(A)the conditions of participation for inpatient units
adopted under Social Security Act, Title XVIII (42 United States Code
§1395 et seq.); and
(B)standards adopted under this chapter.
(63)JCAHO--Joint Commission on Accreditation of Healthcare
Organizations. An independent, nonprofit organization for standard-setting
and accrediting in-home care and other areas of health care.
(64)Joint training--Training provided by DADS at least
semi-annually for home and community support services agencies and
DADS surveyors on subjects that address the 10 most commonly cited
violations of federal or state law by home and community support services
agencies as published in DADS annual reports.
(65)LAR--Legally authorized representative. A person
authorized by law to act on behalf of a client with regard to a matter
described in this chapter, and may include a parent of a minor, guardian
of an adult or minor, managing conservator of a minor, agent under
a medical power of attorney, or surrogate decision-maker under Texas
Health and Safety Code, §313.004.
(66)License holder--A person that holds a license
to operate an agency.
(67)Licensed vocational nurse--A person who is currently
licensed under Texas Occupations Code, Chapter 301, as a licensed
vocational nurse.
(68)Life Safety Code (also referred to as NFPA 101)--The
Code for Safety to Life from Fire in Buildings and Structures, Standard
101, of the National Fire Protection Association (NFPA).
(69)Local emergency management agencies--The local
emergency management coordinator, fire, police, and emergency medical
services.
(70)Local emergency management coordinator-- The person
identified as the emergency management coordinator by the mayor or
county judge in an agency's service area.
(71)Manager--An employee or independent contractor
responsible for providing management services to a home and community
support services agency for the overall operation of a home and community
support services agency including administration, staffing, or delivery
of services. Examples of contracts for services that will not be considered
contracts for management services include contracts solely for maintenance,
laundry, or food services.
(72)Medication administration record--A record used
to document the administration of a client's medications.
(73)Medication list--A list that includes all prescription
and over-the-counter medication that a client is currently taking,
including the dosage, the frequency, and the method of administration.
(74)Mitigation--An action taken to eliminate or reduce
the probability of a disaster, or reduce a disaster's severity or
consequences.
(75)Multiple location--A Medicare-approved alternate
delivery site that meets the definition in 42 CFR §418.3.
(76)Notarized copy--A sworn affidavit stating that
attached copies are true and correct copies of the original documents.
(77)Nursing facility--An institution licensed as a
nursing home under the Texas Health and Safety Code, Chapter 242.
(78)Nutritional counseling--Advising and assisting
individuals or families on appropriate nutritional intake by integrating
information from the nutrition assessment with information on food
and other sources of nutrients and meal preparation consistent with
cultural background and socioeconomic status, with the goal being
health promotion, disease prevention, and nutrition education. Nutritional
counseling may include the following:
(A)dialogue with the client to discuss current eating
habits, exercise habits, food budget, and problems with food preparation;
(B)discussion of dietary needs to help the client
understand why certain foods should be included or excluded from the
client's diet and to help with adjustment to the new or revised or
existing diet plan;
(C)a personalized written diet plan as ordered by
the client's physician or practitioner, to include instructions for
implementation;
(D)providing the client with motivation to help the
client understand and appreciate the importance of the diet plan in
getting and staying healthy; or
(E)working with the client or the client's family
members by recommending ideas for meal planning, food budget planning,
and appropriate food gifts.
(79)Occupational therapist--A person who is currently
licensed under the Occupational Therapy Practice Act, Texas Occupations
Code, Chapter 454, as an occupational therapist.
(80)Operating hours--The days of the week and the
hours of day an agency's place of business is open as identified in
an agency's written policy as required by §97.210 of this chapter
(relating to Agency Operating Hours).
(81)Original active client record--A record composed
first-hand for a client currently receiving services.
(82)Palliative care--Intervention services that focus
primarily on the reduction or abatement of physical, psychosocial,
and spiritual symptoms of a terminal illness. It is client and family-centered
care that optimizes quality of life by anticipating, preventing, and
treating suffering. Palliative care throughout the continuum of illness
involves addressing physical, intellectual, emotional, social, and
spiritual needs and facilitating client autonomy, access to information,
and choice.
(83)Parent agency--An agency that develops and maintains
administrative controls and provides supervision of branch offices
and alternate delivery sites.
(84)Parent company--A person, other than an individual,
who has a direct 100 percent ownership interest in the owner of an
agency.
(85)Person--An individual, corporation, or association.
(86)Personal assistance services--Routine ongoing
care or services required by an individual in a residence or independent
living environment that enable the individual to engage in the activities
of daily living or to perform the physical functions required for
independent living, including respite services. The term includes:
(A)personal care;
(B)health-related services performed under circumstances
that are defined as not constituting the practice of professional
nursing by the Texas Board of Nursing through a memorandum of understanding
with DADS in accordance with Texas Health and Safety Code, §142.016;
and
(C)health-related tasks provided by unlicensed personnel
under the delegation of a registered nurse or that a registered nurse
determines do not require delegation.
(87)Personal care--The provision of one or more of
the following services required by an individual in a residence or
independent living environment:
(A)bathing;
(B)dressing;
(C)grooming;
(D)feeding;
(E)exercising;
(F)toileting;
(G)positioning;
(H)assisting with self-administered medications;
(I)routine hair and skin care; and
(J)transfer or ambulation.
(88)Pharmacist--A person who is licensed to practice
pharmacy under the Texas Pharmacy Act, Texas Occupations Code, Chapter
558.
(89)Pharmacy--A facility defined in the Texas Occupations
Code, §551.003(31), at which a prescription drug or medication
order is received, processed, or dispensed.
(90)Physical therapist--A person who is currently
licensed under Texas Occupations Code, Chapter 453, as a physical
therapist.
(91)Physician--This term includes a person who is:
(A)licensed in Texas to practice medicine or osteopathy
in accordance with Texas Occupations Code, Chapter 155;
(B)licensed in Arkansas, Louisiana, New Mexico, or
Oklahoma to practice medicine, who is the treating physician of a
client and orders home health or hospice services for the client,
in accordance with the Texas Occupations Code, §151.056(b)(4);
or
(C)a commissioned or contract physician or surgeon
who serves in the United States uniformed services or Public Health
Service if the person is not engaged in private practice, in accordance
with the Texas Occupations Code, §151.052(a)(8).
(92)Physician assistant--A person who is licensed
under the Physician Assistant Licensing Act, Texas Occupations Code,
Chapter 204, as a physician assistant.
(93)Physician-delegated task--A task performed in
accordance with the Texas Occupations Code, Chapter 157, including
orders signed by a physician that specify the delegated task, the
individual to whom the task is delegated, and the client's name.
(94)Place of business--An office of a home and community
support services agency that maintains client records or directs home
health, hospice, or personal assistance services. This term includes
a parent agency, a branch office, and an alternate delivery site.
The term does not include an administrative support site.
(95)Plan of care--The written orders of a practitioner
for a client who requires skilled services.
(96)Practitioner--A person who is currently licensed
in a state in which the person practices as a physician, dentist,
podiatrist, or a physician assistant, or a person who is a registered
nurse registered with the Texas Board of Nursing as an advanced practice
nurse.
(97)Preparedness--Actions taken in anticipation of
a disaster.
(98)Presurvey conference--A conference held with DADS
staff and the applicant or the applicant's representatives to review
licensure standards and survey documents, and to provide consultation
before the survey.
(99)Progress note--A dated and signed written notation
by agency personnel summarizing facts about care and the client's
response during a given period of time.
(100)Psychoactive treatment--The provision of a skilled
nursing visit to a client with a psychiatric diagnosis under the direction
of a physician that includes one or more of the following:
(A)assessment of alterations in mental status or evidence
of suicide ideation or tendencies;
(B)teaching coping mechanisms or skills;
(C)counseling activities; or
(D)evaluation of the plan of care.
(101)Recovery--Activities implemented during and after
a disaster response designed to return an agency to its normal operations
as quickly as possible.
(102)Registered nurse delegation--Delegation by a
registered nurse in accordance with:
(A)22 TAC Chapter 224 (concerning Delegation of Nursing
Tasks by Registered Professional Nurses to Unlicensed Personnel for
Clients with Acute Conditions or in Acute Care Environments); and
(B)22 TAC Chapter 225 (relating to RN Delegation to
Unlicensed Personnel and Tasks Not Requiring Delegation in Independent
Living Environments for Clients with Stable and Predictable Conditions).
(103)Residence--A place where a person resides, including
a home, a nursing facility, a convalescent home, or a residential
unit.
(104)Residential unit--A facility that provides living
quarters and hospice services to clients admitted into the unit and
that is in compliance with standards adopted under the Texas Health
and Safety Code, Chapter 142.
(105)Respiratory therapist--A person who is currently
licensed under Texas Occupations Code, Chapter 604, as a respiratory
care practitioner.
(106)Respite services--Support options that are provided
temporarily for the purpose of relief for a primary caregiver in providing
care to individuals of all ages with disabilities or at risk of abuse
or neglect.
(107)Response--Actions taken immediately before an
impending disaster or during and after a disaster to address the immediate
and short-term effects of the disaster.
(108)Restraint--A restraint is:
(A)a manual method, physical or mechanical device,
material, or equipment that immobilizes or reduces the ability of
a client in a hospice inpatient unit to move his or her arms, legs,
body, or head freely, but does not include a device, such as an orthopedically
prescribed device, a surgical dressing or bandage, a protective helmet,
or other method that involves the physical holding of the client for
the purpose of:
(i)conducting a routine physical examination or test;
(ii)protecting the client from falling out of bed;
or
(iii)permitting the client to participate in activities
without the risk of physical harm, not including a physical escort;
or
(B)a drug or medication when used as a restriction
to manage a client's behavior or restrict the client's freedom of
movement in a hospice inpatient unit, but not as a standard treatment
or medication dosage for the client's condition.
(109)RN--Registered nurse. A person who is currently
licensed under the Nursing Practice Act, Texas Occupations Code, Chapter
301, as a registered nurse.
(110)Seclusion--The involuntary confinement of a client
alone in a room or an area in a hospice inpatient unit from which
the client is physically prevented from leaving.
(111)Section--A reference to a specific rule in this
chapter.
(112)Service area--A geographic area established by
an agency in which all or some of the agency's services are available.
(113)Skilled services--Services in accordance with
a plan of care that require the skills of:
(A)a registered nurse;
(B)a licensed vocational nurse;
(C)a physical therapist;
(D)an occupational therapist;
(E)a respiratory therapist;
(F)a speech-language pathologist;
(G)an audiologist;
(H)a social worker; or
(I)a dietitian.
(114)Social worker--A person who is currently licensed
as a social worker under Texas Occupations Code, Chapter 505.
(115)Speech-language pathologist--A person who is
currently licensed as a speech-language pathologist under Texas Occupations
Code, Chapter 401.
(116)Statute--The Texas Health and Safety Code, Chapter
142.
(117)Substantial compliance--A finding in which an
agency receives no recommendation for enforcement action after a survey.
(118)Supervised practical training--Hospice aide training
that is conducted in a laboratory or other setting in which the trainee
demonstrates knowledge while performing tasks on an individual. The
training is supervised by a registered nurse or by a licensed vocational
nurse who works under the direction of a registered nurse.
(119)Supervising nurse--The person responsible for
supervising skilled services provided by an agency and who has the
qualifications described in §97.244(c) of this chapter (relating
to Administrator Qualifications and Conditions and Supervising Nurse
Qualifications). This person may also be known as the director of
nursing or similar title.
(120)Supervision--Authoritative procedural guidance
by a qualified person for the accomplishment of a function or activity
with initial direction and periodic inspection of the actual act of
accomplishing the function or activity.
(121)Support services--Social, spiritual, and emotional
care provided to a client and a client's family by a hospice.
(122)Survey--An on-site inspection or complaint investigation
conducted by a DADS representative to determine if an agency is in
compliance with the statute and this chapter or in compliance with
applicable federal requirements or both.
(123)Terminal illness--An illness for which there
is a limited prognosis if the illness runs its usual course.
(124)Unlicensed person--A person not licensed as a
health care provider. The term includes home health aides, hospice
aides, hospice homemakers, medication aides permitted by DADS, and
other unlicensed individuals providing personal care or assistance
in health services.
(125)Unsatisfied judgments--A failure to fully carry
out the terms or meet the obligation of a court's final disposition
on the matters before it in a suit regarding the operation of an agency.
(126)Violation--A finding of noncompliance with this
chapter or the statute resulting from a survey.
(127)Volunteer--An individual who provides assistance
to a home and community support services agency without compensation
other than reimbursement for actual expenses.
(128)Working day--Any day except Saturday, Sunday,
a state holiday, or a federal holiday.
The agency certifies that legal counsel has
reviewed the adoption and found it to be a valid exercise of the agency's
legal authority.
Filed with the Office
of the Secretary of State on September 21, 2017
TRD-201703723 Karen Ray
Chief Counsel
Department of Aging and Disability Services
Effective date: October 11, 2017
Proposal publication date: April 7, 2017
For further information, please call: (512) 438-5502
|