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 05/28/2010
ACTION Proposed
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) - (2)(No change.)

  [(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.]

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

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

  (5) [(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.

  (6) [(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.

  (7) [(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.

  (8) [(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).

  (9) [(10)] Change of ownership--A change of 50 percent [%] 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.

  (10) [(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, or [ and/or] the Federal Controlled Substance Act of 1970, Public Law 91-513, as amended.

  (11)Controlling person of an applicant, license holder, or facility--A person who, acting alone or with others, has the ability to directly or indirectly influence or direct the management, expenditure of money, or policies of an applicant or license holder or of a facility owned by an applicant or license holder.

    (A)The term includes:

      (i)a person who owns at least 5 percent interest in the applicant or license holder;

      (ii)a spouse of the applicant or license holder;

      (iii)an officer or director, if the applicant or license holder is a corporation;

      (iv)a partner, if the applicant or license holder is a partnership;

      (v)a trustee or trust manager, if the applicant or license holder is a trust;

      (vi)a person that operates or contracts with others to operate the facility;

      (vii)a person who, because of a personal, familial, or other relationship is in a position of actual control or authority over the facility, without regard to whether the person is formally named as an owner, manager, director, officer, provider, consultant, contractor, or employee of the facility; and

      (viii)a person who would be a controlling person of an entity described in clauses (i) - (vii) of this subparagraph, if that entity were the applicant or license holder.

    (B)The term does not include an employee, lender, secured creditor, or other person who does not exercise formal or actual influence or control over the operation of a facility.

  (12) - (22)(No change.)

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

  (24) - (28)(No change.)

  (29)License holder--A person who holds a license to operate a facility.

  (30)[(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).

  (31) [(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.

  (32)[(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.

  (33) [(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.

  (34) [(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)(No change.)

  [(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.]

  (36) [(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.

  (37) [(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.

  (38) [(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.

  (39) [(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.

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

  (41) [(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.

  (42) [(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.

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

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

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

  (46) [(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.

  (47) [(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 proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 12, 2010

TRD-201002549

Kenneth L. Owens

General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: June 27, 2010

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



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