(61)[(60)] Individual and family
choice and control--Individuals and families who express preferences
and make choices about how their support service needs are met.
(62)[(61)] Individualized service
plan--A written plan prepared by the appropriate health care personnel
for a client of a home and community support services agency licensed
to provide personal assistance services.
(63)[(62)] Inpatient unit--A
facility, also referred to as a hospice freestanding inpatient facility,
that provides a continuum of medical or nursing care and other hospice
services to clients admitted into the unit and that is in compliance
with:
(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.
(64)[(63)] JCAHO--The Joint
Commission, previously known as the 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.
(65)[(64)] Joint training--Training
provided by HHSC [DADS] at least semi-annually
for home and community support services agencies and HHSC [
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 HHSC [DADS]
annual reports.
(66)[(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.
(67)[(66)] License holder--A
person that holds a license to operate an agency.
(68)[(67)] Licensed vocational
nurse--A person who is currently licensed under Texas Occupations
Code, Chapter 301, as a licensed vocational nurse.
(69)[(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).
(70) [(69)] Local emergency
management agencies--The local emergency management coordinator, fire,
police, and emergency medical services.
(71) [(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.
(72)[(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.
(73)[(72)] Medication administration
record--A record used to document the administration of a client's
medications.
(74)[(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.
(75)[(74)] Mitigation--An action
taken to eliminate or reduce the probability of a disaster, or reduce
a disaster's severity or consequences.
(76)[(75)] Multiple location--A
Medicare-approved alternate delivery site that meets the definition
in 42 CFR §418.3.
(77)[(76)] Notarized copy--A
sworn affidavit stating that attached copies are true and correct
copies of the original documents.
(78)[(77)] Nursing facility--An
institution licensed as a nursing home under the Texas Health and
Safety Code, Chapter 242.
(79)[(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.
(80)[(79)] Occupational therapist--A
person who is currently licensed under the Occupational Therapy Practice
Act, Texas Occupations Code, Chapter 454, as an occupational therapist.
(81)[(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).
(82)[(81)] Original active client
record--A record composed first-hand for a client currently receiving
services.
(83)[(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.
(84)[(83)] Parent agency--An agency's
principal place of business; the location where an agency [that
] develops and maintains administrative controls and provides
supervision of branch offices and alternate delivery sites.
(85)[(84)] Parent company--A
person, other than an individual, who has a direct 100 percent ownership
interest in the owner of an agency.
(86)[(85)] Person--An individual,
corporation, or association.
(87)[(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.
(88)[(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.
(89)[(88)] Pharmacist--A person
who is licensed to practice pharmacy under the Texas Pharmacy Act,
Texas Occupations Code, Chapter 558.
(90)[(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.
(91)[(90)] Physical therapist--A
person who is currently licensed under Texas Occupations Code, Chapter
453, as a physical therapist.
(92)[(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).
(93)[(92)] Physician assistant--A
person who is licensed under the Physician Assistant Licensing Act,
Texas Occupations Code, Chapter 204, as a physician assistant.
(94)[(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.
(95)[(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.
(96)[(95)] Plan of care--The
written orders of a practitioner for a client who requires skilled
services.
(97)[(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.
(98)[(97)] Preparedness--Actions
taken in anticipation of a disaster.
(99)[(98)] Presurvey conference--A
conference held with HHSC [DADS] staff and the
applicant or the applicant's representatives to review licensure standards
and survey documents, and to provide information regarding [
consultation before] the survey process.
(100)[(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.
(101)[(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.
(102)[(101)] Recovery--Activities
implemented during and after a disaster response designed to return
an agency to its normal operations as quickly as possible.
(103)[(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).
(104)[(103)] Residence--A place
where a person resides, including a home, a nursing facility, a convalescent
home, or a residential unit.
(105)[(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.
(106)[(105)] Respiratory therapist--A
person who is currently licensed under Texas Occupations Code, Chapter
604, as a respiratory care practitioner.
(107)[(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.
(108)[(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.
(109)[(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.
(110)[(109)] RN--Registered
nurse. A person who is currently licensed under the Nursing Practice
Act, Texas Occupations Code, Chapter 301, as a registered nurse.
(111)[(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.
(112)[(111)] Section--A reference
to a specific rule in this chapter.
(113)[(112)] Service area--A
geographic area established by an agency in which all or some of the
agency's services are available.
(114)[(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.
(115)[(114)] Social worker--A
person who is currently licensed as a social worker under Texas Occupations
Code, Chapter 505.
(116)[(115)] Speech-language
pathologist--A person who is currently licensed as a speech-language
pathologist under Texas Occupations Code, Chapter 401.
(117)[(116)] Statute--The Texas
Health and Safety Code, Chapter 142.
(118)[(117)] Substantial compliance--A
finding in which an agency receives no recommendation for enforcement
action after a survey.
(119)[(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.
Cont'd...
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