85R2473 EES-F     By: Clardy H.B. No. 2570       A BILL TO BE ENTITLED   AN ACT   relating to Medicaid beds in nursing facilities.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 32.0213, Human Resources Code, is   amended by adding Subsections (g) through (u) to read as follows:          (g)  Notwithstanding Subsection (f), the commission may not   exempt applicants for Medicaid beds from the requirements of   Subsection (d) on or after September 1, 2017, and before September   1, 2021.          (h)  Except as provided in Subsection (i), the commission may   not contract for new nursing facility beds under Medicaid unless   the statewide occupancy rate of certified Medicaid beds is more   than 90 percent, as determined by the commission annually on   September 1.           (i)  Notwithstanding Subsection (h), the commission may   contract for new Medicaid beds in the following types of nursing   facilities:                (1)  subject to Subsection (k), that is under   development on September 1, 2017, and for which there has been filed   with the commission an application for Medicaid beds;                (2)  subject to Subsections (m), (n), (o), and (p), a   small house nursing facility;                (3)  subject to Subsections (q) and (r), a replacement   nursing facility, without regard to whether the nursing facility is   under development or has been constructed on September 1, 2017;                 (4)  subject to Subsection (s), a nursing facility   located in a county where the occupancy rate of certified Medicaid   beds is more than 85 percent, as determined by the commission on   September 1 and March 1 of a particular year; and                (5)  subject to Subsection (t), a nursing facility   without any unoccupied Medicaid beds for the purpose of providing a   temporary Medicaid bed for a resident of the nursing facility who   has exhausted the resident's resources and, as a result, is newly   eligible for Medicaid.          (j)  Deadlines and any other time limitations relating to the   commission's allocation or certification of Medicaid beds for   nursing facilities not yet under development on September 1, 2017,   and prohibited under Subsection (h) are tolled until September 1,   2021.          (k)  For purposes of Subsections (i)(1) and (j):                (1)  a nursing facility is considered under development   if:                      (A)  funding to construct the nursing facility has   been secured and is being used to construct the nursing facility;                      (B)  any zoning requirements relating to the   construction of the nursing facility have been met;                      (C)  complete construction design plans for the   nursing facility have been submitted to the appropriate   governmental entities regulating fire and building safety not later   than September 1, 2017; and                      (D)  ongoing construction activities are   occurring at the nursing facility site; and                (2)  the commission, in the commission's sole   discretion, shall determine whether an applicant for Medicaid beds   meets the requirements of this subsection.          (l)  The construction design plans described in Subsection   (k)(1)(c) must be an accurate and true depiction of the nursing   facility that is being constructed but may be modified in order to   make technical changes, correct errors and omissions, or comply   with zoning or other requirements of a governmental entity.           (m)  The executive commissioner by rule shall define "small   house nursing facility" for purposes of this section.          (n)  The commission may not contract under Subsection (i)(2)   for more than:                (1)  50 Medicaid beds per small house nursing facility   per year; and                (2)  a total of 100 new Medicaid beds for small house   nursing facilities statewide per year.          (o)  The commission shall approve completed applications for   Medicaid beds by or on behalf of small house nursing facilities   under Subsection (i)(2) in the order in which the applications are   received by the commission.          (p)  The commission shall rescind approval of an application   described by Subsection (o) if:                (1)  the small house nursing facility is not   operational on the anniversary of the date the facility's   application was approved; and                (2)  the commission has previously denied an   application for additional Medicaid beds by or on behalf of another   small house nursing facility because of the limitation on the total   number of Medicaid beds contained in Subsection (n)(2).           (q)  The commission may contract for Medicaid beds in a   replacement nursing facility under Subsection (i)(3) only if:                (1)  the replacement nursing facility:                      (A)  is licensed under Chapter 242, Health and   Safety Code; and                      (B)  is located in the same county as the nursing   facility that is being replaced; and                (2)  the nursing facility that is being replaced:                      (A)  is licensed under Chapter 242, Health and   Safety Code, on September 1, 2017; and                      (B)  surrenders the license described by   Paragraph (A) not later than the 60th day after the date the   replacement nursing facility is licensed under Chapter 242, Health   and Safety Code.          (r)  The commission may not contract for more Medicaid beds   for a replacement nursing facility under Subsection (i)(3) than   were contracted for the nursing facility that the replacement   nursing facility replaced.          (s)  The commission may not contract under Subsection (i)(4)   for:                (1)  more than 50 Medicaid beds per nursing facility;   or                (2)  a number of Medicaid beds that would result in a   countywide occupancy rate of certified Medicaid beds that is below   the statewide occupancy rate.           (t)  The executive commissioner by rule shall develop a   process for contracting for temporary Medicaid beds under   Subsection (i)(5).          (u)  Subsections (g) through (t) and this subsection expire   September 1, 2021.          SECTION 2.  Section 32.0244, Human Resources Code, is   amended by adding Subsection (e) to read as follows:          (e)  Notwithstanding Subsections (a) through (d), the   commission may not contract for new nursing facility beds under   this section on or after September 1, 2017, and before September 1,   2021. This subsection expires September 1, 2021.          SECTION 3.  Section 32.0245, Human Resources Code, is   amended to read as follows:          Sec. 32.0245.  NURSING FACILITY BEDS FOR CERTAIN FACILITIES   TREATING ALZHEIMER'S DISEASE.  (a) The commission shall waive for a   nursing facility a restriction imposed by state law on the   authority to contract under the state Medicaid program for nursing   facility beds based on the percentage of beds that are occupied in a   geographical area if the facility:                (1)  is affiliated with a medical school operated by   the state;                (2)  is participating in a research program for the   care and treatment of persons with Alzheimer's disease; and                (3)  is designed to separate and treat Alzheimer's   disease by stage or functional level.          (b)  Notwithstanding Subsection (a), the commission may not   waive a restriction on the commission's authority to contract for   nursing facility beds under this section on or after September 1,   2017, and before September 1, 2021. This subsection expires   September 1, 2021.          SECTION 4.  If before implementing any provision of this Act   a state agency determines that a waiver or authorization from a   federal agency is necessary for implementation of that provision,   the agency affected by the provision shall request the waiver or   authorization and may delay implementing that provision until the   waiver or authorization is granted.          SECTION 5.  This Act takes effect September 1, 2017.