SB 1472

relating to assisted living facilities allowing residents to
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1.  Section 247.0011(b), Health and Safety Code, is
(b)  The executive commissioner shall protect residents of
(1)  adopting rules relating to quality of care and
(2)  adopting rules relating to the assessment of the
condition and service needs of each resident, including the
designation of an advocate for the resident.
SECTION 2.  Section 247.002, Health and Safety Code, is
amended by amending Subdivision (1) and adding Subdivision (1-a) to
(1)  "Advocate" means an individual who advocates on
behalf of a resident, including:
(A)  the resident's spouse, family member,
(B)  the  parent, legal custodian, or guardian of
a resident under 18 years of age;
(C)  an agent the resident designates under a
durable power of attorney for health care; and
(D)  an individual a court appoints to act as the
(1-a)  "Assisted living facility" means an
(A)  furnishes, in one or more facilities, food
and shelter to four or more persons who are unrelated to the
proprietor of the establishment;
(i)  personal care services; or
(ii)  administration of medication by a
person licensed or otherwise authorized in this state to administer
(C)  may provide assistance with or supervision of
the administration of medication;
(D)  may provide skilled nursing services for the
(i)  coordination of resident care with
outside home and community support services agencies and other
(ii)  provision or delegation of personal
care services and medication administration as described by this
(iii)  assessment of residents to determine
(iv)  for periods of time as established by
department rule, delivery of temporary skilled nursing treatment
for a minor illness, injury, or emergency; and
(E)  may provide health maintenance activities as
defined by rule by the Texas Board of Nursing.
SECTION 3.  Section 247.021(d), Health and Safety Code, is
(d)  The executive commissioner by rule shall establish
procedures to issue a six-month provisional license to existing
facilities with residents.  The department may issue a provisional
(1)  the facility is in compliance with resident care
(2)  the facility voluntarily discloses that the
facility needs additional time to comply with life safety code and
(3)  the disclosure is made in writing by certified
(4)  an investigation of the violation was not
initiated and the violation was not independently detected by the
(5)  the disclosure is made promptly after knowledge of
the information disclosed is obtained by the facility; and
(6)  the facility adopts advocate policies and
procedures in accordance with Section 247.073 and rules adopted
SECTION 4.  Section 247.064(b), Health and Safety Code, is
(b)  The residents' bill of rights must provide that each
resident in the assisted living facility has the right to:
(1)  manage the resident's financial affairs;
(2)  determine the resident's dress, hair style, or
other personal effects according to individual preference, except
that the resident has the responsibility to maintain personal
(3)  retain and use personal property in the resident's
immediate living quarters and to have an individual locked cabinet
in which to keep personal property;
(4)  receive and send unopened mail;
(5)  unaccompanied access to a telephone at a
reasonable hour or in case of an emergency or personal crisis;
(7)  unrestricted communication, including personal
visitation with any person of the resident's choice, at any
reasonable hour, including family members and representatives of
advocacy groups and community service organizations;
(8)  make contacts with the community and to achieve
the highest level of independence, autonomy, and interaction with
the community of which the resident is capable;
(9)  present grievances on behalf of the resident or
others to the operator, state agencies, or other persons without
threat of reprisal in any manner;
(10)  a safe and decent living environment and
considerate and respectful care that recognizes the dignity and
(11)  refuse to perform services for the facility,
except as contracted for by the resident and operator;
(12)  practice the religion of the resident's choice;
(13)  leave the facility temporarily or permanently,
subject to contractual or financial obligations; [and]
(14)  not be deprived of any constitutional, civil, or
legal right solely by reason of residence in an assisted living
(15)  designate an advocate in accordance with Section
247.073 and rules adopted under that section.
SECTION 5.  Subchapter D, Chapter 247, Health and Safety
Code, is amended by adding Section 247.073 to read as follows:
Sec. 247.073.  ADVOCATE DESIGNATION POLICIES AND
PROCEDURES.  (a)  The executive commissioner by rule shall require
each assisted living facility to develop and implement policies
providing each resident an opportunity to designate an advocate for
whom the facility will provide meaningful in-person access to the
resident, specifically during the resident's final days of life,
regardless of any declared public health disaster or emergency
restricting in-person visitation.
(b)  The policies and procedures described by Subsection (a)
(1)  require or coerce a resident to waive the
resident's rights under this section;
(2)  require the resident's visits with the designated
(3)  authorize an individual to serve as an advocate
for a resident if a court found the individual abused the resident
or the facility determines the individual poses a serious risk to
(c)  The facility shall provide and explain the policies and
procedures described by Subsection (a) to each resident:
(1)  during the facility's admission process; and
(2)  before the facility implements any changes to the
SECTION 6.  As soon as practicable after the effective date
of this Act, the executive commissioner of the Health and Human
Services Commission shall adopt rules as necessary to implement
Section 247.073, Health and Safety Code, as added by this Act.
SECTION 7.  This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution.  If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2025.