(a) In this section:
(1) “Abuse” has the meaning assigned by Section 260A.001.
(2) “Immediate threat to health and safety” means a situation in which immediate corrective action is necessary because the facility’s noncompliance with one or more requirements has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident.
(3) “Neglect” has the meaning assigned by Section 260A.001.
(a-1) The department, after providing notice and opportunity for a hearing to the applicant or license holder, may deny, suspend, or revoke a license if the department finds that the applicant, the license holder, or any other person described by § 242.032(d) has:
(1) violated this chapter or a rule, standard, or order adopted or license issued under this chapter in either a repeated or substantial manner;
(2) committed any act described by Sections 242.066(a)(2)-(6); or
(3) failed to comply with § 242.074.

(a-2) Except as provided by Subsection (a-3) or (e-1), the executive commissioner shall revoke a license under Subsection (a-1) if the department finds that:
(1) the license holder has committed three violations described by Subsection (a-1), within a 24-month period, that constitute an immediate threat to health and safety related to the abuse or neglect of a resident; and
(2) each of the violations described by Subdivision (1) is reported in connection with a separate survey, inspection, or investigation visit that occurred on separate entrance and exit dates.

Text of subsection effective until April 01, 2025

(a-3) The executive commissioner may not revoke a license under Subsection (a-2) due to a violation described by Subsection (a-2)(1), if:
(1) the violation and the determination of immediate threat to health and safety are not included on the written list of violations left with the facility at the time of the initial exit conference under § 242.0445(b) for a survey, inspection, or investigation;
(2) the violation is not included on the final statement of violations described by § 242.0445; or
(3) the violation has been reviewed under the informal dispute resolution process established by § 531.058, Government Code, and a determination was made that:
(A) the violation should be removed from the license holder’s record; or
(B) the violation is reduced in severity so that the violation is no longer cited as an immediate threat to health and safety related to the abuse or neglect of a resident.

Text of subsection effective on April 01, 2025

(a-3) The executive commissioner may not revoke a license under Subsection (a-2) due to a violation described by Subsection (a-2)(1), if:
(1) the violation and the determination of immediate threat to health and safety are not included on the written list of violations left with the facility at the time of the initial exit conference under § 242.0445(b) for a survey, inspection, or investigation;
(2) the violation is not included on the final statement of violations described by § 242.0445; or
(3) the violation has been reviewed under the informal dispute resolution process established by § 526.0202, Government Code, and a determination was made that:
(A) the violation should be removed from the license holder’s record; or
(B) the violation is reduced in severity so that the violation is no longer cited as an immediate threat to health and safety related to the abuse or neglect of a resident.
(b) The status of a person as an applicant for a license or a license holder is preserved until final disposition of the contested matter, except as the court having jurisdiction of a judicial review of the matter may order in the public interest for the welfare and safety of the residents.
(c) The department may deny, suspend, or revoke the license of an institution if any person described by § 242.032(d) has been excluded from holding a license under § 242.0615.
(c-1) In the case of revocation of a license under Subsection (a-2), to ensure the health and safety of residents of the institution, the department may:
(1) request the appointment of a trustee to operate the institution under Subchapter D;
(2) assist with obtaining a new operator for the institution; or
(3) assist with the relocation of residents to another institution.
(d) A court having jurisdiction of a judicial review of the matter may not order arbitration, whether on motion of any party or on the court’s own motion, to resolve a dispute involving the denial, suspension, or revocation of a license under this section or the conduct with respect to which the denial, suspension, or revocation of the license is sought.
(e) The executive commissioner may stay a license revocation required by Subsection (a-2) if the executive commissioner determines that the stay would not jeopardize the health and safety of the residents of the facility or place the residents at risk of abuse or neglect. The executive commissioner by rule shall establish criteria under which a license revocation may be stayed under this subsection. The executive commissioner shall follow negotiated rulemaking procedures prescribed by Chapter 2008, Government Code, for the adoption of rules establishing the criteria. The criteria established must permit the executive commissioner to stay a license revocation of a nursing facility for which the department has deployed a rapid response team under § 255.004, if the facility has cooperated with the rapid response team and demonstrated improvement in quality of care, as determined by the rapid response team.
(e-1) The executive commissioner may stay a license revocation required by Subsection (a-2) for a veterans home, as defined by § 164.002, Natural Resources Code, if the Veterans’ Land Board contracts with a different entity to operate the veterans home than the entity that operated the home during the period in which the violations described by Subsection (a-2) occurred.