The following words and terms, when used in this chapter, shall
have the following meanings.
(1) Act--The Texas Hospital Licensing Law, Texas Health
and Safety Code (HSC), Chapter 241.
(2) Actual harm--A negative outcome that compromises
a patient's physical, mental, or emotional well-being.
(3) Advance directive--A directive, as that term is
defined by HSC §166.031 (relating to Definitions), an out-of-hospital
do not resuscitate (DNR) order as that term is defined by HSC §166.081
(relating to Definitions), or a medical power of attorney under HSC
Chapter 166, Subchapter D (relating to Medical Power of Attorney).
(4) Advanced practice registered nurse (APRN)--A registered
nurse authorized by the Texas Board of Nursing to practice as an advanced
practice registered nurse in Texas. The term includes a nurse practitioner,
nurse midwife, nurse anesthetist, and clinical nurse specialist. The
term is synonymous with "advanced nurse practitioner."
(5) Adverse event--An event that results in unintended
harm to the patient by an act of commission or omission rather than
by the underlying disease or condition of the patient.
(6) Applicant--A person who seeks a limited services
rural hospital (LSRH) license from the Texas Health and Human Services
Commission (HHSC) and is legally responsible for the operation of
the LSRH, whether by lease or ownership.
(7) Attending physician--A physician selected by or
assigned to a patient who has primary responsibility for a patient's
treatment and care.
(8) Available--When referring to on-site personnel,
on the premises and able to rapidly perform hands-on care in an emergency
situation.
(9) Biological indicators--Commercially available microorganisms
(e.g., United States Food and Drug Administration approved strips
or vials of Bacillus species endospores).
(10) Cardiopulmonary resuscitation--Any medical intervention
used to restore circulatory or respiratory function that has ceased.
(11) Chemical dependency services--A planned, structured,
and organized program designed to initiate and promote a person's
chemical-free status or to maintain the person free of illegal drugs.
It includes the application of planned procedures to identify and
change patterns of behavior related to or resulting from chemical
dependency that are maladaptive, destructive, or injurious to health,
or to restore appropriate levels of physical, psychological, or social
functioning lost due to chemical dependency.
(12) Competent--Possessing the ability, based on reasonable
medical judgment, to understand and appreciate the nature and consequences
of a treatment decision, including the significant benefits and harms
of and reasonable alternatives to a proposed treatment decision.
(13) Comprehensive medical rehabilitation--The provision
of rehabilitation services that are designed to improve or minimize
a person's physical or cognitive disabilities, maximize a person's
functional ability, or restore a person's lost functional capacity
through close coordination of services, communication, interaction,
and integration among several professions that share responsibility
to achieve team treatment goals for the person.
(14) Contaminated linen--Linen that has been soiled
with blood or other potentially infectious materials or may contain
sharps.
(15) Dentist--A person licensed to practice dentistry
by the Texas State Board of Dental Examiners. This includes a doctor
of dental surgery or a doctor of dental medicine.
(16) Dietitian--A person who is currently licensed
by the Texas Department of Licensing and Regulation as a licensed
dietitian or provisional licensed dietitian, or who is a registered
dietitian with the Academy of Nutrition and Dietetics.
(17) Do not resuscitate (DNR) order--An order issued
under HSC Chapter 166, Subchapter E (relating to Health Care Facility
Do-Not-Resuscitate Orders), instructing a health care professional
not to attempt cardiopulmonary resuscitation on a patient whose circulatory
or respiratory function ceases.
(18) Emergency medical condition--A medical condition
manifesting itself by acute symptoms of sufficient severity (including
severe pain, psychiatric disturbances or symptoms of substance abuse)
such that the absence of immediate medical attention could reasonably
be expected to result in one or all of the following:
(A) placing the health of the individual (or with respect
to a pregnant individual, the health of the pregnant individual or
her unborn child) in serious jeopardy;
(B) serious impairment to bodily functions;
(C) serious dysfunction of any bodily organ or part;
or
(D) with respect to a pregnant individual who is having
contractions:
(i) that there is inadequate time to safely transfer
to another hospital before delivery; or
(ii) that transfer may pose a threat to the health
or safety of the pregnant individual or the unborn child.
(19) General hospital--An establishment that:
(A) offers services, facilities, and beds for use for
more than 24 hours for two or more unrelated individuals requiring
diagnosis, treatment, or care for illness, injury, deformity, abnormality,
or pregnancy; and
(B) regularly maintains, at a minimum, clinical laboratory
services, diagnostic X-ray services, treatment facilities, including
surgery or obstetrical care or both, and other definitive medical
or surgical treatment of similar extent.
(20) Governing body--The governing authority of an
LSRH that is responsible for the LSRH's organization, management,
control, and operation, including appointment of medical staff. This
term includes the owner or partners for an LSRH owned or operated
by an individual or partners.
(21) Governmental unit--A political subdivision of
the state, including a hospital district, county, or municipality,
and any department, division, board, or other agency of a political
subdivision.
(22) Incompetent--Lacking the ability, based on reasonable
medical judgment, to understand and appreciate the nature and consequences
of a treatment decision, including the significant benefits and harms
of and reasonable alternatives to a proposed treatment decision.
(23) Inpatient--An individual admitted to a facility
for an intended length of stay of 24 hours or greater.
(24) Inpatient services--Services provided to an individual
admitted to an LSRH for an intended length of stay of 24 hours or
greater.
(25) Legally authorized representative (LAR)--A person
authorized by law to act on behalf of another person with regard to
a matter described in this chapter, including:
(A) a parent, guardian, or managing conservator of
a minor;
(B) the guardian of an adult;
(C) an agent to whom authority to make health care
decisions is delegated under a medical power of attorney or durable
power of attorney in accordance with state law; or
(D) the representative of a deceased person.
(26) Licensed vocational nurse (LVN)--A person who
is currently licensed by the Texas Board of Nursing as a licensed
vocational nurse or who holds a valid vocational nursing license with
multi-state licensure privilege from another compact state.
(27) Licensee--The person or governmental unit named
in the application for issuance of an LSRH license.
(28) Limited services rural hospital (LSRH)--A general
or special hospital that is or was licensed under HSC Chapter 241
and that:
(A) is:
(i) located in a rural area, as defined by:
(I) Texas Health and Human Services Commission rule;
or
(II) 42 U.S.C. Section 1395ww(d)(2)(D); or
(ii) designated by the Centers for Medicare & Medicaid
Services as a critical access hospital, rural referral center, or
sole community hospital; and
(B) otherwise meets the requirements to be designated
as to be designated as a rural emergency hospital under Code of Federal
Regulations Title 42 (42 CFR) Part 485, Subpart E.
(29) Limited services rural hospital (LSRH) administration--Administrative
body of an LSRH headed by an individual who has the authority to represent
the LSRH and who is responsible for the operation of the LSRH according
to the policies and procedures of the LSRH's governing body.
(30) Medical staff--A physician or group of physicians
and a podiatrist or group of podiatrists who by action of the governing
body of an LSRH are privileged to work in and use the facilities of
an LSRH for or in connection with the observation, care, diagnosis,
or treatment of an individual who is, or may be, suffering from a
mental or physical disease or disorder or a physical deformity or
injury.
Cont'd... |