	(1)  the gradations of penalties established under
	Subsection (d);
	(2)  the seriousness of the violation, including the
	nature, circumstances, extent, and gravity of the prohibited act
	and the hazard or potential hazard created by the act to the health
	or safety of the public;
	(3)  the history of previous violations;
	(4)  deterrence of future violations; and
	(5)  efforts to correct the violation.
	(i)  The commission shall develop and use a system to record
	and track the scope and severity of each violation of this chapter
	or a rule, standard, or order adopted under this chapter for the
	purpose of assessing an administrative penalty for the violation or
	taking some other enforcement action against the appropriate
	institution to deter future violations. The system:
	(1)  must be comparable to the system used by the
	Centers for Medicare and Medicaid Services to categorize the scope
	and severity of violations for nursing homes; and
	(2)  may be modified, as appropriate, to reflect
	changes in industry practice or changes made to the system used by
	the Centers for Medicare and Medicaid Services.
	SECTION 4.  Section 242.0665, Health and Safety Code, is
	amended to read as follows:
	Sec. 242.0665.  RIGHT TO CORRECT. (a) The commission
	[department] may not collect an administrative penalty against an
	institution under this subchapter if, not later than the 45th day
	after the date the institution receives notice under Section
	242.067(c), the institution corrects the violation.
	(b)  Subsection (a) does not apply:
	(1)  to a violation that the commission [department]
	determines:
	(A)  represents a pattern of violations that
	results in actual [serious] harm [to or death of a resident];
	(B)  results in actual harm that is pervasive
	throughout the services provided by the institution or that
	represents a systemic failure by the institution that affects or
	has the potential to affect a large number of or all of the
	residents of the institution;
	(C)  constitutes the potential for actual harm
	that is pervasive throughout the services provided by the
	institution or that represents a systemic failure by the
	institution that affects or has the potential to affect a large
	number of or all of the residents of the institution and is a
	violation of this chapter or a rule, standard, or order adopted
	under this chapter relating to:
	(i)  residents' rights;
	(ii)  treatment of residents;
	(iii)  resident behavior and institution
	practices;
	(iv)  quality of care;
	(v)  medication errors;
	(vi)  standard menus and nutritional
	adequacy;
	(vii)  physician visits;
	(viii)  infection control;
	(ix)  life safety from fire; or
	(x)  emergency preparedness and response;
	(D) [(B)]  constitutes an immediate [a serious]
	threat to the health or safety of a resident; or
	(E) [(C)]  substantially limits the institution's
	capacity to provide care;
	(2)  to a violation described by Sections
	242.066(a)(2)-(7);
	(3)  to a violation of Section 260A.014 or 260A.015; or
	(4)  to a violation of a right of a resident adopted
	under Subchapter L.
	(c)  An institution that corrects a violation under
	Subsection (a) must maintain the correction. If the institution
	fails to maintain the correction until at least the first
	anniversary of the date the correction was made, the commission
	[department] may assess an administrative penalty under this
	subchapter for the subsequent violation. A penalty assessed under
	this subsection shall be equal to three times the amount of the
	penalty assessed but not collected under Subsection (a). The
	commission [department] is not required to provide the institution
	an opportunity to correct the subsequent violation under this
	section.
	(d)  In this section:
	(1)  "Actual harm" means a negative outcome that
	compromises a resident's physical, mental, or emotional
	well-being.
	(2)  "Immediate threat to the health or safety of a
	resident" means a situation that causes, or is likely to cause,
	serious injury, harm, or impairment to or the death of a resident.
	(3)  "Pattern of violations" means the repeated, but
	not pervasive, occurrence of violations that are found throughout
	the services provided by an institution or that affect or involve
	the same residents or institution employees.
	SECTION 5.  Section 247.023, Health and Safety Code, is
	amended to read as follows:
	Sec. 247.023.  ISSUANCE AND RENEWAL OF LICENSE.  (a)  The
	commission [department] shall issue a license if, after inspection
	and investigation, it finds that the applicant, the assisted living
	facility, and all controlling persons with respect to the applicant
	or facility meet the requirements of this chapter and the standards
	adopted under this chapter.  The license expires on the third
	[second] anniversary of the date of its issuance.  The executive
	commissioner by rule shall [may] adopt a system under which
	licenses expire on staggered [various] dates during each [the]
	three-year [two-year] period.  The commission shall prorate the
	license fee as appropriate if the expiration date of a license
	changes as a result of this subsection [For the year in which a
	license expiration date is changed, the department shall prorate
	the license fee on a monthly basis.   Each license holder shall pay
	only that portion of the license fee allocable to the number of
	months during which the license is valid.   A license holder shall
	pay the total license renewal fee at the time of renewal].
	(b)  To renew a license, the license holder must submit to
	the commission [department] the license renewal fee.
	(c)  The commission [department] may require participation
	in a continuing education program as a condition of renewal of a
	license.  The executive commissioner shall adopt rules to implement
	this subsection.
	SECTION 6.  Section 247.027, Health and Safety Code, is
	amended to read as follows:
	Sec. 247.027.  INSPECTIONS. (a) In addition to the
	inspection required under Section 247.023(a), the commission:
	(1)  shall [department may] inspect each [an] assisted
	living facility every two years following the initial inspection
	required under Section 247.023(a); [annually] and
	(2)  may inspect a facility at other reasonable times
	as necessary to assure compliance with this chapter.
	(b)  The commission [department] shall establish an
	inspection checklist based on the minimum standards that describes
	the matters subject to inspection. The commission [department]
	shall use the inspection checklist in conducting inspections under
	this section and Section 247.023(a).
	SECTION 7.  Section 247.0451, Health and Safety Code, is
	amended by amending Subsections (a), (b), (d), and (f) and adding
	Subsections (g) and (h) to read as follows:
	(a)  The commission [department] may assess an
	administrative penalty against a person who:
	(1)  violates this chapter or a rule, standard, or
	order adopted under this chapter or a term of a license issued under
	this chapter;
	(2)  makes a false statement, that the person knows or
	should know is false, of a material fact:
	(A)  on an application for issuance or renewal of
	a license or in an attachment to the application; or
	(B)  with respect to a matter under investigation
	by the commission [department];
	(3)  refuses to allow a representative of the
	commission [department] to inspect:
	(A)  a book, record, or file required to be
	maintained by an assisted living facility; or
	(B)  any portion of the premises of an assisted
	living facility;
	(4)  wilfully interferes with the work of a
	representative of the commission [department] or the enforcement of
	this chapter;
	(5)  wilfully interferes with a representative of the
	commission [department] preserving evidence of a violation of this
	chapter or a rule, standard, or order adopted under this chapter or
	a term of a license issued under this chapter;
	(6)  fails to pay a penalty assessed under this chapter
	not later than the 30th day after the date the assessment of the
	penalty becomes final; or
	(7)  fails to notify the commission [department] of a
	change of ownership before the effective date of the change of
	ownership.
	(b)  Except as provided by Section 247.0452(c), the penalty
	may not exceed:
	(1)  $5,000 for each violation that results in actual
	harm or that constitutes an immediate threat to the health or safety
	of a resident; or
	(2)  $1,000 for each other violation.
	(d)  In determining the amount of a penalty, the commission
	[department] shall consider any matter that justice may require,
	but must consider each of the following and make a record of the
	extent to which each of the following was considered:
	(1)  the gradations of penalties established under
	Subsection (c);
	(2)  the seriousness of the violation, including the
	nature, circumstances, extent, and gravity of the prohibited act
	and the hazard or potential hazard created by the act to the health
	or safety of the public;
	(3)  the history of previous violations;
	(4)  deterrence of future violations;
	(5)  efforts to correct the violation; and
	(6)  the size of the facility and of the business entity
	that owns the facility.
	(f)  The commission [department] may not assess a penalty
	under this section against a resident of an assisted living
	facility unless the resident is also an employee of the facility or
	a controlling person.
	(g)  The commission shall develop and use a system to record
	and track the scope and severity of each violation of this chapter
	or a rule, standard, or order adopted under this chapter for the
	purpose of assessing an administrative penalty for the violation or
	taking some other enforcement action against the appropriate
	assisted living facility to deter future violations. The system:
	(1)  must be comparable to the system used by the
	Centers for Medicare and Medicaid Services to categorize the scope
	and severity of violations for nursing homes; and
	(2)  may be modified, as appropriate, to reflect
	changes in industry practice or changes made to the system used by
	the Centers for Medicare and Medicaid Services.
	(h)  In this section:
	(1)  "Actual harm" has the meaning assigned by Section
	247.0452.
	(2)  "Immediate threat to the health or safety of a
	resident" has the meaning assigned by Section 247.0452.
	SECTION 8.  Section 247.0452, Health and Safety Code, is
	amended to read as follows:
	Sec. 247.0452.  RIGHT TO CORRECT.  (a)  The commission
	[department] may not collect an administrative penalty from an
	assisted living facility under Section 247.0451 if, not later than
	the 45th day after the date the facility receives notice under
	Section 247.0453(c), the facility corrects the violation.
	(b)  Subsection (a) does not apply:
	(1)  to a violation that the commission [department]
	determines represents a pattern of violations that results in
	actual [serious] harm [to or death of a resident];
	(2)  to a violation that the commission determines
	results in actual harm that is pervasive throughout the services
	provided by the assisted living facility or that represents a
	systemic failure by the assisted living facility that affects or
	has the potential to affect a large number of or all of the
	residents of the facility;
	(3)  to a violation that the commission determines
	constitutes the potential for actual harm that is pervasive
	throughout the services provided by the assisted living facility or
	that represents a systemic failure by the assisted living facility
	that affects or has the potential to affect a large number of or all
	of the residents of the facility and is a violation of this chapter
	or a rule, standard, or order adopted under this chapter relating
	to:
	(A)  resident assessment;
	(B)  staffing, including staff training;
	(C)  resident policies, including residents'
	rights;
	(D)  administration of medication;
	(E)  activities;
	(F)  infection control;
	(G)  restraints; or
	(H)  emergency preparedness and response;
	(4)  to a violation that the commission determines
	constitutes an immediate threat to the health or safety of a
	resident;
	(5) [(2)]  to a violation described by Sections
	247.0451(a)(2)-(7) or a violation of Section 260A.014 or 260A.015;
	(6) [(3)]  to a second or subsequent violation of:
	(A)  a right of the same resident under Section
	247.064; or
	(B)  the same right of all residents under Section
	247.064; or
	(7) [(4)]  to a violation described by Section 247.066,
	which contains its own right to correct provisions.
	(c)  An assisted living facility that corrects a violation
	must maintain the correction. If the facility fails to maintain the
	correction until at least the first anniversary of the date the
	correction was made, the commission [department] may assess and
	collect an administrative penalty for the subsequent violation. An
	administrative penalty assessed under this subsection is equal to
	three times the amount of the original penalty assessed but not
	collected. The commission [department] is not required to provide
	the facility with an opportunity under this section to correct the
	subsequent violation.
	(d)  In this section:
	(1)  "Actual harm" means a negative outcome that
	compromises a resident's physical, mental, or emotional
	well-being.
	(2)  "Immediate threat to the health or safety of a
	resident" means a situation that causes, or is likely to cause,
	serious injury, harm, or impairment to or the death of a resident.
	(3)  "Pattern of violations" means the repeated, but
	not pervasive, occurrence of violations that are found throughout
	the services provided by an assisted living facility or that affect
	or involve the same residents or facility employees.
	SECTION 9.  Section 248A.053, Health and Safety Code, is
	amended to read as follows:
	Sec. 248A.053.  INITIAL OR RENEWAL LICENSE TERM; RENEWAL;
	NOTIFICATION.  (a)  An initial or renewal license issued under this
	chapter expires on the third [second] anniversary of the date of
	issuance.  The executive commissioner by rule shall adopt a system
	under which licenses expire on staggered dates during each
	three-year period.  The commission shall prorate the license fee as
	appropriate if the expiration date of a license changes as a result
	of this subsection.
	(b)  A person applying to renew a center license shall:
	(1)  submit a renewal application to the commission
	[department] on a [the form] prescribed form [by the department] at
	least 60 days but not more than 120 days before expiration of the
	license;
	(2)  submit the renewal fee in the amount required by
	agency [department] rule; and
	(3)  comply with any other requirements specified by
	agency [department] rule.
	(c)  The commission [department] shall assess a $50 per day
	late fee to a license holder who submits a renewal application after
	the date required by Subsection (b)(1), except that the total
	amount of a late fee may not exceed the lesser of 50 percent of the
	license renewal fee or $500.
	(d)  At least 120 days before expiration of a center license,
	the commission [department] shall notify the owner or operator of
	the center of the license expiration.
	SECTION 10.  Subchapter F, Chapter 248A, Health and Safety
	Code, is amended by adding Section 248A.2515 to read as follows:
	Sec. 248A.2515.  SYSTEM FOR ASSESSMENT OF PENALTY. The
	commission shall develop and use a system to record and track the
	scope and severity of each violation of this chapter or a rule or
	standard adopted or order issued under this chapter for the purpose
	of assessing an administrative penalty for the violation or taking
	some other enforcement action against the appropriate center to
	deter future violations.  The system:
	(1)  must be comparable to the system used by the
	Centers for Medicare and Medicaid Services to categorize the scope
	and severity of violations for nursing homes; and
	(2)  may be modified, as appropriate, to reflect
	changes in industry practice or changes made to the system used by
	the Centers for Medicare and Medicaid Services.
	SECTION 11.  Sections 252.033(a), (b), (d), (f), and (h),
	Health and Safety Code, are amended to read as follows:
	(a)  After receiving the application, the commission
	[department] shall issue a license if, after inspection and
	investigation, it finds that the applicant and facility meet the
	requirements established under this chapter.
	(b)  The commission [department] may issue a license only
	for:
	(1)  the premises and persons or governmental unit
	named in the application; and
	(2)  the maximum number of beds specified in the
	application.
	(d)  A license is renewable on the third [second] anniversary
	of issuance or renewal of the license after:
	(1)  an inspection;
	(2)  filing and approval of a renewal report; and
	(3)  payment of the renewal fee.
	(f)  The commission [department] may not issue a license for
	new beds or an expansion of an existing facility under this chapter
	unless the addition of new beds or the expansion is included in the
	plan approved by the commission in accordance with Section
	533A.062.
	(h)  The executive commissioner by rule shall:
	(1)  define specific, appropriate, and objective
	criteria on which the commission [department] may deny an initial
	license application or license renewal or revoke a license; and
	(2)  adopt a system under which:
	(A)  licenses expire on staggered dates during
	each three-year period; and
	(B)  the commission prorates the license fee as
	appropriate if the expiration date of a license changes as a result
	of the system adopted under Paragraph (A).
	SECTION 12.  Section 252.041, Health and Safety Code, is
	amended to read as follows:
	Sec. 252.041.  UNANNOUNCED INSPECTIONS. (a) Each licensing
	period, the commission [department] shall conduct at least three
	[two] unannounced inspections of each facility.
	(b)  In order to ensure continuous compliance, the
	commission [department] shall randomly select a sufficient
	percentage of facilities for unannounced inspections to be
	conducted between 5 p.m. and 8 a.m. Those inspections must be
	cursory to avoid to the greatest extent feasible any disruption of
	the residents.
	(c)  The commission [department] may require additional
	inspections.
	(d)  As considered appropriate and necessary by the
	commission [department], the commission [department] may invite at
	least one person as a citizen advocate to participate in
	inspections. The invited advocate must be an individual who has an
	interest in or who is employed by or affiliated with an organization
	or entity that represents, advocates for, or serves individuals
	with an intellectual disability or a related condition.
	SECTION 13.  Section 252.065, Health and Safety Code, is
	amended by amending Subsections (a), (b), (e), (f), (i), and (j) and
	adding Subsections (l) and (m) to read as follows:
	(a)  The commission [department] may assess an
	administrative penalty against a person who:
	(1)  violates this chapter or a rule, standard, or
	order adopted or license issued under this chapter;
	(2)  makes a false statement, that the person knows or
	should know is false, of a material fact:
	(A)  on an application for issuance or renewal of
	a license or in an attachment to the application; or
	(B)  with respect to a matter under investigation
	by the commission [department];
	(3)  refuses to allow a representative of the
	commission [department] to inspect:
	(A)  a book, record, or file required to be
	maintained by the institution; or
	(B)  any portion of the premises of an
	institution;
	(4)  wilfully interferes with the work of a
	representative of the commission [department] or the enforcement of
	this chapter;
	(5)  wilfully interferes with a representative of the
	commission [department] preserving evidence of a violation of this
	chapter or a rule, standard, or order adopted or license issued
	under this chapter;
	(6)  fails to pay a penalty assessed by the commission
	[department] under this chapter not later than the 10th day after
	the date the assessment of the penalty becomes final;
	(7)  fails to submit a plan of correction within 10 days
	after receiving a statement of licensing violations; or
	(8)  fails to notify the commission [department] of a
	change in ownership before the effective date of that change of
	ownership.
	(b)  The penalty for a facility with fewer than 60 beds shall
	be not less than $100 or more than $1,000 for each violation. The
	penalty for a facility with 60 beds or more shall be not less than
	$100 or more than $5,000 for each violation. [The total amount of
	the penalty assessed for a violation continuing or occurring on
	separate days under this subsection may not exceed $5,000 for a
	facility with fewer than 60 beds or $25,000 for a facility with 60
	beds or more.] Each day a violation occurs or continues is a
	separate violation for purposes of imposing a penalty.
	(e)  The executive commissioner by rule shall provide the
	facility with a reasonable period of time, not less than 45 days,
	following the first day of a violation to correct the violation
	before the commission [department] may assess an administrative
	penalty if a plan of correction has been implemented. This
	subsection does not apply to a violation described by Subsections
	(a)(2)-(8) or to a violation that the commission [department]
	determines:
	(1)  represents a pattern of violations that results
	[has resulted] in actual [serious] harm [to or the death of a
	resident];
	(2)  results in actual harm that is pervasive
	throughout the services provided by the facility or that represents
	a systemic failure by the facility that affects or has the potential
	to affect a large number of or all of the residents of the facility;
	(3)  constitutes the potential for actual harm that is
	pervasive throughout the services provided by the facility or that
	represents a systemic failure by the facility that affects or has
	the potential to affect a large number of or all of the residents of
	the facility and is a violation of this chapter or a rule, standard,
	or order adopted under this chapter relating to:
	(A)  staff treatment of a resident;
	(B)  active treatment;
	(C)  client behavior and facility practices;
	(D)  health care services;
	(E)  drug administration;
	(F)  infection control;
	(G)  food and nutrition services; or
	(H)  emergency preparedness and response;
	(4) [(2)]  constitutes an immediate [a serious] threat
	to the health or safety of a resident; or
	(5) [(3)]  substantially limits the facility's
	[institution's] capacity to provide care.
	(f)  The commission [department] may not assess an
	administrative penalty for a minor violation if the person corrects
	the violation not later than the 46th day after the date the person
	receives notice of the violation.
	(i)  The commission [department] may not assess an
	administrative penalty against a state agency.
	(j)  Notwithstanding any other provision of this section, an
	administrative penalty ceases to be incurred on the date a
	violation is corrected. The administrative penalty ceases to be
	incurred only if the facility:
	(1)  notifies the commission [department] in writing of
	the correction of the violation and of the date the violation was
	corrected; and
	(2)  shows later that the violation was corrected.
	(l)  The commission shall develop and use a system to record
	and track the scope and severity of each violation of this chapter
	or a rule, standard, or order adopted under this chapter for the
	purpose of assessing an administrative penalty for the violation or
	taking some other enforcement action against the appropriate
	facility to deter future violations. The system:
	(1)  must be comparable to the system used by the
	Centers for Medicare and Medicaid Services to categorize the scope
	and severity of violations for nursing homes; and
	(2)  may be modified, as appropriate, to reflect
	changes in industry practice or changes made to the system used by
	the Centers for Medicare and Medicaid Services.
	(m)  In this section:
	(1)  "Actual harm" means a negative outcome that
	compromises a resident's physical, mental, or emotional
	well-being.
	(2)  "Immediate threat to the health or safety of a
	resident" means a situation that causes, or is likely to cause,
	serious injury, harm, or impairment to or the death of a resident.
	(3)  "Pattern of violations" means the repeated, but
	not pervasive, occurrence of violations that are found throughout
	the services provided by a facility or that affect or involve the
	same residents or facility employees.
	SECTION 14.  Section 103.003, Human Resources Code, is
	amended by amending Subdivision (1) and adding Subdivisions (1-a)
	and (4-b) to read as follows:
	(1)  "Commission" means the Health and Human Services
	Commission.
	(1-a)  "Day activity and health services facility"
	means a facility that provides services under a day activity and
	health services program on a daily or regular basis but not
	overnight to four or more elderly persons or persons with
	disabilities who are not related by blood, marriage, or adoption to
	the owner of the facility.
	(4-b)  "Facility" means a day activity and health
	services facility.
	SECTION 15.  Sections 103.006(a) and (b), Human Resources
	Code, are amended to read as follows:
	(a)  The commission [department] shall issue a license to
	operate a day activity and health services facility to a person who
	has met the application requirements and received approval after an
	on-site inspection.
	(b)  The license expires three [two] years from the date of
	its issuance. The executive commissioner by rule shall [may] adopt
	a system under which licenses expire on staggered [various] dates
	during the three-year [two-year] period. The commission shall
	prorate the license fee as appropriate if the expiration date of a
	license changes as a result of this subsection [For the year in
	which a license expiration date is changed, the department shall
	prorate the license fee on a monthly basis. Each license holder
	shall pay only that portion of the license fee allocable to the
	number of months for which the license is valid. A license holder
	shall pay the total license renewal fee at the time of renewal].
	SECTION 16.  Section 103.008, Human Resources Code, is
	amended to read as follows:
	Sec. 103.008.  INSPECTIONS. (a) In addition to the
	inspection required under Section 103.006(a), the commission:
	(1)  shall inspect each facility every two years
	following the initial inspection required under Section
	103.006(a); and
	(2)  [The department] may inspect [enter the premises
	of] a facility at other reasonable times as [and make an inspection]
	necessary to ensure compliance with this chapter [issue a license
	or renew a license].
	(b)  Any person may request an inspection of a facility by
	notifying the commission [department] in writing of an alleged
	violation of a licensing requirement. The complaint shall be as
	detailed as possible and signed by the complainant. The commission
	[department] shall perform an on-site inspection as soon as
	feasible but no later than 30 days after receiving the complaint
	unless after an investigation the complaint is found to be
	frivolous. The commission [department] shall respond to a
	complainant in writing. The commission [department] shall also
	receive and investigate anonymous complaints.
	SECTION 17.  Section 103.012, Human Resources Code, is
	amended by amending Subsections (a) and (e) and adding Subsection
	(g) to read as follows:
	(a)  The commission [department] may assess an
	administrative penalty against a person who:
	(1)  violates this chapter, a rule, standard, or order
	adopted under this chapter, or a term of a license issued under this
	chapter;
	(2)  makes a false statement of a material fact that the
	person knows or should know is false:
	(A)  on an application for issuance or renewal of
	a license or in an attachment to the application; or
	(B)  with respect to a matter under investigation
	by the commission [department];
	(3)  refuses to allow a representative of the
	commission [department] to inspect:
	(A)  a book, record, or file required to be
	maintained by a day activity and health services facility; or
	(B)  any portion of the premises of a day activity
	and health services facility;
	(4)  wilfully interferes with the work of a
	representative of the commission [department] or the enforcement of
	this chapter;
	(5)  wilfully interferes with a representative of the
	commission [department] preserving evidence of a violation of this
	chapter, a rule, standard, or order adopted under this chapter, or a
	term of a license issued under this chapter;
	(6)  fails to pay a penalty assessed under this chapter
	not later than the 30th day after the date the assessment of the
	penalty becomes final; or
	(7)  fails to notify the commission [department] of a
	change of ownership before the effective date of the change of
	ownership.
	(e)  In determining the amount of a penalty, the commission
	[department] shall consider any matter that justice may require,
	including:
	(1)  the gradations of penalties established under
	Subsection (d);
	(2)  the seriousness of the violation, including the
	nature, circumstances, extent, and gravity of the prohibited act
	and the hazard or potential hazard created by the act to the health
	or safety of the public;
	(3)  the history of previous violations;
	(4)  the deterrence of future violations; and
	(5)  the efforts to correct the violation.
	(g)  The commission shall develop and use a system to record
	and track the scope and severity of each violation of this chapter
	or a rule, standard, or order adopted under this chapter for the
	purpose of assessing an administrative penalty for the violation or
	taking some other enforcement action against the appropriate
	facility to deter future violations. The system:
	(1)  must be comparable to the system used by the
	Centers for Medicare and Medicaid Services to categorize the scope
	and severity of violations for nursing homes; and
	(2)  may be modified, as appropriate, to reflect
	changes in industry practice or changes made to the system used by
	the Centers for Medicare and Medicaid Services.
	SECTION 18.  Section 103.013, Human Resources Code, is
	amended to read as follows:
	Sec. 103.013.  RIGHT TO CORRECT BEFORE IMPOSITION OF
	ADMINISTRATIVE PENALTY. (a) The commission [department] may not
	collect an administrative penalty from a day activity and health
	services facility under Section 103.012 if, not later than the 45th
	day after the date the facility receives notice under Section
	103.014(c), the facility corrects the violation.
	(b)  Subsection (a) does not apply to:
	(1)  a violation that the commission [department]
	determines:
	(A)  represents a pattern of violations that
	results in actual [serious] harm [to or death of a person attending
	the facility];
	(B)  results in actual harm that is pervasive
	throughout the services provided by the facility or that represents
	a systemic failure by the facility that affects or has the potential
	to affect a large number of or all of the elderly persons and
	persons with disabilities receiving services at the facility;
	(C)  constitutes the potential for actual harm and
	is a violation of this chapter or a rule, standard, or order adopted
	under this chapter relating to:
	(i)  staffing, including staff training,
	ratio, and health;
	(ii)  administration of medication; or
	(iii)  emergency preparedness and response;
	(D) [(B)]  constitutes an immediate [a serious]
	threat to the health or [and] safety of an elderly person or a
	person with a disability receiving services at a [a person
	attending the] facility; or
	(E) [(C)]  substantially limits the facility's
	capacity to provide care;
	(2)  a violation described by Sections
	103.012(a)(2)-(7); or
	(3)  a violation of Section 103.011.
	(c)  A day activity and health services facility that
	corrects a violation must maintain the correction. If the facility
	fails to maintain the correction until at least the first
	anniversary after the date the correction was made, the commission
	[department] may assess and collect an administrative penalty for
	the subsequent violation. An administrative penalty assessed under
	this subsection is equal to three times the amount of the original
	penalty assessed but not collected. The commission [department] is
	not required to provide the facility with an opportunity under this
	section to correct the subsequent violation.
	(d)  In this section:
	(1)  "Actual harm" means a negative outcome that
	compromises the physical, mental, or emotional well-being of an
	elderly person or a person with a disability receiving services at a
	facility.
	(2)  "Immediate threat to the health or safety of an
	elderly person or a person with a disability" means a situation that
	causes, or is likely to cause, serious injury, harm, or impairment
	to or the death of an elderly person or a person with a disability
	receiving services at a facility.
	(3)  "Pattern of violations" means the repeated, but
	not pervasive, occurrence of violations that are found throughout
	the services provided by a facility or that affect or involve the
	same elderly persons or persons with disabilities receiving
	services at the facility or the same facility employees.
	SECTION 19.  Section 247.0025, Health and Safety Code, is
	repealed.
	SECTION 20.  The changes in law made by this Act apply only
	to actions taken by the Health and Human Services Commission and
	license holders under Chapter 103, Human Resources Code, and
	Chapters 242, 247, 248A, and 252, Health and Safety Code, on or
	after the effective date of this Act.  An action taken before the
	effective date of this Act is governed by the law in effect at that
	time, and the former law is continued in effect for that purpose.
	SECTION 21.  This Act takes effect September 1, 2017.