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TITLE 40SOCIAL SERVICES AND ASSISTANCE
PART 1DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 15LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS
SUBCHAPTER APURPOSE, SCOPE, LIMITATIONS, COMPLIANCE, AND DEFINITIONS
RULE §15.5Definitions
Historical Texas Register

The following words and terms, when used in this chapter, have the following meanings unless the context clearly indicates otherwise.

  (1) Active Play--Any physical activity from which a minor derives amusement, entertainment, enjoyment, or satisfaction by taking a participatory rather than a passive role. Active play includes various forms of activities, from the exploration of objects and toys to the structured play of formal games, sports, and hobbies.

  (2) Actual census--The number of minors at a center at any given time.

  (3) Administration of medication--The direct application of a medication to the body of a minor by any route. This includes removing an individual or unit dose from a previously dispensed, correctly labeled container, verifying it with the medication order, giving the correct medication and the correct dose to the correct minor at the correct time by the correct route, and accurately recording the time and dose given.

  (4) Administrator--The person who is responsible for implementing and supervising the administrative polices and operations of a center and for administratively supervising the provision of services to minors and their parents on a day-to-day basis.

  (5) Adult minor--A minor who is 18 years of age or older or is emancipated, and has not been adjudged incompetent.

  (6) Affiliate--With respect to an applicant or license holder that is:

    (A) a corporation--means an officer, director, or stockholder with direct ownership or disclosable interest of at least five percent, a subsidiary, or a parent company;

    (B) a limited liability company--means an officer, member, or parent company;

    (C) an individual--means:

      (i) the individual's spouse;

      (ii) each partnership and each partner thereof of which an individual or any affiliate of an individual is a partner; and

      (iii) each corporation in which an individual is an officer, director, or stockholder with a direct ownership of at least five percent;

    (D) a partnership--means a partner or a parent company of the partnership; and

    (E) a group of co-owners under any other business arrangement means an officer, director, or the equivalent under the specific business arrangement or a parent company.

  (7) Applicant--A person who applies for a license to operate a center under THSC Chapter 248A and this chapter. The applicant is the person in whose name DADS issues the license.

  (8) Audiologist--A person who has a valid license under Texas Occupations Code, Chapter 401, as an audiologist.

  (9) Basic services--Include:

    (A) the development, implementation, and monitoring of a comprehensive protocol of care that:

      (i) is provided to a medically dependent or technologically dependent minor;

      (ii) is developed in conjunction with the minor's parent; and

      (iii) specifies the medical, nursing, psychosocial, therapeutic, and developmental services required by the minor; and

    (B) the caregiver training needs of a medically dependent or technologically dependent minor's parent.

  (10) Behavioral emergency--A situation that occurs after which preventative, or de-escalating techniques are attempted and determined to be ineffective and it is immediately necessary to restrain a minor to prevent immediate probable death or substantial bodily harm to the minor or to others because the minor is attempting serious bodily harm or immediate physical harm to the minor or to others.

  (11) Business day--Any day except a national or state holiday listed in Texas Government Code §662.003(a) or (b). The term includes Saturday or Sunday if the center is open on that day.

  (12) Center--A prescribed pediatric extended care center. A facility operated for profit or on a nonprofit basis that provides nonresidential basic services to four or more medically dependent or technologically dependent minors who require the services of the facility and who are not related by blood, marriage, or adoption to the owner or operator of the facility.

  (13) Change of ownership--An event that results in a change to the federal taxpayer identification number of the license holder of a facility. The substitution of a personal representative for a deceased license holder is not a change of ownership.

  (14) Chemical restraint--The use of any chemical, including pharmaceuticals, through topical application, oral administration, injection, or other means, to restrict the free movement of all or a portion of a minor's body for the purpose of modifying or controlling the minor's behavior and which is not a standard treatment for a minor's medical or psychosocial condition.

  (15) Chief financial officer--An individual who is responsible for supervising and managing all financial activities for a center.

  (16) Clinical note--A notation of a contact with a minor or a minor's family member that is written and dated by any staff providing services on behalf of a center and that describes signs and symptoms of the minor, and treatments and medications administered to the minor, including the minor's reaction or response, and any changes in physical, emotional, psychosocial, or spiritual condition of the minor during a given period of time.

  (17) Commission--The Texas Health and Human Services Commission.

  (18) Commissioner--The commissioner of DADS.

  (19) Community disaster resources--A local, statewide, or nationwide emergency system that provides information and resources during a disaster, including weather information, transportation, evacuation and shelter information, disaster assistance and recovery efforts, evacuee and disaster victim resources, and resources for locating evacuated friends and relatives.

  (20) Complaint--An allegation against a center or involving services provided at a center that involves a violation of this chapter or THSC Chapter 248A.

  (21) Continuous face-to-face observation--Maintaining an in-person line of sight of a minor that is uninterrupted and free from distraction.

  (22) Contractor--An individual providing services ordered by a prescribing physician on behalf of a center that the center would otherwise provide by its employees.

  (23) Controlling person--A person who has the ability, acting alone or in concert with others, to directly or indirectly influence, direct, or cause the direction of the management of, expenditure of money for, or policies of a center or other person.

    (A) A controlling person includes:

      (i) a management company, landlord, or other business entity that operates or contracts with another person for the operation of a center;

      (ii) any person who is a controlling person of a management company or other business entity that operates a center or that contracts with another person for the operation of a center; and

      (iii) any other person who, because of a personal, familial, or other relationship with the owner, manager, landlord, tenant, or provider of a center, is in a position of actual control of or authority with respect to the center, regardless of whether the person is formally named as an owner, manager, director, officer, provider, consultant, contractor, or employee of the center.

    (B) Notwithstanding any other provision of this paragraph, a controlling person of a center or of a management company or other business entity described by subparagraph (A)(i) of this paragraph that is a publicly traded corporation or is controlled by a publicly traded corporation means an officer or director of the corporation. The term does not include a shareholder or lender of the publicly traded corporation.

    (C) A controlling person described by subparagraph (A)(iii) of this paragraph does not include a person, including an employee, lender, secured creditor, or landlord, who does not exercise any formal or actual influence or control over the operation of the center.

  (24) Conviction--An adjudication of guilt based on a finding of guilt, a plea of guilty, or a plea of nolo contendere.

  (25) DADS--Department of Aging and Disability Services or its successor agency.

  (26) Daily census--The number of minors served at a center during a center's hours of operation for a 24-hour period, starting at midnight.

  (27) Day--A calendar day, unless otherwise specified in the text. A calendar day includes Saturday, Sunday, and a holiday.

  (28) Dietitian--A person who has a valid license under the Licensed Dietitian Act, Texas Occupations Code, Chapter 701, as a licensed dietitian or provisional licensed dietitian, or who is registered as a dietitian by the Commission on Dietetic Registration of the American Dietetic Association.

  (29) Direct ownership interest--Ownership of equity in the capital, stock, or profits of, or a membership interest in, an applicant or license holder.

  (30) Disclosable interest--Five percent or more direct or indirect ownership interest in an applicant or license holder.

  (31) Emergency situation--An impending or actual situation that:

    (A) interferes with normal activities of a center or minors at a center;

    (B) may:

      (i) cause injury or death to a minor or individual at the center; or

      (ii) cause damage to the center's property;

    (C) requires the center to respond immediately to mitigate or avoid injury, death, damage, or interference; and

    (D) does not include a situation that arises from the medical condition of a minor such as cardiac arrest, obstructed airway, or cerebrovascular accident.

  (32) Executive commissioner--The executive commissioner of the Texas Health and Human Services Commission.

  (33) Functional assessment--An evaluation of a minor's abilities, wants, interests, and needs related to self-care, communication skills, social skills, motor skills, play with toys or objects, growth, and development appropriate for age.

  (34) Health care provider--An individual or facility licensed, certified, or otherwise authorized to administer health care in the ordinary course of business or professional practice.

  (35) Health care setting--A location at which licensed, certified, or otherwise regulated health care is administered.

  (36) IDT--Interdisciplinary team. Individuals who work together to meet the medical, nursing, psychosocial, and developmental needs of a minor and a minor's parent's training needs.

  (37) Inactive medical record--A record for a minor who was admitted by a center to receive services and was subsequently discharged by the center.

  (38) Indirect ownership interest--Any ownership or membership interest in a person that has a direct ownership interest in an applicant or license holder.

  (39) Inspection--An on-site examination or audit of a center by DADS to determine compliance with THSC Chapter 248A and this chapter.

  (40) Isolation--The involuntary confinement of a minor in a room of a center for the purposes of infection control, assessment, and observation away from other minors in a room at the center. When in isolation, a minor is physically prevented from contact with other minors.

  (41) Joint training--Training provided by DADS to service providers and DADS inspectors on subjects that address the 10 most commonly cited violations of state law governing centers, as published in DADS annual reports. DADS determines the frequency of joint training.

  (42) License--A license to operate a center issued by DADS under THSC Chapter 248A and this chapter. The term includes initial, renewal, and temporary licenses unless specifically stated otherwise.

  (43) Licensed assistant in speech-language pathology--A person who has a valid license under Texas Occupations Code, Chapter 401, as a licensed assistant in speech-language pathology and who provides speech language support services under the supervision of a licensed speech-language pathologist.

  (44) License holder--A person that holds a license to operate a center under THSC Chapter 248A and this chapter.

  (45) Licensed vocational nurse--LVN. A person who has a valid license under Texas Occupations Code, Chapter 301, as a licensed vocational nurse.

  (46) Life Safety Code--A publication of the National Fire Protection Association (NFPA), also known as NFPA 101, 2000 edition.

  (47) Local emergency management agencies--The local emergency management coordinator, fire, police, and emergency medical services.

  (48) Local emergency management coordinator--The person identified as the emergency management coordinator by the mayor or county judge for the geographical area in which a center is located.

  (49) Mechanical restraint--The use of any mechanical device, material, or equipment to restrict the free movement of all or a portion of a minor's body for the purpose of modifying or controlling the minor's behavior.

Cont'd...

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