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Texas “Three Strikes (And You’re Closed) Rule” Passes Senate

As the members of the baby boomer generation age and will undoubtedly create an increasing demand for health care, including at nursing homes and long-term care facilities, state governments and the federal government appear to be looking for ways to help regulate nursing homes and ensure more protection and safety for facility residents. This is especially important where so many nursing home owners are so focused on their bottom line that they are willing to cut overhead, which includes keeping staff at disturbingly low levels in order to save money, all the while overtaxing the existing aides with too much work. Such scenarios unfortunately can lead to abuse and neglect against patients, which also can occur even at seemingly normally staffed nursing homes.

As part of increased oversight, the federal government has given its review and rating process for nursing homes more teeth, and states in general have sought to find ways to strengthen regulations and come down harder on offending facilities or individual aides and staffers. Illinois’ push toward allowing nursing home residents to keep cameras in their rooms to surveil what goes on is one such example of trying to better protect residents. For months, Texas, which is also one of the worst states for nursing home quality care in the country, there has been a push to enact a bill that would make it much easier to close a nursing home if it is found to have multiple violations of the law or regulations. This is called the “Three Strikes Rule” bill.

The Details of the Law

The “Three Strikes Rule” bill, or Texas Senate Bill 304, actually passed through the Senate at the start of April, and will go to the Texas House of Representatives Human Services Committee for an eventual vote there. If passed in committee, it would go to the main House of Representatives for a full vote, and if passed there, then it would move on to the governor for his signature. If the bill becomes a law, the state Department of Aging and Disability Services would be able to close down a nursing home facility that is hit with three severe citations within a two-year time period, with a caveat that violations must occur on separate days. This bill does not merely providing latitude for the agency to use its discretion in shutting down a facility; rather, the bill proposes that such a closure be mandated as a result of three severe citations. Such deficiencies may include not just abuse or neglect, but other items such as an unsanitary living environment and poor food quality.

By requiring shut down, the bill aims to counter the lacking response of the state to abuse and neglect (and in some instances a failure to report it), by taking away that element of discretion. As the bill still has a ways to go, the nursing home industry will presumably look to push representatives on the committee, or later in the full House, to vote against it. Reportedly, about two-thirds of the 27 bills proposed in the state legislature that would affect nursing home regulation never even made it out of their committees, let alone out of each full House and Senate. Some point to the influence of the nursing home industry, such as through campaign contributions to state lawmakers, to kill many of these bills. It remains to be seen what happens with the “Three Strikes Rule,” but so far so good, and it will also be worth monitoring pro-nursing home safety trends in Illinois and across the country.

See Related Blog Posts:

Texas Lawmaker Moves Forward with Three Strikes Proposal

Texas Legislature Wants ‘3 Strikes and You’re Closed’ Rule