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)Actual harm--A negative outcome
that compromises a resident's physical, mental, or emotional well-being.
(2)[(1)] Addition--The addition
of floor space to a facility.
(3)[(2)] Administrator--The
administrator of a facility.
(4)[(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.
(5)[(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.
(6)[(5)] Applicant--A person
applying for a license under Texas Health and Safety Code, Chapter
252.
(7)[(6)] APA--The Administrative
Procedure Act, Texas Government Code, Chapter 2001.
(8)[(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.
(9)[(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.
(10)[(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.
(11)[(10)] 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.
(12)[(11)] CMS--Centers for
Medicare & Medicaid Services. 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).
(13)[(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.
(14)[(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 spouse of the applicant or license holder;
(ii)an officer or director, if the applicant or license
holder is a corporation;
(iii)a partner, if the applicant or license holder
is a partnership;
(iv)a trustee or trust manager, if the applicant or
license holder is a trust;
(v)a person that operates or contracts with others
to operate the facility;
(vi)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
(vii)a person who would be a controlling person of
an entity described in clauses (i) - (vi) 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.
(15)[(14)] DADS--The term
referred to the Department of Aging and Disability Services; it now
refers to HHSC [The Department of Aging and Disability
Services or its successor agency].
(16)[(15)] Dangerous drug--Any
drug as defined in the Texas Dangerous Drug Act, Health and Safety
Code, Chapter 483.
(17)[(16)] Department--HHSC [
The Department of Aging and Disability Services.]
(18)[(17)] Designee--A state
agency or entity with which HHSC [DADS] contracts
to perform specific, identified duties related to the fulfillment
of a responsibility prescribed by this chapter.
(19)[(18)] Direct ownership
interest--Ownership of equity in the capital, stock, or profits of,
or a membership interest in, an applicant or license holder.
(20)[(19)] Disclosable interest--Five
percent or more direct or indirect ownership interest in an applicant
or license holder.
(21)[(20)] 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.
(22)[(21)] Establishment--A
place of business or a place where business is conducted which includes
staff, fixtures, and property.
(23)[(22)] 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).
(24)[(23)] Governmental unit--A
state or a political subdivision of the state, including a county
or municipality.
(25)[24)] 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.
(26)[(25)] 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.
[(26)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.]
(27)HHSC--The Texas Health and Human Services Commission.
(28)[(27)] 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.
(29)Immediate threat to the health
or safety of a resident--A situation that causes, or is likely to
cause, serious injury, harm, or impairment or death of a resident.
(30)[(28)] Incident--An unusual
or abnormal event or occurrence in, at, or affecting the facility
or the residents of the facility.
(31)[(29)] Indirect ownership
interest--Any ownership or membership interest in a person that has
a direct ownership interest in an applicant or license holder.
(32)[(30)] Inspection--Any on-site
visit to or survey of a facility by HHSC [DADS]
for the purpose of inspection of care, licensing, monitoring, complaint
investigation, architectural review, or similar purpose.
(33)[(31)] 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.
(34)Isolated--A very limited number
of residents are affected and a very limited number of staff are involved,
or the situation has occurred only occasionally or in a very limited
number of locations.
(35)[(32)] Large facility--Facilities
with 17 or more resident beds.
(36)[(33)] Legal guardian--A
person who is appointed guardian under §693 of the Probate Code.
(37)[(34)] 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.
(38)[(35)] License--Approval
from HHSC [DADS] to establish or operate a facility.
(39)[(36)] License holder--A
person that holds a license to operate a facility.
(40)[(37)] Licensed nurse--A
licensed vocational nurse, registered nurse, or advanced practice
nurse.
(41)[(38)] Life Safety Code--NFPA
101.
(42)[(39)] 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.
(43)[(40)] 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.
(44)[(41)] 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.
(45)[(42)] LVN--Licensed vocational
nurse. A person licensed to practice vocational nursing in accordance
with Texas Occupations Code, Chapter 301.
(46)[(43)] 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.
(47)[(44)] Metered dose inhaler--A
device that delivers a measured amount of medication as a mist that
can be inhaled.
(48)[(45)] NFPA--The National
Fire Protection Association. If the term is immediately followed by
a number, it is a reference to a publication of NFPA, as referenced
in NFPA 101.
(49)[(46)] NFPA 99--NFPA 99,
Health Care Facilities Code, 2012 Edition. A publication of the NFPA
that provides minimum requirements for the installation, testing,
maintenance, performance, and safe practices for health care facilities
and for material, equipment, and appliances, used for patient care
in health care facilities. CMS [The Centers for Medicare
and Medicaid Services] has incorporated NFPA 99, 2012 Edition,
except Chapters 7, 8, 12, and 13, by reference as a Condition of Participation
in the ICF/IID program for facilities that meet the definition of
a health care occupancy. Copies of NFPA 99 may be obtained from NFPA,
1 Batterymarch Park, Quincy, MA 02169.
(50)[(47)] NFPA 101--NFPA 101,
Life Safety Code, 2012 Edition. A publication of the NFPA that provides
minimum requirements, with due regard to function, for the design,
operation, and maintenance of buildings and structures for safety
to life from fire. CMS [The Centers for Medicare and
Medicaid Services] has incorporated NFPA 101, 2012 Edition,
by reference as a Condition of Participation in the ICF/IID program.
Copies of NFPA 101 may be obtained from NFPA, 1 Batterymarch Park,
Quincy, MA 02169.
(51)[(48)] Oral medication--Medication
administered by way or through the mouth and does not include sublingual
or buccal.
(52)Pattern of violation--Repeated,
but not widespread in scope, failures of a facility to comply with
Texas Health and Safety Code, Chapter 252, or a rule, standard or
order adopted under Chapter 252 that:
(A)result in a violation; and
(B)are found throughout the services provided by the
facility or that affect or involve the same residents or facility
employees.
(53)[(49)] Person--An individual,
firm, partnership, corporation, association, or joint stock company,
and any legal successor of those entities.
(54)[(50)] 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.
(55)Potential for minimal harm--A
violation that has the potential for causing no more than a minor
negative impact on a resident.
(56)[(51)] QIDP--Qualified intellectual
disability professional. A person who has at least one year of experience
working directly with persons with an intellectual disability or related
conditions and is one of the following:
(A)a doctor of medicine or osteopathy;
(B)a registered nurse; or
(C)an individual who holds at least a bachelor's degree
in one of the following areas:
(i)occupational therapy;
(ii)physical therapy;
(iii)social work;
(iv)speech-language pathology or audiology;
(v)recreation or a specialty area such as art, dance,
music or physical education;
(vi)dietetics; or
(vii)human services, such as sociology, special education,
rehabilitation counseling, or psychology (as specified in Title 42,
Code of Federal Regulations, §483.430(b)(5)(x)(W180)).
(57)[(52)] Quality-of-care monitor--A
registered nurse, pharmacist, or dietitian, employed by HHSC [
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 HHSC Long Term Care [
DADS] Regulatory Services Division.
[(53)Registered nurse--A person licensed
to practice professional nursing in accordance with Texas Occupations
Code, Chapter 301.]
Cont'd...
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