Texas Register

TITLE 40 SOCIAL SERVICES AND ASSISTANCE
PART 1DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 90INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION OR RELATED CONDITIONS
SUBCHAPTER AINTRODUCTION
RULE §90.3Definitions
ISSUE 05/26/2006
ACTION Final/Adopted
Preamble No Rule Available

The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise. Individual subchapters may have definitions that are specific to the subchapter.

  (1)Addition--The addition of floor space to a facility.

  (2)Administrator--The administrator of a facility.

  (3)Affiliate--With respect to a:

    (A)partnership, each partner thereof;

    (B)corporation, each officer, director, principal stockholder, and subsidiary; and each person with a disclosable interest (defined in the section);

    (C)natural person which includes each:

      (i)person's spouse;

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

      (iii)corporation in which said person is an officer, director, principal stockholder, or person with a disclosable interest.

  (4)Applicant--A person applying for a license under Health and Safety Code, Chapter 252.

  (5)APA--The Administrative Procedure Act, Texas Government Code, Chapter 2001.

  (6)Attendant personnel--All persons who are responsible for direct and non-nursing services to residents of a facility. (Nonattendant personnel are all persons who are not responsible for direct personal services to residents.) Attendant personnel come within the categories of: administration, dietitians, medical records, activities, housekeeping, laundry, and maintenance.

  (7)Behavioral emergency--A situation in which severely aggressive, destructive, violent, or self-injurious behavior exhibited by a resident:

    (A)poses a substantial risk of imminent probable death of, or substantial bodily harm to, the resident or others;

    (B)has not abated in response to attempted preventive de-escalatory or redirection techniques;

    (C)is not addressed in a behavior therapy program; and

    (D)does not occur during a medical or dental procedure.

  (8)Care and treatment--Services required to maximize resident independence, personal choice, participation, health, self-care, psychosocial functioning and provide reasonable safety, all consistent with the preferences of the resident.

  (9)Centers for Medicare and Medicaid Services (CMS)--The federal agency that provides funding and oversight for the Medicare and Medicaid programs. CMS was formerly known as the Health Care Financing Administration (HCFA).

  (10)Change of ownership--A change of 50% or more in the ownership of the business organization that is licensed to operate the facility, or a change in the federal taxpayer identification number.

  (11)Controlled substance--A drug, substance, or immediate precursor as defined in the Texas Controlled Substance Act, Health and Safety Code, Chapter 481, as amended, and/or the Federal Controlled Substance Act of 1970, Public Law 91-513, as amended.

  (12)DADS--The Department of Aging and Disability Services.

  (13)Dangerous drug--Any drug as defined in the Texas Dangerous Drug Act, Health and Safety Code, Chapter 483.

  (14)Department--The Department of Aging and Disability Services.

  (15)Designee--A state agency or entity with which DADS contracts to perform specific, identified duties related to the fulfillment of a responsibility prescribed by this chapter.

  (16)Drug (also referred to as medication)--A drug is:

    (A)any substance recognized as a drug in the official United States Pharmacopeia, official Homeopathic Pharmacopeia of the United States, or official National Formulary, or any supplement to any of them;

    (B)any substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in man;

    (C)any substance (other than food) intended to affect the structure or any function of the human body; and

    (D)any substance intended for use as a component of any substance specified in subparagraphs (A) - (C) of this paragraph. It does not include devices or their components, parts, or accessories.

  (17)Establishment--A place of business or a place where business is conducted which includes staff, fixtures, and property.

  (18)Facility--A facility serving persons with mental retardation or related conditions licensed under this chapter as described in §90.2 of this title (relating to Scope) and required to be licensed under the Health and Safety Code, Chapter 252.

  (19)Governmental unit--A state or a political subdivision of the state, including a county or municipality.

  (20)Hearing--A contested case hearing held in accordance with the Administrative Procedure Act, Government Code, Chapter 2001, and the formal hearing procedures in 1 TAC Chapter 357, Subchapter I.

  (21)Immediate and serious threat--A situation in which there is a high probability that serious harm or injury to residents could occur at any time or has already occurred and may occur again if residents are not protected effectively from the harm or if the threat is not removed.

  (22)Immediate jeopardy to health and safety--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 receiving care in the facility.

  (23)Incident--An unusual or abnormal event or occurrence in, at, or affecting the facility and/or the residents of the facility.

  (24)Inspection--Any on-site visit to or survey of a facility by DADS for the purpose of inspection of care, licensing, monitoring, complaint investigation, architectural review, or similar purpose.

  (25)Large facility--Facilities with 17 or more resident beds.

  (26)Legal guardian--A person who is appointed guardian under §693 of the Probate Code.

  (27)Legally authorized representative--A person authorized by law to act on behalf of a person with regard to a matter described in this chapter, and may include a parent, guardian, or managing conservator of a minor, or the guardian of an adult.

  (28)License--Approval from DADS to establish or operate a facility.

  (29)Life Safety Code (also referred to as the Code or NFPA 101)--The Code for Safety to Life from Fire in Buildings and Structures, Standard 101, of the National Fire Protection Association (NFPA).

  (30)Life safety features--Fire safety components required by the Life Safety Code such as building construction, fire alarm systems, smoke detection systems, interior finishes, sizes and thicknesses of doors, exits, emergency electrical systems, sprinkler systems, etc.

  (31)Local authorities--A local health authority, fire marshal, building inspector, etc., who may be authorized by state law, county order, or municipal ordinance to perform certain inspections or certifications.

  (32)Local health authority--The physician having local jurisdiction to administer state and local laws or ordinances relating to public health, as described in the Health and Safety Code, §§121.021 - 121.025.

  (33)Management services--Services provided under contract between the owner of a facility and a person to provide for the operation of a facility, including administration, staffing, maintenance, or delivery of resident services. Management services shall not include contracts solely for maintenance, laundry, or food services.

  (34)Manager--A person having a contractual relationship to provide management services to a facility.

  (35)Person--An individual, firm, partnership, corporation, association, or joint stock company, and any legal successor of those entities.

  (36)Person with a disclosable interest--Any person who owns 5.0% interest in any corporation, partnership, or other business entity that is required to be licensed under Health and Safety Code, Chapter 252. A person with a disclosable interest does not include a bank, savings and loan, savings bank, trust company, building and loan association, credit union, individual loan and thrift company, investment banking firm, or insurance company unless such entity participates in the management of the facility.

  (37)Personal hold--

    (A)A manual method, except for physical guidance or prompting of brief duration, used to restrict:

      (i)free movement or normal functioning of all or a portion of a resident's body; or

      (ii)normal access by a resident to a portion of the resident's body.

    (B)Physical guidance or prompting of brief duration becomes a restraint if the resident resists the guidance or prompting.

  (38)Qualified mental retardation professional (QMRP)--A person with at least a bachelor's degree who has at least one year of experience working with persons with mental retardation or related conditions.

  (39)Quality-of-care monitor--A registered nurse, pharmacist, or dietitian, employed by DADS, who is trained and experienced in long-term care regulations, standards of practice in long-term care, and evaluation of resident care and functions independently of DADS' Regulatory Services Division.

  (40)Remodeling--The construction, removal, or relocation of walls and partitions, or construction of foundations, floors, or ceiling-roof assemblies, including expanding of safety systems (i.e., sprinkler systems, fire alarm systems), that will change the existing plan and use areas of the facility.

  (41)Renovation--The restoration to a former better state by cleaning, repairing, or rebuilding, e.g., routine maintenance, repairs, equipment replacement, painting.

  (42)Restraint--A manual method, or a physical or mechanical device, material, or equipment attached or adjacent to the resident's body that the resident cannot remove easily, that restricts freedom of movement or normal access to the resident's body. This term includes a personal hold.

  (43)Seclusion--The involuntary separation of a resident away from other residents and the placement of the resident alone in an area from which the resident is prevented from leaving.

  (44)Small facilities--Facilities with 16 or fewer resident beds.

  (45)Specialized staff--Personnel with expertise in developmental disabilities.

  (46)Standards--The minimum conditions, requirements, and criteria with which a facility will have to comply to be licensed under this chapter.

  (47)Universal precautions--The use of barrier precautions by facility personnel to prevent direct contact with blood or other body fluids that are visibly contaminated with blood.

  (48)Well-recognized church or religious denomination--An organization which has been granted a tax-exempt status as a religious association from the state or federal government.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 12, 2006

TRD-200602668

Marianne Reat

General Counsel

Department of Aging and Disability Services

Effective date: June 1, 2006

Proposal publication date: February 24, 2006

For further information, please call: (512) 438-3734



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