Texas Register December 22, 2023 Volume: 48 Number: 51

Governor

Appointments Re:

Appointed to the State Board of Dental Examiners for a term to expire February 1, 2029:

• Bryan N. Henderson, II, D.D.S of Dallas, Texas;
• Lorie L. Jones of Magnolia, Texas;
• Sarah C. Lamb of Dallas, Texas; and
• Michael B. “Brady” Morehead, D.D.S. of San Antonio, Texas.

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Appointed to the Texas Optometry Board for a term to expire January 31, 2029:

• Steven N. Nguyen, O.D. of Irving, Texas;
• Mala L. Sharma of Houston, Texas; and
• Billy C. “Bill” Thompson, Jr., O.D. of Richardson, Texas.

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Appointed to the Texas State Board of Examiners of Marriage and Family Therapists for a term to expire February 1, 2027, Elvira Reyna of Little Elm, Texas.

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Texas Department of Licensing and Regulation

Proposed Rules Re:

Amending 16 TAC §111.1, to change the name of the section from “Authority” to “Authority and Applicability.”

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER A. GENERAL PROVISIONS
16 TAC §111.1

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.1; Subchapter C, §111.23; Subchapter F, §111.50; Subchapter P, §§111.150, 111.151, and 111.155; Subchapter Q, §111.160; and Subchapter T, §111.190 and §111.192; and the repeal of existing rules at Subchapter O, §111.140, regarding the Speech-Language Pathologists and Audiologists program. These proposed changes are referred to as “proposed rules.”

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111, implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists; and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department. Specific provisions within this rule chapter also implement the statutory requirements under Texas Occupations Code, Chapters 53, 108, 111, 112, 116, and 402, as applicable.

The proposed rules are necessary to implement recommended changes from the Speech Language Pathologists and Audiologists Advisory Board with input from two of its workgroups; implement select changes from Department staff as a result of the four-year rule review; and make technical corrections from two previous rulemakings.

SECTION-BY-SECTION SUMMARY

Subchapter A. General Provisions.

The proposed rules amend §111.1. Authority and Applicability. The proposed rules change the name of the section from “Authority” to “Authority and Applicability.” The proposed rules amend subsection (a) to identify the other statutes that are implemented by the rules in Chapter 111. The proposed rules also add new subsection (b) to explain that the Chapters 60 and 100 rules also apply to the Speech-Language Pathologists and Audiologists program. This new provision replaces the rules under Subchapter O, §111.140, Rules, which are being repealed.

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Amending 16 TAC §111.23, to recognize the two different jurisprudence exams and update references to the examinations.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER C. EXAMINATIONS
16 TAC §111.23

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.1; Subchapter C, §111.23; Subchapter F, §111.50; Subchapter P, §§111.150, 111.151, and 111.155; Subchapter Q, §111.160; and Subchapter T, §111.190 and §111.192; and the repeal of existing rules at Subchapter O, §111.140, regarding the Speech-Language Pathologists and Audiologists program. These proposed changes are referred to as “proposed rules.”

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111, implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists; and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department. Specific provisions within this rule chapter also implement the statutory requirements under Texas Occupations Code, Chapters 53, 108, 111, 112, 116, and 402, as applicable.

The proposed rules are necessary to implement recommended changes from the Speech Language Pathologists and Audiologists Advisory Board with input from two of its workgroups; implement select changes from Department staff as a result of the four-year rule review; and make technical corrections from two previous rulemakings.

SECTION-BY-SECTION SUMMARY

Subchapter C. Examinations.

The proposed rules amend §111.23, License Examination–Jurisprudence Examinations. The proposed rules change the name of the section from “License Examination–Jurisprudence Examination” to “License Examination–Jurisprudence Examinations.” The proposed rules amend subsection (a) to recognize that there are two separate jurisprudence exams – one for speech-language pathology and another for audiology; and amend subsection (b) to update the reference to examinations. The proposed rules also create separate provisions for the speech-language pathology jurisprudence examination and the audiology jurisprudence examination. The current general provision under subsection (c) is amended to apply only to the speech-language pathology jurisprudence examination, and a separate provision for the audiology jurisprudence examination is being added as new subsection (d). There are no substantive changes to these provisions.

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Amending 16 TAC §111.50, to make technical corrections.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER F. REQUIREMENTS FOR ASSISTANT IN SPEECH-LANGUAGE PATHOLOGY LICENSE
16 TAC §111.50

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.1; Subchapter C, §111.23; Subchapter F, §111.50; Subchapter P, §§111.150, 111.151, and 111.155; Subchapter Q, §111.160; and Subchapter T, §111.190 and §111.192; and the repeal of existing rules at Subchapter O, §111.140, regarding the Speech-Language Pathologists and Audiologists program. These proposed changes are referred to as “proposed rules.”

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111, implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists; and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department. Specific provisions within this rule chapter also implement the statutory requirements under Texas Occupations Code, Chapters 53, 108, 111, 112, 116, and 402, as applicable.

The proposed rules are necessary to implement recommended changes from the Speech Language Pathologists and Audiologists Advisory Board with input from two of its workgroups; implement select changes from Department staff as a result of the four-year rule review; and make technical corrections from two previous rulemakings.

SECTION-BY-SECTION SUMMARY

Subchapter F. Requirements for Assistant in Speech-Language Pathology License.

The proposed rules amend §111.50, Assistant in Speech-Language Pathology License–Licensing Requirements–Education and Clinical Observation and Experience. The proposed rules make technical corrections to §111.50(e) from two previous rulemakings as discussed above. Under subsection (e), the proposed rules remove the “in-person” references under paragraphs (e)(4) and (e)(6).

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Repealing 16 TAC §111.140, to remove unnecessary explanatory provisions.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER O. RESPONSIBILITIES OF THE COMMISSION AND THE DEPARTMENT
16 TAC §111.140

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.1; Subchapter C, §111.23; Subchapter F, §111.50; Subchapter P, §§111.150, 111.151, and 111.155; Subchapter Q, §111.160; and Subchapter T, §111.190 and §111.192; and the repeal of existing rules at Subchapter O, §111.140, regarding the Speech-Language Pathologists and Audiologists program. These proposed changes are referred to as “proposed rules.”

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111, implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists; and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department. Specific provisions within this rule chapter also implement the statutory requirements under Texas Occupations Code, Chapters 53, 108, 111, 112, 116, and 402, as applicable.

The proposed rules are necessary to implement recommended changes from the Speech Language Pathologists and Audiologists Advisory Board with input from two of its workgroups; implement select changes from Department staff as a result of the four-year rule review; and make technical corrections from two previous rulemakings.

SECTION-BY-SECTION SUMMARY

Subchapter O. Responsibilities of the Commission and the Department.

The proposed rules repeal Subchapter O, Responsibilities of the Commission and the Department, and §111.140, Rules. These explanatory provisions are no longer necessary, since sufficient time has passed since the program was transferred to the Department. New provisions regarding the applicability of the rules under Chapters 60 and 100 have been included in the changes to §111.1, Authority and Applicability. The rules under Chapters 60 and 100 have broader applicability than the specific provisions cited in §111.140.

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Amending 16 TAC §§111.150, 111.151, 111.155, to require that a licensee provide proof of licensure to clients upon request.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER P. RESPONSIBILITIES OF THE LICENSEE AND CODE OF ETHICS
16 TAC §§111.150, 111.151, 111.155

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.1; Subchapter C, §111.23; Subchapter F, §111.50; Subchapter P, §§111.150, 111.151, and 111.155; Subchapter Q, §111.160; and Subchapter T, §111.190 and §111.192; and the repeal of existing rules at Subchapter O, §111.140, regarding the Speech-Language Pathologists and Audiologists program. These proposed changes are referred to as “proposed rules.”

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111, implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists; and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department. Specific provisions within this rule chapter also implement the statutory requirements under Texas Occupations Code, Chapters 53, 108, 111, 112, 116, and 402, as applicable.

The proposed rules are necessary to implement recommended changes from the Speech Language Pathologists and Audiologists Advisory Board with input from two of its workgroups; implement select changes from Department staff as a result of the four-year rule review; and make technical corrections from two previous rulemakings.

SECTION-BY-SECTION SUMMARY

Subchapter P. Responsibilities of the Licensee and Code of Ethics.

• The proposed rules amend §111.150, Changes of Name, Address, or Other Information. The proposed rules update subsection (a) to provide that a licensee notify the Department of any changes to the specified information in a form and manner prescribed by the Department.
• The proposed rules amend §111.151, Consumer Information, Display of License, and Proof of Licensure. The proposed rules reflect the recommendations from the Speech-Language Pathology and Audiology Advisory Board with input from its Licensing Workgroup as discussed above. The proposed rules change the name of the section from “Consumer Information and Display of License” to “Consumer Information, Display of License, and Proof of Licensure.” The proposed rules add a new subsection (e), which requires a licensee, upon request, to provide proof of licensure to a client by showing the current license certificate, the current license identification card, or the current results of a license search on the Department’s website.
• The proposed rules amend §111.155, Standards of Ethical Practice (Code of Ethics). The proposed rules update the statutory citation in subsection (a)(16).

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Amending 16 TAC §111.160, to update the fee language.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER Q. FEES
16 TAC §111.160

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.1; Subchapter C, §111.23; Subchapter F, §111.50; Subchapter P, §§111.150, 111.151, and 111.155; Subchapter Q, §111.160; and Subchapter T, §111.190 and §111.192; and the repeal of existing rules at Subchapter O, §111.140, regarding the Speech-Language Pathologists and Audiologists program. These proposed changes are referred to as “proposed rules.”

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111, implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists; and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department. Specific provisions within this rule chapter also implement the statutory requirements under Texas Occupations Code, Chapters 53, 108, 111, 112, 116, and 402, as applicable.

The proposed rules are necessary to implement recommended changes from the Speech Language Pathologists and Audiologists Advisory Board with input from two of its workgroups; implement select changes from Department staff as a result of the four-year rule review; and make technical corrections from two previous rulemakings.

SECTION-BY-SECTION SUMMARY

Subchapter Q. Fees.

The proposed rules amend §111.160, Fees. The proposed rules update the cross-referenced fee provisions in subsections (k) – (m) to use updated, standardized fee language.

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Amending 16 TAC §111.190, §111.192, to clarify that individuals licensed under the Act may conduct communication screenings and specify what those screenings can include.

CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER T. SCREENING PROCEDURES
16 TAC §111.190, §111.192

OVERVIEW

The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.1; Subchapter C, §111.23; Subchapter F, §111.50; Subchapter P, §§111.150, 111.151, and 111.155; Subchapter Q, §111.160; and Subchapter T, §111.190 and §111.192; and the repeal of existing rules at Subchapter O, §111.140, regarding the Speech-Language Pathologists and Audiologists program. These proposed changes are referred to as “proposed rules.”

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC Chapter 111, implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists; and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Department. Specific provisions within this rule chapter also implement the statutory requirements under Texas Occupations Code, Chapters 53, 108, 111, 112, 116, and 402, as applicable.

The proposed rules are necessary to implement recommended changes from the Speech Language Pathologists and Audiologists Advisory Board with input from two of its workgroups; implement select changes from Department staff as a result of the four-year rule review; and make technical corrections from two previous rulemakings.

SECTION-BY-SECTION SUMMARY

Subchapter T. Screening Procedures.

• The proposed rules amend §111.190, Communication Screening. The proposed rules reflect the recommendations from the Speech-Language Pathology and Audiology Advisory Board with input from its Standard of Care Workgroup as discussed above. The proposed rules amend subsection (a) to clarify that individuals licensed under the Act may conduct communication screenings. In addition, the proposed rules amend subsection (b) to provide that communication screenings may include cursory assessments of cognition to determine if further testing is indicated, and to provide that the aspects of cognition to be screened are any cognitive processes affecting communication function. Finally, the proposed rules amend subsection (c) to provide that cognition screenings should be conducted in the client’s dominant language and primary mode of communication.
• The proposed rules amend §111.192, Newborn Hearing Screening. The proposed rules update the rule citation in subsection (b) to reflect the Health and Human Services Commission’s transfer of the rules related to Early Childhood Intervention Services to a new rule chapter in the Texas Administrative Code (TAC).

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Adopted Rules Re:

Amending 16 TAC §115.80, to reduce the initial application fee for midwife licenses from $275 to $195 and reduce the renewal fee from $550 to $390.

CHAPTER 115. MIDWIVES
16 TAC §115.80

OVERVIEW

The Texas Commission of Licensing and Regulation (Commission) adopts amendments to an existing rule at 16 Texas Administrative Code (TAC), Chapter 115, §115.80, regarding the Midwives program, without changes to the proposed text as published in the October 13, 2023, issue of the Texas Register (48 TexReg 5881). This rule will not be republished.

BACKGROUND AND JUSTIFICATION

The rules under 16 TAC, Chapter 115, implement Texas Occupations Code, Chapter 203, Midwives.

The adopted rule lowers the application fee for an initial midwife license from $275 to $195 and lowers the application fee for renewal of a midwife license from $550 to $390. The adopted rule is necessary to set fees in amounts reasonable and necessary to cover the costs of administering the Midwives program, as required by Texas Occupations Code §51.202. Department staff reviewed the costs of administering the Midwives program and determined that license application fees should be lowered so that the revenue from the fees does not exceed the costs of administering the program.

SECTION-BY-SECTION SUMMARY

The adopted rule amends §115.80, Fees, by reducing the midwife license initial application fee in paragraph (1) from $275 to $195 and by reducing the midwife license renewal application fee in paragraph (2) from $550 to $390 for each two-year renewal period.

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In Addition Re:

Notice of Vacancy on Speech-Language Pathologists and Audiologists Advisory Board

OVERVIEW

The Texas Department of Licensing and Regulation (Department) announces one vacancy on the Speech-Language Pathologists and Audiologists Advisory Board (Board) established by Texas Occupations Code, Chapter 401. The purpose of the Speech-Language Pathologists and Audiologists Advisory Board is to provide advice and recommendations to the Department on technical matters relevant to the administration of this chapter. This announcement is for:

• one public member who is a licensed physician in this state and certified in otolaryngology or pediatrics.

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Texas Board of Nursing

Proposed Rules Re:

New 22 TAC §213.36, §213.37, to set forth the procedures the Board must follow when investigating a standard of care violation by an APRN.

CHAPTER 213. PRACTICE AND PROCEDURE
22 TAC §213.36, §213.37

OVERVIEW

Introduction. The Texas Board of Nursing (Board) proposes new §213.36, relating to Alleged Standard of Care Violations by Advanced Practice Registered Nurses and new §213.37, relating to Disclosure of Expert Reviewer’s Report. These rules are proposed under the authority of the Occupations Code § 301.151 and are necessary for compliance with the statutory mandates found in Texas Occupations Code §§ 301.457, 301.4575, and 301.464.

BACKGROUND AND JUSTIFICATION

During the 88th Legislative Session, the Texas Legislature enacted SB 1343 which requires that complaints alleging a standard-of-care violation by an Advanced Practice Registered Nurse (APRN) be reviewed by an expert reviewer, appointed by the Board, who is an APRN practicing in the same advanced practice role and with the same population focus as the APRN who is the subject of the complaint. The bill further requires that the appointed expert reviewer determine whether the APRN violated the standard-of-care applicable to the circumstances of the allegation, record the expert reviewer’s conclusions in a report, and submit the report to the Board. Before initiating informal proceedings involving the APRN, the Board must provide notice of the proceedings along with a deidentified copy of the expert reviewer’s report. The proposed rule sections implement these statutory requirements.

SECTION-BY-SECTION SUMMARY

• Proposed new 22 Texas Administrative Code §213.36 sets forth the process the Board must follow when investigating an alleged standard of care violation by an APRN. Proposed §213.36(a) implements Tex. Occ. Code § 301.457(h) by establishing that the Board shall appoint an APRN reviewer to assist in the investigation in the same practice role with the same population focus if the Board determines that an act of the APRN likely falls below an applicable standard of care. Proposed §213.36(b) implements Tex. Occ. Code § 301.457(i), mirroring the statutory language regarding when the Board may not refer a complaint to against an APRN to an APRN reviewer. Proposed §213.36(c) implements Tex. Occ. Code § 301.4575(1)&(2), mirroring the statutory language regarding the procedures for an advanced practice registered nurse review. Proposed §213.36(d) implements Tex. Occ. Code § 301.4575 by providing guidance as to the contents of the preliminary report to be submitted by the reviewer.
• Proposed new 22 Texas Administrative Code §213.37 sets forth the procedure for the disclosure of the expert reviewer’s report. This new section implements Tex. Occ. Code § 301.464(b) by providing that the notice of any informal proceeding include a copy of the expert report with any identifying information other than the role and population focus of the expert reviewer redacted.

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New 22 TAC §214.14, to explain the permissible and impermissible ways a vocational nursing education program may use a student’s score on a standardized examination.

CHAPTER 214. VOCATIONAL NURSING EDUCATION
22 TAC §214.14

OVERVIEW

The Texas Board of Nursing (Board) proposes new 22 Texas Administrative Code §214.14, relating to use of vendor created standardized examinations by a private school of nursing in a manner that may deny students graduation and opportunity to take the NCLEX (National Council Licensure Examination) licensure exam. The rule is being proposed under the authority of the Occupations Code § 301.151 and Tex. Occ. Code § 301.1571, effective September 1, 2023.

BACKGROUND AND JUSTIFICATION

In 2017, the Texas Board of Nursing (BON) issued the Board Education Guideline 3.7.4.a in response to numerous reports and questions from students, parents, and policymakers about the use of vendor-created standardized examinations, especially when these exams are used to deny students the opportunity to take the NCLEX licensure exam. Many vocational and professional nursing education programs had incorporated the use of these exams into the curriculum in various ways. At the time, a survey revealed many nursing programs were using these exams as a graduation requirement or to deny students from receiving their affidavit of graduation, which is required to be submitted to register for the NCLEX licensure exam.

SECTION-BY-SECTION SUMMARY

• 22 Texas Administrative Code §214.14(a) prohibits a vocational nursing education program from using a student’s score on a standardized examination as a graduation requirement; or as the basis for denying the student an affidavit of graduation.
• 22 Texas Administrative Code §214.14(b) prohibits the vocational nursing education program from using a student’s score to account for more than 10 (ten) percent of the student’s final grade in any course provided under the program.
• 22 Texas Administrative Code §214.14(c) lists the only permissible ways vocational nursing education program may use a standardized examination prepared by a private entity. These include letting students familiarize themselves with computerized testing, using scores as a component of program admissions criteria, evaluating a student’s strengths and weaknesses for remediation purposes; and identifying students who are experiencing academic difficulties and require early remediation. The rule also allows use of standardized test scores in assessing the effectiveness of the program by providing trend data, comparisons with nationwide averages, assessment of student knowledge of program content, assessment of success in curriculum revisions or changes, and as a measure of student mastery of program content.
• 22 Texas Administrative Code §214.14(d) prohibits the vocational nursing education program from requiring the student, based on the student’s score, to attend any course offered by the private entity that created the standardize exam.
• 22 Texas Administrative Code §214.149(e) clarifies that failure to comply with the requirements of this section will subject a vocational nursing education program to board disciplinary action, including a change in the program’s approval status.

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New 22 TAC §215.14, to explain the permissible and impermissible ways a professional nursing education program may use a student’s score on a standardized examination.

CHAPTER 215. PROFESSIONAL NURSING EDUCATION
22 TAC §215.14

OVERVIEW

The Texas Board of Nursing (Board) proposes new 22 Texas Administrative Code §215.14, relating to use of vendor created standardized examinations by a private school of nursing in a manner that may deny students graduation and opportunity to take the NCLEX (National Council Licenser Examination) licensure exam. The rule is being proposed under the authority of the Texas Occupations Code § 301.151 and Texas Occupations Code § 301.1571, effective September 1, 2023.

BACKGROUND AND JUSTIFICATION

In 2017, the Texas Board of Nursing (BON) issued the Board Education Guideline 3.7.4.a in response to numerous reports and questions from students, parents, and policymakers about the use of vendor-created standardized examinations, especially when these exams are used to deny students the opportunity to take the NCLEX licensure exam. Many vocational and professional nursing education programs had incorporated the use of these exams into the curriculum in various ways. At the time, a survey revealed many nursing programs were using these exams as a graduation requirement or to deny students from receiving their affidavit of graduation, which is required to be submitted to register for the NCLEX licensure exam.

SECTION-BY-SECTION SUMMARY

• 22 Texas Administrative Code §215.14(a) prohibits a professional nursing education program from using a student’s score on a standardized examination as a graduation requirement; or as the basis for denying the student an affidavit of graduation.
• 22 Texas Administrative Code §215.14(b) prohibits the professional nursing education program from using a student’s score to account for more than 10 (ten) percent of the student’s final grade in any course provided under the program.
• 22 Texas Administrative Code §215.14(c) lists the only permissible ways professional nursing education program may use a standardized examination prepared by a private entity. These include letting students familiarize themselves with computerized testing, using scores as a component of program admissions criteria, evaluating a student’s strengths and weaknesses for remediation purposes; and identifying students who are experiencing academic difficulties and require early remediation. The rule also allows use of standardized test scores in assessing the effectiveness of the program by providing trend data, comparisons with nationwide averages, assessment of student knowledge of program content, assessment of success in curriculum revisions or changes, and as a measure of student mastery of program content.
• 22 Texas Administrative Code §215.14(d) prohibits the professional nursing education program from requiring the student, based on the student’s score, to attend any course offered by the private entity that created the standardize exam.
• 22 Texas Administrative Code §215.14(e) clarifies that failure to comply with the requirements of this section will subject a professional nursing education program to board disciplinary action, including a change in the program’s approval status.

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Texas State Board of Pharmacy

Proposed Rules Re:

Amending 22 TAC §283.12, to specify that the requirements for obtaining an interim license for a military service member or military spouse do not affect rights that may be provided under federal law.

CHAPTER 283. LICENSING REQUIREMENTS FOR PHARMACISTS
22 TAC §283.12

OVERVIEW

The Texas State Board of Pharmacy proposes amendments to §283.12, concerning Licenses for Military Service Members, Military Veterans, and Military Spouses. The amendments, if adopted, clarify that the requirements for obtaining an interim license for a military service member or military spouse do not affect rights that may be provided under federal law.

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Amending 22 TAC §291.74, to specify the labeling requirements for a participating provider to dispense donated prescription drugs.

CHAPTER 291. PHARMACIES
SUBCHAPTER D. INSTITUTIONAL PHARMACY (CLASS C)
22 TAC §291.74

OVERVIEW

The Texas State Board of Pharmacy proposes amendments to §291.74, concerning Operational Standards. The amendments, if adopted, specify prepackaging and labeling requirements for a participating provider to dispense donated prescription drugs under Chapter 442, Health and Safety Code, in accordance with House Bill 4332.

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Amending 22 TAC §297.10, to specify that he requirements for obtaining an interim registration for a military service member or military spouse do not affect rights that may be provided under federal law.

CHAPTER 297. PHARMACY TECHNICIANS AND PHARMACY TECHNICIAN TRAINEES
22 TAC §297.10

OVERVIEW

The Texas State Board of Pharmacy proposes amendments to §297.10, concerning Registration for Military Service Members, Military Veterans, and Military Spouses. The amendments, if adopted, clarify that the requirements for obtaining an interim registration for a military service member or military spouse do not affect rights that may be provided under federal law.

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Texas Health and Human Services Commission

Proposed Rules Re:

Amending 26 TAC §§553.3, 553.5, 553.7, 553.9, to provide guidance on evacuation capabilities and to give more specificity to resident requirements.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER A. INTRODUCTION
26 TAC §§553.3, 553.5, 553.7, 553.9

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

• The proposed amendment to §553.3, Definitions, removes a provision from the definitions for “abuse,” “exploitation,” and “neglect,” relating to a person under 18 years of age who is not an emancipated minor, to coincide with the proposed amendments to §553.9, General Characteristics of a Resident, and §553.259, Admission Policies and Procedures, that clarify a resident in an assisted living facility must be at least 18 years old or an emancipated minor. The proposed amendment also adds definitions for “activities of daily living,” “assistive devices,” “bedfast,” “capacity,” “durable medical equipment,” “outside resources,” “plan of removal,” “resident evaluation,” “significant change,” and “skilled nursing.” Definitions related to life safety code are relocated to proposed amended §553.101, Definitions, including “listed,” “local code,” and “NFPA 101.” The proposed amendment deletes definitions not used in the chapter: “commingles,” “flame spread,” “personal care staff,” “qualified medical personnel,” “safety,” and “short term-acute episode.” The proposed amendment to §553.3 also makes changes to certain definitions to add more clarity or update a reference, including “attendant,” “authorized electronic monitoring (AEM),” “behavioral emergency,” “delegation,” “health care professional,” “health maintenance activity,” “legally authorized representative,” “license holder,” “medication supervision or supervision,” “personal care services,” “restraints,” “seclusion,” and “stable and predictable.”
• The proposed amendment to §553.5, Types of Assisted Living Facilities, adds additional guidance related to the evacuation capability required of a resident in a Type A facility.
• The proposed amendment to §553.7, Assisted Living Facility Services, updates citations and references and adds more clarity.
• The proposed amendment to §553.9, General Characteristics of a Resident, adds the statement that a resident must be 18 years of age or older or an emancipated minor and updates guidance related to some general characteristics of a resident. Key updates to the list of general characteristics include a statement that a resident may have assistive devices and a list of examples of these and a statement that a resident may have a permanently placed percutaneous endoscopic gastrostomy tube, as well as specifying that this would require RN delegation or designation as a health maintenance activity.

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Amending 26 TAC §§553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.45, 553.47, to provide clarity on licensing requirements for multi-building facilities.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER B. LICENSING
26 TAC §§553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.45, 553.47

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

• The proposed amendment to §553.17, Criteria for Licensing, adds more specific guidance related to whether an assisted living facility that has multiple buildings requires licensing as a small or large facility or requires multiple licenses.
• Proposed amendments to §553.17, Criteria for Licensing; §553.23, Initial License Application Procedures and Requirements; §553.325, Initial License for a Type A or Type B Facility for an Applicant in Good Standing; §553.27, Certification of a Type B Facility or Unit for Persons with Alzheimer’s Disease and Related Disorders; §553.29, Alzheimer’s Certification of a Type B Facility for an Initial License Applicant in Good Standing; §553.31, Provisional License; §553.33, Renewal Procedures and Qualifications; §553.37, Relocation; §553.39, Increase in Capacity; §553.47, License Fees; §553.132, Space Planning and Utilization Requirements for an Existing Large Type A Assisted Living Facility; §553.142, Space Planning and Utilization Requirements for an Existing Large Type B Assisted Living Facility; §553.232, Space Planning and Utilization Requirements for a New Large Type A Assisted Living Facility; §553.242, Space Planning and Utilization Requirements for a New Large Type B Assisted Living Facility; and §553.331, Determinations and Actions (Investigation Findings), correct the hyphenation of a word.
• Proposed amendments to §553.21, Time Periods for Processing All Types of License Applications; §553.23, Initial License Application Procedures and Requirements; §553.25, Initial License for a Type A or Type B Facility for an Applicant in Good Standing; §553.27, Certification of a Type B Facility or Unit for Persons with Alzheimer’s Disease and Related Disorders; §553.29, Alzheimer’s Certification of a Type B Facility for an Initial License Applicant in Good Standing; §553.31, Provisional License; §553.33, Renewal Procedures and Qualifications; §553.37, Relocation; §553.39, Increase in Capacity; and §553.47, License Fees, are to update citations and references and add more clarity.

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Repealing 26 TAC §553.43, to restructure the rule’s subparts and eliminate any duplicative language.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER B. LICENSING
26 TAC §553.43

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

The proposed repeal of §553.43, Disclosure of Facility Identification Number, duplicates information also located in proposed repealed §553.272, Advertisements, Solicitations, and Promotional Material, and proposed new §553.292, Advertisements, Solicitations, and Promotional Material. The proposed repeal of §553.261, Coordination of Care, will restructure each of this rule’s subsections into a separate new section to make these key topics easier to find and eliminate Coordination of Care as a section name in the chapter. These topics include: §553.261(a), Medications; §553.261(b), Accident, Injury and Acute Illness; §553.261(c), Health Care Professional, §553.261(d), Activities Program; §553.261(e), Dietary Services; §553.261(f), Infection Prevention and Control; §553.261(g), Restraints and Seclusion; and §553.261(h) Wheelchair Self-Release Seat Belts.

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Amending 26 TAC §553.100, §553.101, to move definitions which are specific to facility construction to this section.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER D. FACILITY CONSTRUCTION
26 TAC §553.100, §553.101

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §553.101, Definitions, relocates definitions specific to facility construction from §553.3, Definitions, to §553.101.

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Amending 26 TAC §553.103, §553.104, to clarify that assisted living facilities may not permit accumulation of waste in attic spaces and to clarify what is considered an abrupt change in level.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER D. FACILITY CONSTRUCTION
26 TAC §553.103, §553.104

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

• The proposed amendment to §553.103, Site and Location for all Assisted Living Facilities, clarifies what constitutes an abrupt change in level.
• The proposed amendment to §553.104, Safety Operations, details when an assisted living facility must maintain onsite documentation or written records and clarifies that an assisted living facility must not permit an accumulation of waste in attic spaces.

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Amending 26 TAC §§553.111 – 553.113, 553.115, to relocate requirements related to the preparation of food and operation of the kitchen.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER D. FACILITY CONSTRUCTION
26 TAC §§553.111 – 553.113, 553.115

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

• Proposed amendments to §553.111, Construction Requirements for an Existing Small Type A Assisted Living Facility, and §553.112, Space Planning and Utilization Requirements for an Existing Small Type A Assisted Living Facility, relocate requirements related to the preparation of food and operation of the kitchen to §553.275, Dietary Services.
• Proposed amendments to §553.113, Means of Escape Requirements for an Existing Small Type A Assisted Living Facility, and §553.115, Fire Protection Systems Requirements for an Existing Small Type A Assisted Living Facility, update citations and references and add more clarity.

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Amending 26 TAC §553.122, §553.125, to update citations and references and to relocate requirements related to the preparation of food and operation of the kitchen

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER D. FACILITY CONSTRUCTION
26 TAC §553.122, §553.125

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

• The proposed amendment to §553.122, Space Planning and Utilization Requirements for an Existing Small Type B Assisted Living Facility, relocates requirements related to the preparation of food and operation of the kitchen to §553.275, Dietary Services.
• Proposed amendments to §553.125, Fire Protection Systems Requirements for an Existing Small Type B Assisted Living Facility, and §553.131, Construction Requirements for an Existing Large Type A Assisted Living Facility, update citations and references and add more clarity where required.

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Amending 26 TAC §§553.131, 553.132, 553.135, to correct and error and to relocate requirements related to the preparation of food and operation of the kitchen.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER D. FACILITY CONSTRUCTION
26 TAC §§553.131, 553.132, 553.135

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

• The proposed amendment to §553.132, Space Planning and Utilization Requirements for an Existing Large Type A Assisted Living Facility, relocates requirements related to the preparation of food and operation of the kitchen to §553.275, Dietary Services.
• The proposed amendment to §553.135, Fire Protection Systems Requirements for an Existing Large Type A Assisted Living Facility, corrects an error.

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Amending 26 TAC §553.142, to relocate requirements related to the preparation of food and operation of the kitchen.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER D. FACILITY CONSTRUCTION
26 TAC §553.142

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §553.142, Space Planning and Utilization Requirements for an Existing Large Type B Assisted Living Facility, §553.211, Space Planning and Utilization Requirements for a New Small Type A Assisted Living Facility, and §553.212, Space Planning and Utilization Requirements for a New Small Type A Assisted Living Facility, relocates requirements related to the preparation of food and operation of the kitchen to §553.275, Dietary Services.

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Amending 26 TAC §§553.211, 553.212, 553.215, to outline the requirements for electronic supervision of a fire sprinkler system in new Small Type A Assisted Living Facilities.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER D. FACILITY CONSTRUCTION
26 TAC §§553.211, 553.212, 553.215

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §553.215, Fire Protection Systems Requirements for a New Small Type A Assisted Living Facility, adds clarity to a requirement related to electronic supervision of a fire sprinkler system.

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Amending 26 TAC §553.222, §553.225, to relocate requirements related to the preparation of food and operation of the kitchen and to outline the requirements for electronic supervision of a fire sprinkler system for new Small Type B Assisted Living Facilities.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER D. FACILITY CONSTRUCTION
26 TAC §553.222, §553.225

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

• The proposed amendment to §553.222, Space Planning and Utilization Requirements for a New Small Type B Assisted Living Facility, relocates requirements related to the preparation of food and operation of the kitchen to §553.275, Dietary Services.
• The proposed amendment to §553.225, Fire Protection Systems Requirements for a New Small Type B Assisted Living Facility, adds clarity to a requirement related to electronic supervision of a fire sprinkler system.

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Amending 26 TAC §§553.231, 553.232, 553.235, to to relocate requirements related to the preparation of food and operation of the kitchen and to outline the requirements for electronic supervision of a fire sprinkler system for new Large Type A Assisted Living Facilities.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER D. FACILITY CONSTRUCTION
26 TAC §§553.231, 553.232, 553.235

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

• The proposed amendment to §553.231, Construction Requirements for a New Large Type A Assisted Living Facility, adds clarity to a requirement related to electronic supervision of a fire sprinkler system.
• The proposed amendment to §553.232, Space Planning and Utilization Requirements for a New Large Type A Assisted Living Facility, relocates requirements related to the preparation of food and operation of the kitchen to §553.275, Dietary Services.
• The proposed amendment to §553.235, Fire Protection Systems Requirements for a New Large Type A Assisted Living Facility, corrects references.

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Amending 26 TAC §§553.231, 553.232, 553.235, to to relocate requirements related to the preparation of food and operation of the kitchen and to outline the fire protection system requirements for new Large Type B Assisted Living Facilities.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER D. FACILITY CONSTRUCTION
26 TAC §§553.241, 553.242, 553.245, 553.246

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

• The proposed amendment to §553.241, Construction Requirements for a New Large Type B Assisted Living Facility, clarifies that a building being structurally sound is determined and enforced by local authorities.
• The proposed amendment to §553.242, Space Planning and Utilization Requirements for a New Large Type B Assisted Living Facility, relocates requirements related to the preparation of food and operation of the kitchen to §553.275, Dietary Services.
• The proposed amendment to §553.245, Fire Protection Systems Requirements for a New Large Type B Assisted Living Facility, corrects an error.
• The proposed amendment to §553.246, Hazardous Area Requirements for a New Large Type B Assisted Living Facility, corrects references.

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New 26 TAC §553.250, to provide construction requirements for a Certified Alzheimer’s Assisted Living Facility.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER D. FACILITY CONSTRUCTION
26 TAC §553.250

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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Amending 26 TAC §§553.253, 553.255, 553.257, 553.259 and new 26 TAC §§ 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291 – 553.293, 553.295, to explain the types of staff required and provide information and requirements for reporting certain incidents to HHSC.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER E. STANDARDS FOR LICENSURE
26 TAC §§553.253, 553.255, 553.257, 553.259, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291 – 553.293, 553.295

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

• The proposed amendment to §553.253, Employee Qualifications and Training, restructures manager and staff training requirements to add clarity. The amendment specifies that a facility must have dedicated staff on duty for each shift and must not share on-duty staff with another facility or provider type. It also adds details to the required posting of the facility’s 24-hour staffing pattern, contains a statement that a facility must not use a companion care provider or solicit or involve family members to provide care to residents to mitigate staffing shortages, and adds infection prevention and control principles to the list of required training and continued education.
• The proposed amendment to §553.255, All Staff Policy for Residents with Alzheimer’s Disease or a Related Disorder, corrects a reference.
• The proposed amendment to §553.257, Personnel, updates citations and references.
• The proposed amendment to §553.259, Admission Policies and Procedures, adds a statement that a facility must not admit a resident under the age of 18 years unless the person is an emancipated minor. The amendment adds a rule that an assisted living facility that allows pets must have a pet policy and specifies the information the policy must include. It also changes the term “resident assessment” to “resident evaluation” and states the resident evaluation must be done annually and upon a significant change in condition and updates references and citations. The amendment also relocates information to new §553.261, Inappropriate Placement in a Type A or Type B facilities.
• Proposed amendments throughout the chapter update and correct citations and references and restructure sentences to use active voice.
• Proposed new §553.261, Inappropriate Placement in a Type A or Type B Facility, relocates content from proposed amended §553.259, Admission Policies and Procedures. Proposed new §553.263, Resident Transfer and Discharge, creates a new section to relocate rules for residents’ rights pertaining to being transferred or discharged from proposed repealed §553.267, Rights, so they are easier to find. Proposed new §553.265, Respite Admissions, contains new rules to provide more specific guidance concerning residents admitted for respite care.
• Proposed new §553.267, Medications, relocates the rule from proposed repealed §553.261, Coordination of Care, and restructures the rules so they are easier to navigate. The proposed new rule also adds requirements for assisted living facilities to have written medication policies and procedures and a medication administration record for each resident who receives medication administration or supervision where staff must record all medication doses administered and missed. The rule proposed for repeal only requires staff to record missed doses. The requirement for monthly medication counseling for residents who self-administer medications is amended to require additional medication counseling whenever a resident has a significant change in condition that might affect the ability to self-administer medications. The option to include a medication take-back program is added to the requirement that drug disposal be carried out by a licensed pharmacist.
• Proposed new §553.269, Accident, Injury, or Acute Illness, and new §553.271, Health Care Professional, relocates the rule from proposed repealed §553.261, Coordination of Care, and provides updated citations and references where needed.
• Proposed new §553.273, Activities Program, relocates the rule from proposed repealed §553.261, Coordination of Care, and changes the requirement from offering residents an activity at least once a week to offering residents a daily activity.
• Proposed new §553.275, Dietary Services, relocates the rule from proposed repealed §553.261, Coordination of Care, and relocates rules for food preparation and kitchen area from proposed amended sections in Subchapter D, Facility Construction, as the guidance is more relative to this section. It also adds a rule that staff who work with or handle unpackaged food must complete an accredited food handler training course, clarifies that the three daily meals must include all five basic food groups, and updates citations and references.
• Proposed new §553.277, Infection Prevention and Control, relocates the rule from proposed repealed §553.261, Coordination of Care, adds a requirement that during a declared emergency residents must be permitted visits from their chosen essential caregivers, provides additional guidance for employee TB screening, and updates citations and references.
• Proposed new §553.279, Restraints and Seclusion, relocates the rule from proposed repealed §553.261, Coordination of Care, and adds specific guidance pertaining to the use of bed rails.
• Proposed new §553.281, Health Maintenance Activities, relocates the rule from proposed repealed §553.263, Health maintenance activities, updates citations and references, and relocates the rule relating to RN delegation to proposed new §553.283, RN Delegation of Care Tasks, to clarify that RN delegation is separate from health maintenance activities.
• Proposed new §553.285, Resident Records and Retention, relocates the rule from proposed repealed §553.265, Resident Records and Retention, adds a requirement to retain resident records for five years after services end, and provides guidance pertaining to electronic records and destruction of records.
• Proposed new §553.287, Rights, relocates the rule from proposed repealed §553.267, Rights; lists examples of interference, coercion, discrimination, and reprisal from which residents have the right to be free; and adds specificity and clarity to rules pertaining to residents’ rights to privacy and retaining personal property. The rule also relocates most residents’ rights pertaining to being transferred or discharged into proposed new §553.263, Resident Transfer and Discharge.
• Proposed new §553.289, Access to Residents and Records by the State Long-Term Care Ombudsman Program, and §553.291, Postings, relocate the rule from proposed repealed §553.261, Coordination of Care.
• Proposed new §553.292, Advertisements, Solicitations, and Promotional Material, relocates the rule from proposed repealed §553.272, Advertisements, Solicitations, and Promotional Material.
• Proposed new §553.293, Abuse, Neglect, or Exploitation and Incidents Reportable to HHSC by Facilities, and new §553.295, Emergency Preparedness and Response, relocate the rule from proposed repealed §553.261, Coordination of Care.

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Repealing 26 TAC §§553.261, 553.263, 553.265, 553.267, 553.269, 553.271 – 553.273, 553.275, to allow for the relocation of the subsections.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER E. STANDARDS FOR LICENSURE
26 TAC §§553.261, 553.263, 553.265, 553.267, 553.269, 553.271 – 553.273, 553.275

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

The proposed repeals of §553.263, Health Maintenance Activities; §553.265, Resident Records and Retention; §553.267, Rights; §553.269, Access to Residents and Records by the State Long-Term Care Ombudsman Program; §553.271, Postings; §553.272, Advertisements, Solicitations, and Promotional Material; §553.273, Abuse, Neglect, or Exploitation Reportable to HHSC by Facilities; and §553.275, Emergency Preparedness and Response, make these section numbers available to allow for the relocation of all subsections under §553.261, Coordination of Care, and maintain these key topics in their same general order and location in the chapter. The proposed repeal of §553.311, Physical Plant Requirements for Alzheimer’s Units, relocates these rules to new proposed §553.250, Construction Requirements for a Certified Alzheimer’s Assisted Living Facility.

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Amending 26 TAC §§553.301, 553.303, 553.305, 553.307, 553.309, to restructure and clarify the rule.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER F. ADDITIONAL LICENSING STANDARDS FOR CERTIFIED ALZHEIMER’S ASSISTED LIVING FACILITIES
26 TAC §§553.301, 553.303, 553.305, 553.307, 553.309

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

Proposed amendments to §553.301, Staffing, §553.303, Staff Training, §553.307, Admission Procedures, Assessment, and Service Plan, and §553.309, Activities Program, restructure some rules and clarify certain guidance to make information easier to find and understand and update citations and references.

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Repealing 26 TAC §553.311, to allow the rule to be relocated.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER F. ADDITIONAL LICENSING STANDARDS FOR CERTIFIED ALZHEIMER’S ASSISTED LIVING FACILITIES
26 TAC §553.311

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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Amending 26 TAC §§553.327, 553.328, 553.331, to provide that HHSC may inspect an assisted living facility approximately once every two years after initial inspection.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER G. INSPECTIONS, INVESTIGATIONS, AND INFORMAL DISPUTE RESOLUTION
26 TAC §§553.327, 553.328, 553.331

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §553.327, Inspections, Investigations, and Other Visits, clarifies that HHSC “may” inspect an assisted living facility approximately once every two years after initial inspection, as Long-Term Care Regulation does not have sufficient survey operations staff to inspect facilities at that frequency at all times.

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Repealing 26 TAC §553.351, §553.353, to make room for a new enforcement provision.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §553.351, §553.353

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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New 26 TAC §553.351, to provide general information about enforcement such as when HHSC may take enforcement action.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §553.351

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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Repealing 26 TAC §§553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, to make room for replacement rules.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §§553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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New 26 TAC §553.401, to explain the suspension actions which may be taken against a license.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §553.401

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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Repealing 26 TAC §§553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, to make room for new rules.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §§553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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New 26 TAC §553.451, to outline revocation actions against a license.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §553.451

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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Repealing 26 TAC §553.501, §553.503, to remove the existing sections.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §553.501, §553.503

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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New 26 TAC §553.501, to describe when HHSC would refer a facility to the Office of the Attorney General or a local prosecuting authority for a temporary restraining order or an injunction.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §553.501

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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Repealing 26 TAC §§553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, to remove these sections which pertain to license suspension and orders for an immediate closing.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §§553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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New 26 TAC §§553.551, to outline when HHSC may suspend a license or order an immediate closing of all or part of a facility.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §§553.551

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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Repealing 26 TAC §553.601, §553.603, to make room for the proposed rule concerning when HHSC may refer a facility to the Office of the Attorney General for assessment of civil penalties.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §553.601, §553.603

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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New 26 TAC §553.601, to clarify when HHSC may refer a facility to the Office of the Attorney General for assessment of civil penalties.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §553.601

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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Repealing 26 TAC §§553.651, 553.653, 553.655, 553.657, 553.659, 553.661, to remove these rules so they may be replaced with a new rule concerning when HHSC may petition a court for the involuntary appointment of a trustee to operate a facility.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §§553.651, 553.653, 553.655, 553.657, 553.659, 553.661

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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New 26 TAC §§553.651, to outline when HHSC may petition a court for the appointment of a trustee to operate a facility.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §§553.651

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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Repealing 26 TAC §§553.701, 553.703, 553.705, 553.707, 553.709, 553.711, to make room for a new rule concerning requests by facilities for the appointment of a trustee.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §§553.651

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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New 26 TAC §553.701, to describe when a facility may request the appointment of a trustee.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §§553.651

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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Amending 26 TAC §553.751, to outline when HHSC ay assess an administrative penalty for a license holder.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER H. ENFORCEMENT
26 TAC §553.751

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§553.3, 553.5, 553.7, 553.9, 553.17, 553.21, 553.23, 553.25, 553.27, 553.29, 553.31, 553.33, 553.37, 553.39, 553.47, 553.100, 553.101, 553.103, 553.104, 553.107, 553.111, 553.112, 553.113, 553.115, 553.122, 553.125, 553.131, 553.132, 553.135, 553.142, 553.211, 553.212, 553.215, 553.222, 553.225, 553.231, 553.232, 553.235, 553.241, 553.242, 553.245, 553.246, 553.253, 553.255, 553.257, 553.259, 553.301, 553.303, 553.305, 553.307, 553.309, 553.327, 553.331, 553.401, and 553.751; the repeal of §§553.43, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.272, 553.273, 553.275, 553.311, 553.351, 553.353, 553.401, 553.403, 553.405, 553.407, 553.409, 553.411, 553.413, 553.415, 553.417, 553.419, 553.421, 553.423, 553.425, 553.427, 553.429, 553.431, 553.433, 553.435, 553.437, 553.439, 553.451, 553.453, 553.455, 553.457, 553.459, 553.461, 553.463, 553.465, 553.467, 553.469, 553.471, 553.473, 553.475, 553.477, 553.479, 553.481, 553.483, 553.501, 553.503, 553.551, 553.553, 553.555, 553.557, 553.559, 553.561, 553.563, 553.565, 553.567, 553.569, 553.571, 553.573, 553.575, 553.577, 553.579, 553.581, 553.583, 553.585, 553.587, 553.589, 553.591, 553.593, 553.595, 553.597, 553.601, 553.603, 553.651, 553.653, 553.655, 553.657, 553.659, 553.661, 553.701, 553.703, 553.705, 553.707, 553.709, and 553.711; and new §§553.45, 553.250, 553.261, 553.263, 553.265, 553.267, 553.269, 553.271, 553.273, 553.275, 553.277, 553.279, 553.281, 553.283, 553.285, 553.287, 553.289, 553.291, 553.292, 553.293, 553.295, 553.328, 553.351, 553.401, 553.451, 553.501, 553.551, 553.601, 553.651, and 553.701 in Title 26, Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to reorganize certain rules so key topics are easier to find, add more clarity or specificity to certain rules that are vague, and update references throughout the chapter.

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Proposed Rule Reviews Re:

Reviewing Title 1, Part 15, to consider for readoption, revision, or repeal the chapter related to Refugee Cash Assistance and Medical Assistance Programs.

OVERVIEW

The Texas Health and Human Services Commission (HHSC) proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 1, Part 15, of the Texas Administrative Code:

Chapter 375, Refugee Cash Assistance and Medical Assistance Programs

Subchapter A Program Purpose and Scope

Subchapter B Contractor Requirements for The Refugee Cash Assistance Program (RCA)

Subchapter C Program Administration for The Refugee Cash Assistance Program (RCA)

Subchapter D Refugee Cash Assistance Participant Requirements

Subchapter E Refugee Medical Assistance

Subchapter F Modified Adjusted Gross Income Methodology

Subchapter G Local Resettlement Agency Requirements

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Reviewing Title 26, Part 1, to consider for readoption, revision, or repeal the chapter related to IDD-BH Training.

OVERVIEW

The Texas Health and Human Services Commission (HHSC) proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 26, Part 1, of the Texas Administrative Code:

Chapter 302, IDD-BH Training

Subchapter A Mental Health First Aid

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Adopted Rule Reviews Re:

Adopting the review of Title 26, Part 1, concerning LIDDA Service Coordination.

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts the review of the chapter below in Title 26, Part 1, of the Texas Administrative Code (TAC):

Chapter 331, LIDDA Service Coordination

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In Addition Re:

Public Notice – Texas State Plan for Medical Assistance Amendment

OVERVIEW

The Texas Health and Human Services Commission (HHSC) announces its intent to submit amendments to the Texas State Plan for Medical Assistance under Title XIX of the Social Security Act. The proposed amendment is effective January 1, 2024.

The purpose of the amendment is to clarify the coverage of certain services like durable medical equipment and drugs for renal dialysis services as payable outside of the current composite rate.

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Texas Medical Disclosure Panel

Adopted Rules Re:

Repealing 25 TAC §§601.1 – 601.9, to remove previous rules concerning informed consent.

CHAPTER 601. INFORMED CONSENT
25 TAC §§601.1 – 601.9

OVERVIEW

The Texas Medical Disclosure Panel (Panel) adopts the repeal of Texas Administrative Code (TAC), Title 25, Part 7, Chapter 601, concerning Informed Consent, and replacement with new Chapter 601, concerning General. The repealed chapter consists of §§601.1 – 601.9. The new chapter consists of §601.1 and §601.2.

The repeal of §§601.1 – 601.9 and new §601.1 and §601.2 are adopted without changes to the proposed text as published in the July 28, 2023, issue of the Texas Register (48 TexReg 4081). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The repeals and new rules are adopted in accordance with Texas Civil Practice and Remedies Code §74.102, which created the Panel to determine which risks and hazards related to medical care and surgical procedures must be disclosed by health care providers or physicians to their patients or persons authorized to consent for their patients and to establish the general form and substance of such disclosure.

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New 25 TAC §601.1, §601.2, to provide the general purpose of the chapter and provide a history of the procedures requiring disclosures.

CHAPTER 601. INFORMED CONSENT
25 TAC §601.1, §601.2

OVERVIEW

The Texas Medical Disclosure Panel (Panel) adopts the repeal of Texas Administrative Code (TAC), Title 25, Part 7, Chapter 601, concerning Informed Consent, and replacement with new Chapter 601, concerning General. The repealed chapter consists of §§601.1 – 601.9. The new chapter consists of §601.1 and §601.2.

The repeal of §§601.1 – 601.9 and new §601.1 and §601.2 are adopted without changes to the proposed text as published in the July 28, 2023, issue of the Texas Register (48 TexReg 4081). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The repeals and new rules are adopted in accordance with Texas Civil Practice and Remedies Code §74.102, which created the Panel to determine which risks and hazards related to medical care and surgical procedures must be disclosed by health care providers or physicians to their patients or persons authorized to consent for their patients and to establish the general form and substance of such disclosure.

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New 25 TAC §§602.1 – 602.22, to outline a list of procedures which require full disclosure of the risks and hazards associated with them.

CHAPTER 602. PROCEDURE REQUIRING FULL DISCLOSURE OF SPECIFIC RISKS AND HAZARDS–LIST A
25 TAC §§602.1 – 602.22

OVERVIEW

The Texas Medical Disclosure Panel (Panel) adopts new Texas Administrative Code (TAC), Title 25, Part 7, Chapter 602, concerning Procedures Requiring Full Disclosure of Specific Risks and Hazards–List A. The new chapter consists of §§602.1 – 602.22.

New §§602.2, 602.7, 602.8, and 602.15 are adopted with changes to the proposed text as published in the July 28, 2023, issue of the Texas Register (48 TexReg 4085). These rules will be republished.

New §§602.1, 602.3 – 602.6, 602.9 – 602.14, and 602.16 – 602.22 are adopted without changes to the proposed text as published in the July 28, 2023, issue of the Texas Register (48 TexReg 4085). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

These new rules are adopted in accordance with Texas Civil Practice and Remedies Code §74.102, which created the Panel to determine which risks and hazards related to medical care and surgical procedures must be disclosed by health care providers or physicians to their patients or persons authorized to consent for their patients and to establish the general form and substance of such disclosure.

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New 25 TAC §§603.1 – 603.21, to list the procedures which require no disclosure of the risks and hazards associated with them.

CHAPTER 603. PROCEDURES REQUIRING NO DISCLOSURE OF SPECIFIC RISKS AND HAZARDS–LIST B
25 TAC §§603.1 – 603.21

OVERVIEW

The Texas Medical Disclosure Panel (Panel) adopts new Texas Administrative Code (TAC), Title 25, Part 7, Chapter 603, concerning Procedures Requiring No Disclosure Of Specific Risks And Hazards–List B. The new chapter consists of §§603.1 – 603.21.

New §§603.1 – 603.21 are adopted without changes to the proposed text as published in the July 28, 2023, issue of the Texas Register (48 TexReg 4109). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

These rule repeals and new rules are adopted in accordance with Texas Civil Practice and Remedies Code §74.102, which created the Panel to determine which risks and hazards related to medical care and surgical procedures must be disclosed by health care providers or physicians to their patients or persons authorized to consent for their patients and to establish the general form and substance of such disclosure.

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New 25 TAC §§604.1 – 604.5, to outline the requirements for consent forms for procedures requiring full disclosures of risks and hazards.

CHAPTER 604. DISCLOSURE FORMS
25 TAC §§604.1 – 604.5

OVERVIEW

The Texas Medical Disclosure Panel (Panel) adopts new Texas Administrative Code (TAC), Title 25, Part 7, Chapter 604, concerning Disclosure Forms. The new chapter consists of §§604.1 – 604.5.

New §604.2 is adopted with changes to the proposed text as published in the July 28, 2023, issue of the Texas Register (48 TexReg 4113). This rule will be republished.

New §§604.1, and 604.3 – 604.5 are adopted without changes to the proposed text as published in the July 28, 2023, issue of the Texas Register (48 TexReg 4113). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

These rule repeals and new rules are adopted in accordance with Texas Civil Practice and Remedies Code §74.102, which created the Panel to determine which risks and hazards related to medical care and surgical procedures must be disclosed by health care providers or physicians to their patients or persons authorized to consent for their patients and to establish the general form and substance of such disclosure.

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Texas Department of Insurance

Adopted Rules Re:

Amending 28 TAC §3.9901, to modify the valuation manual in order to make changes which are substantially similar to those adopted by the National Association of Insurance Commissioners (NAIC).

CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
SUBCHAPTER RR. VALUATION MANUAL
28 TAC §3.9901

OVERVIEW

The commissioner of the Texas Department of Insurance (TDI) adopts amended 28 TAC §3.9901, concerning the adoption of a valuation manual for reserving and related requirements. The amendment is adopted without changes to the proposed text published in the October 6, 2023, issue of the Texas Register (48 TexReg 5810) and will not be republished.

BACKGROUND AND JUSTIFICATION

An amendment is necessary to comply with Insurance Code §425.073, which requires the commissioner to adopt a valuation manual that is substantially similar to the valuation manual adopted by the National Association of Insurance Commissioners (NAIC)

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In Addition Re:

Company Licensing

Application for incorporation in the state of Texas for Harbor Health Insurance Company, a domestic life, accident and/or health company. The home office is in Austin, Texas.

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Texas Department of Insurance, Division of Workers’ Compensation

Adopted Rules Re:

Amending 28 TAC §133.240, §133.250, to correct typos and to add the requirement that insurance carriers must give priority and accelerate to a member of the Texas military forces’s qualifying claim for medical benefits.

CHAPTER 133. GENERAL MEDICAL PROVISIONS
SUBCHAPTER C. MEDICAL BILL PROCESSING/AUDIT BY INSURANCE CARRIER
28 TAC §133.240, §133.250

OVERVIEW

The Texas Department of Insurance, Division of Workers’ Compensation (DWC) adopts amendments to 28 TAC §§133.240, 133.250, 133.305, and 133.308, concerning medical disputes for workers’ compensation claims. The amendments are adopted without changes to the proposed text published in the November 3, 2023, issue of the Texas Register (48 TexReg 6451). The text will not be republished.

BACKGROUND AND JUSTIFICATION

HB 90 added Labor Code §§401.027, 501.027, 501.028, and 501.029; and amended Labor Code §501.001. The proposed amendments to §§133.240, 133.250, 133.305, and 133.308 are necessary to implement the changes in HB 90 by clarifying workers’ compensation coverage for authorized travel by members of the Texas military forces, ensuring that insurance carriers expedite claims for medical benefits by injured members of the Texas military forces, and ensuring that DWC expedites disputes about those claims. The proposed amendments also include an update to the agency’s address and nonsubstantive editorial and formatting changes that make updates for plain language and agency style to improve the rule’s clarity.

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Amending 28 TAC §133.305, §133.308, to clarify when the travel of a member of the Texas military forces to or from the member’s duty location is considered to be in the course and scope of the member’s employment.

CHAPTER 133. GENERAL MEDICAL PROVISIONS
SUBCHAPTER D. DISPUTE OF MEDICAL BILLS
28 TAC §133.305, §133.308

OVERVIEW

The Texas Department of Insurance, Division of Workers’ Compensation (DWC) adopts amendments to 28 TAC §§133.240, 133.250, 133.305, and 133.308, concerning medical disputes for workers’ compensation claims. The amendments are adopted without changes to the proposed text published in the November 3, 2023, issue of the Texas Register (48 TexReg 6451). The text will not be republished.

BACKGROUND AND JUSTIFICATION

HB 90 added Labor Code §§401.027, 501.027, 501.028, and 501.029; and amended Labor Code §501.001. The proposed amendments to §§133.240, 133.250, 133.305, and 133.308 are necessary to implement the changes in HB 90 by clarifying workers’ compensation coverage for authorized travel by members of the Texas military forces, ensuring that insurance carriers expedite claims for medical benefits by injured members of the Texas military forces, and ensuring that DWC expedites disputes about those claims. The proposed amendments also include an update to the agency’s address and nonsubstantive editorial and formatting changes that make updates for plain language and agency style to improve the rule’s clarity.

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Amending 28 TAC §134.600, to require insurance carriers to accelerate and give priority to a qualifying claim for medical benefits by a member of the Texas military forces.

CHAPTER 134. BENEFITS–GUIDELINES FOR MEDICAL SERVICES, CHARGES, AND PAYMENTS
SUBCHAPTER G. PROSPECTIVE AND CONCURRENT REVIEW OF HEALTH CARE
28 TAC §134.600

OVERVIEW

The Texas Department of Insurance, Division of Workers’ Compensation (DWC) adopts amendments to 28 TAC §134.600, concerning preauthorization, concurrent utilization review, and voluntary certification of health care. The amendments are adopted without changes to the proposed text published in the November 3, 2023, issue of the Texas Register (48 TexReg 6455). The text will not be republished.

BACKGROUND AND JUSTIFICATION

House Bill (HB) 90 added Labor Code §§401.027, 501.027, 501.028, and 501.029; and amended Labor Code §501.001. The amendments to §134.600 are necessary to implement the changes in HB 90 by ensuring that insurance carriers expedite claims for medical benefits by injured members of the Texas military forces, including all health care required for the compensable injury. The amendments also include nonsubstantive editorial and formatting changes that make updates for plain language and agency style to improve the rule’s clarity.

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Texas Department of State Health Services

Proposed Rule Reviews Re:

Reviewing Title 25, Part 1, to consider for readoption, revision, or repeal the chapter relating to Laboratories.

OVERVIEW

The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 25, Part 1, of the Texas Administrative Code:

Chapter 73, Laboratories

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The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State of Health Services (DSHS), proposes to review and consider for readoption, revision, or repeal the chapter related to Training and Certification of Promotores or Community Health Workers.

OVERVIEW

The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State of Health Services (DSHS), proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 25, Part 1, of the Texas Administrative Code:

Chapter 146, Training and Certification of Promotores or Community Health Workers

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Adopted Rule Reviews Re:

Adopting the review of Title 25, Part 1, concerning Texas Asbestos Health Protection.

OVERVIEW

The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), adopts the review of the chapter below in Title 25, Part 1, of the Texas Administrative Code (TAC):

Chapter 296, Texas Asbestos Health Protection

Subchapter A General Provisions

Subchapter B Definitions

Subchapter C Standards of Conduct

Subchapter D License and Registration

Subchapter E Training Provider License and Training Courses

Subchapter F License and Registration Fees

Subchapter G State Licensing Examination

Subchapter H License and Registration Provisions Related to Military Service Members, Military Veterans, and Military Spouses

Subchapter I Accreditation

Subchapter J Exemptions

Subchapter K Asbestos Management in a Public Building, Commercial Building, or Facility

Subchapter L General Requirements, and Practices and Procedures for Asbestos Abatement in a Public Building

Subchapter M Alternative Asbestos Practices and Procedures in a Public Building

Subchapter N Notifications

Subchapter O Inspections and Investigations

Subchapter P Recordkeeping

Subchapter Q Compliance.

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