Texas Attorney General Opinion: LO97-088 Page: 4 of 7
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Dr. William R. Archer, III - Page 4
services, the facility must provide them, either by providing the rehabilitation services itself or by
obtaining them from an outside provider." "Specialized rehabilitation services," which include, but
are not limited to "physical therapy, speech-language pathology, occupational therapy, and mental
health rehabilitative services for mental illness and mental retardation," must be provided under the
written order of a physician by qualified personnel.16
The Texas Department of Human Services has promulgated regulations for the licensure and
Medicaid certification of long-term care nursing facilities that conform to the federal requirements.7
Long-term care nursing facilities must be licensed by the Texas Department of Human Services as
nursing facilities."
The legislative history of Senate Bill 212 does not indicate that the legislature intended to
change the licensing requirements for nursing facilities that provide specialized rehabilitation
services to residents in compliance with the requirements for Medicaid certification. Section
241.122 describes "inpatient comprehensive medical rehabilitation" as medical services that "are
more intensive than nursing facility care and minor treatment." The legislative history of Senate Bill
212 shows that the legislature distinguished "inpatient comprehensive medical rehabilitation" from
the kind of rehabilitation typically provided by nursing facilities as a condition of Medicaid
certification.
Section 241.122 in Senate Bill 212 as introduced by Senators Zaffirini, Moncrief and Harris
of Tarrant County, read as follows:
Unless a person has a license issued under this chapter, a person may not
provide inpatient comprehensive medical rehabilitation services to a patient
who requires medical services that are provided under the supervision of a
physician and that are more intensive than general nursing care and minor
treatment.9
At a hearing on Senate Bill 212 held by the Senate Health and Human Services Committee
on March 16, 1993, a witness who represented nursing homes and intermediate care facilities for the
151d. 483.45.
16Id.
17See 40 T.A.C. 19.1(a) (citing laws that govern requirements for long-term care nursing facility licensure
and Medicaid certification), .801(2) (requiring comprehensive assessment of each resident), .802 (requiring
comprehensive care plan), .1301 (requiring provision of specialized rehabilitation services to residents, tracking
requirements stated in 42 C.F.R. 483A45).
'81d. 19.2301; see Health & Safety Code ch. 242 (licensure provisions for nursing homes); Act of August
9, 1991, 72d Leg., 1st C.S., ch. 15, 1.11, 1991 Tex. Gen. Laws 281,298.'9S.B. 212, 73d Leg., R.S. (1993).
(L097-088)
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Texas. Attorney-General's Office. Texas Attorney General Opinion: LO97-088, text, September 26, 1997; (https://texashistory.unt.edu/ark:/67531/metapth277270/m1/4/?q=%221997~%22: accessed July 16, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.