The bill, S.B. No. 457, aims to enhance the regulation of nursing facilities in Texas by establishing new licensing and Medicaid participation requirements. Key provisions include the requirement for nursing facilities to comply with a direct care expense ratio, which mandates that at least 80% of the medical assistance reimbursement for patient care expenses be allocated to direct care expenses. Additionally, the bill introduces a new section that requires nursing facility provider agreements to include compliance with this direct care expense ratio. It also mandates that nursing facilities notify the commission of any changes in ownership interests and outlines the process for recouping incentive payments if facilities fail to meet program requirements.

Furthermore, the bill amends existing laws to ensure timely payment to nursing facilities for clean claims and to improve the overall quality of care by reducing preventable events and unnecessary institutionalizations. It emphasizes the importance of discharge planning and transitional care, as well as the establishment of a claims submission portal for nursing facilities. The bill is set to take effect on September 1, 2025, and includes provisions for seeking federal waivers if necessary for implementation.

Statutes affected:
Introduced: Health and Safety Code 242.032, Human Resources Code 32.028 (Human Resources Code 32, Health and Safety Code 242)