TX SB457

Nursing facilities must continue receiving uninterrupted Medicaid reimbursement while change in ownership applications are pending, provided the new owner accepts the previous owner's Medicaid provider agreement, meets licensing requirements, and enters into a commission-approved successor liability agreement

Establishes an annual patient care expense ratio requiring nursing facilities to spend at least 80% of the Medicaid reimbursement amount attributable to patient care on reasonable and necessary patient care expenses, including staff compensation, medical supplies, and dietary services

Allows the Health and Human Services Commission to recoup reimbursements from facilities failing to meet the 80% patient care expense ratio, with exemptions for facilities with four-star or higher CMS ratings, low-occupancy facilities meeting a 70% threshold, or those affected by declared disasters

Requires nursing facility license applications to disclose all persons with 5% or more direct or indirect ownership interest in both the facility and the real property where it is located, and mandates notification of any ownership changes

Takes effect September 1, 2025, with the commission required to submit a report to the legislature by November 1, 2027 assessing the impact of the patient care expense ratio on cost and quality of care