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)Administration of medication--Removing a unit or
dose of medication from a previously dispensed, properly labeled container;
verifying the medication with the medication order; giving the proper
medication in the proper dosage to the proper resident at the proper
time by the proper administration route; and recording the time of
administration and dosage administered.
(4)Advanced practice nurse--A person licensed to practice
professional nursing in accordance with Texas Occupations Code, Chapter
301, and authorized by the Texas Board of Nursing to practice as an
advanced practice nurse.
(5)Applicant--A person applying for a license under
Texas Health and Safety Code, Chapter 252.
(6)APA--The Administrative Procedure Act, Texas Government
Code, Chapter 2001.
(7)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.
(8)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.
(9)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.
(10)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).
(11)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.
(12)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 the Federal Controlled
Substance Act of 1970, Public Law 91-513, as amended.
(13)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.
(14)DADS--The Department of Aging and Disability Services.
(15)Dangerous drug--Any drug as defined in the Texas
Dangerous Drug Act, Health and Safety Code, Chapter 483.
(16)Department--The Department of Aging and Disability
Services.
(17)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.
(18)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.
(19)Establishment--A place of business or a place
where business is conducted which includes staff, fixtures, and property.
(20)Facility--A facility serving persons with an intellectual
disability or related conditions licensed under this chapter as described
in §90.2 of this chapter (relating to Scope) and required to
be licensed under the Health and Safety Code, Chapter 252, or
the entity that operates such a facility; or, in Subchapters C, D,
and F of this chapter, a program provider that must comply with those
subchapters in accordance with §9.212 of this title (relating
to Non-licensed Providers Meeting Licensure Standards).
(21)Governmental unit--A state or a political subdivision
of the state, including a county or municipality.
(22)Health care professional--A person licensed, certified,
or otherwise authorized to administer health care, for profit or otherwise.
The term includes a physician, licensed nurse, physician assistant,
podiatrist, dentist, physical therapist, speech therapist, and occupational
therapist.
(23)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.
(24)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.
(25)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.
(26)Incident--An unusual or abnormal event or occurrence
in, at, or affecting the facility or the residents of the facility.
(27)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.
(28)IPP--Individual program plan.
A plan developed by the interdisciplinary team of a facility resident
that identifies the resident's training, treatment, and habilitation
needs, and describes programs and services to meet those needs.
(29)[(28)] Large facility--Facilities
with 17 or more resident beds.
(30)[(29)] Legal guardian--A
person who is appointed guardian under §693 of the Probate Code.
(31)[(30)] 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.
(32)[(31)] License--Approval
from DADS to establish or operate a facility.
(33)[(32)] License holder--A
person who holds a license to operate a facility.
(34)[(33)] Licensed nurse--A
licensed vocational nurse, registered nurse, or advanced practice
nurse.
(35)[(34)] 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).
(36)[(35)] 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.
(37)[(36)] 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.
(38)[(37)] Local health authority--The
physician having local jurisdiction to administer state and local
laws or ordinances relating to public health, as described in the
Texas Health and Safety Code, §§121.021 - 121.025.
(39)[(38)] LVN--Licensed vocational
nurse. A person licensed to practice vocational nursing in accordance
with Texas Occupations Code, Chapter 301.
(40)[(39)] 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.
(41)[(40)] Metered dose inhaler--A
device that delivers a measured amount of medication as a mist that
can be inhaled.
(42)[(41)] Oral medication--Medication
administered by way or through the mouth and does not include sublingual
or buccal.
(43)[(42)] Person--An individual,
firm, partnership, corporation, association, or joint stock company,
and any legal successor of those entities.
(44)[(43)] 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.
(45)[(44)] 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 an intellectual disability or related conditions.
(46)[(45)] 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.
(47)[(46)] Registered nurse--A
person licensed to practice professional nursing in accordance with
Texas Occupations Code, Chapter 301.
(48)[(47)] 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.
(49)[(48)] Renovation--The restoration
to a former better state by cleaning, repairing, or rebuilding, e.g.,
routine maintenance, repairs, equipment replacement, painting.
(50)[(49)] 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.
(51)[(50)] 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.
(52)[(51)] Small facilities--Facilities
with 16 or fewer resident beds.
(53)[(52)] Specialized staff--Personnel
with expertise in developmental disabilities.
(54)[(53)] Standards--The minimum
conditions, requirements, and criteria with which a facility will
have to comply to be licensed under this chapter.
(55)[(54)] Topical medication--Medication
applied to the skin but does not include medication administered in
the eyes.
(56)[(55)] 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.
(57)[(56)] Vaccine preventable
diseases--The diseases included in the most current recommendations
of the Advisory Committee on Immunization Practices of the Centers
for Disease Control and Prevention.
(58)[(57)] 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.
The agency certifies that legal counsel has
reviewed the proposal and found it to be within the state agency's
legal authority to adopt.
Filed with the Office
of the Secretary of State on December 18, 2015
TRD-201505836 Lawrence Hornsby
General Counsel
Department of
Aging and Disability Services
Earliest possible date of adoption: February 7, 2016
For further information, please call: (512) 438-2264
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