(A) classifies at least two-thirds of the hospital's
Medicare patients or, if data is available, all patients:
(i) in not more than two major diagnosis-related groups;
or
(ii) in surgical diagnosis-related groups.
(B) specializes in one or more of the following areas:
(i) cardiac;
(ii) orthopedics;
(iii) surgery; or
(iv) women's health; and
(C) is not:
(i) a public hospital;
(ii) a hospital for which the majority of inpatient
claims are for major diagnosis-related groups relating to rehabilitation,
psychiatry, alcohol and drug treatment, or children or newborns; or
(iii) a hospital with fewer than 10 claims per bed
per year.
(36) Nurse--A registered, vocational, or advanced practice
registered nurse licensed by the Texas Board of Nursing or entitled
to practice in this state under Occupations Code, Chapters 301, 304,
or 305.
(37) Outpatient--An individual who presents for diagnostic
or treatment services for an intended length of stay of less than
24 hours; provided, however, that an individual who requires continued
observation may be considered as an outpatient for a period of time
not to exceed a total of 48 hours.
(38) Outpatient services--Services provided to patients
whose medical needs can be met in less than 24 hours and are provided
within the hospital; provided, however, that services that require
continued observation may be considered as outpatient services for
a period of time not to exceed a total of 48 hours.
(39) Owner--One of the following persons or governmental
unit which will hold or does hold a license issued under the statute
in the person's name or the person's assumed name:
(A) a corporation;
(B) a governmental unit;
(C) a limited liability company;
(D) an individual;
(E) a partnership if a partnership name is stated in
a written partnership agreement or an assumed name certificate;
(F) all partners in a partnership if a partnership
name is not stated in a written partnership agreement or an assumed
name certificate; or
(G) all co-owners under any other business arrangement.
(40) Patient--An individual who presents for diagnosis
or treatment.
(41) Pediatric and adolescent hospital--A general hospital
that specializes in providing services to children and adolescents,
including surgery and related ancillary services.
(42) Person--An individual, firm, partnership, corporation,
association, or joint stock company, and includes a receiver, trustee,
assignee, or other similar representative of those entities.
(43) Physician--A physician licensed by the Texas Medical
Board.
(44) Physician assistant--A person licensed as a physician
assistant by the Texas Physician Assistant Board.
(45) Podiatrist--A podiatrist licensed by the Texas
State Board of Podiatric Medical Examiners.
(46) Practitioner--A health care professional licensed
in the State of Texas, other than a physician, podiatrist, or dentist.
A practitioner shall practice in a manner consistent with their underlying
practice act.
(47) Premises--A premises may be any of the following:
(A) a single building where inpatients receive hospital
services; or
(B) multiple buildings where inpatients receive hospital
services provided that the following criteria are met:
(i) all buildings in which inpatients receive hospital
services are subject to the control and direction of the same governing
body;
(ii) all buildings in which inpatients receive hospital
services are within a 30-mile radius of the primary hospital location;
(iii) there is integration of the organized medical
staff of each of the hospital locations to be included under the single
license;
(iv) there is a single chief executive officer for
all of the hospital locations included under the license who reports
directly to the governing body and through whom all administrative
authority flows and who exercises control and surveillance over all
administrative activities of the hospital;
(v) there is a single chief medical officer for all
of the hospital locations under the license who reports directly to
the governing body and who is responsible for all medical staff activities
of the hospital;
(vi) each hospital location to be included under the
license that is geographically separate from the other hospital locations
contains at least one nursing unit for inpatients which is staffed
and maintains an active inpatient census, unless providing only diagnostic
or laboratory services, or a combination of diagnostic or laboratory
services, in the building for hospital inpatients; and
(vii) each hospital that is to be included in the license
complies with the emergency services standards:
(I) for a general hospital, if the hospital provides
surgery or obstetrical care or both; or
(II) for a special hospital, if the hospital does not
provide surgery or obstetrical care.
(48) Presurvey conference--A conference held with department
staff and the applicant or the applicant's representative to review
licensure rules and survey documents and provide consultation prior
to the on-site licensure inspection.
(49) Psychiatric disorder--A clinically significant
behavioral or psychological syndrome or pattern that occurs in an
individual and that is typically associated with either a painful
syndrome (distress) or impairment in one or more important areas of
behavioral, psychological, or biological function and is more than
a disturbance in the relationship between the individual and society.
(50) Quality improvement--A method of evaluating and
improving processes of patient care which emphasizes a multidisciplinary
approach to problem solving, and focuses not on individuals, but systems
of patient care which might be the cause of variations.
(51) Registered nurse (RN)--A person who is currently
licensed by the Texas Board of Nursing for the State of Texas as a
registered nurse or who holds a valid registered nursing license with
multi-state licensure privilege from another compact state.
(52) SAFE-ready facility--A facility designated by
the Health and Human Services Commission as a sexual assault forensic
exam-ready facility.
(53) Sexual assault forensic examiner--A certified
sexual assault nurse examiner or a physician with specialized training
on conducting a forensic medical examination.
(54) Sexual assault survivor--An individual who is
a victim of a sexual assault, regardless of whether a report is made
or a conviction is obtained in the incident.
(55) Special hospital--An establishment that:
(A) offers services, facilities, and beds for use for
more than 24 hours for two or more unrelated individuals who are regularly
admitted, treated, and discharged and who require services more intensive
than room, board, personal services, and general nursing care;
(B) has clinical laboratory facilities, diagnostic
X-ray facilities, treatment facilities, or other definitive medical
treatment;
(C) has a medical staff in regular attendance; and
(D) maintains records of the clinical work performed
for each patient.
(56) Stabilize--With respect to an emergency medical
condition, to provide such medical treatment of the condition necessary
to assure, within reasonable medical probability, that no material
deterioration of the condition is likely to result from or occur during
the transfer of the individual from a facility, or that the woman
has delivered the child and the placenta.
(57) Surgical technologist--A person who practices
surgical technology as defined in Health and Safety Code, Chapter
259.
(58) Transfer--The movement (including the discharge)
of an individual outside a hospital's facilities at the direction
of any person employed by (or affiliated or associated, directly or
indirectly, with) the hospital, but does not include such a movement
of an individual who has been declared dead, or leaves the facility
without the permission of any such person.
(59) Universal precautions--Procedures for disinfection
and sterilization of reusable medical devices and the appropriate
use of infection control, including hand washing, the use of protective
barriers, and the use and disposal of needles and other sharp instruments
as those procedures are defined by the Centers for Disease Control
and Prevention (CDC) of the Department of Health and Human Services.
This term includes standard precautions as defined by CDC which are
designed to reduce the risk of transmission of blood borne and other
pathogens in hospitals.
(60) Violation--Failure to comply with the licensing
statute, a rule or standard, special license provision, or an order
issued by the executive commissioner of health and human services
(executive commissioner) or the executive commissioner's designee,
adopted or enforced under the licensing statute. Each day a violation
continues or occurs is a separate violation for purposes of imposing
a penalty.
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Source Note: The provisions of this §133.2 adopted to be effective June 21, 2007, 32 TexReg 3587; amended to be effective December 9, 2010, 35 TexReg 10716; amended to be effective November 11, 2012, 37 TexReg 8809; amended to be effective September 14, 2014, 39 TexReg 7140; amended to be effective September 20, 2018, 43 TexReg 5952; amended to be effective February 2, 2020, 45 TexReg 555 |