The following words and terms, when used in this chapter, have
the following meanings, unless the context clearly indicates otherwise.
(1) Abuse--Negligent or willful infliction of injury,
unreasonable confinement, intimidation, or punishment with resulting
physical or emotional harm or pain to a resident; or sexual abuse,
including involuntary or nonconsensual sexual conduct that would constitute
an offense under Texas Penal Code §21.08 (indecent exposure)
or Texas Penal Code Chapter 22 (assaultive offenses), sexual harassment,
sexual coercion, or sexual assault.
(2) Act--Chapter 242 of the Texas Health and Safety
Code.
(3) Activities assessment--See Comprehensive Assessment
and Comprehensive Care Plan.
(4) Activity director--The qualified individual appointed
by the facility to direct the activities program as described in §554.702
of this chapter (relating to Activities).
(5) Addition--The addition of floor space to an institution.
(6) Administrator--A person currently licensed in accordance
with 26 TAC Chapter 555 (relating to Nursing Facility Administrators).
(7) Admission MDS assessment--An MDS assessment that
determines a recipient's initial determination of eligibility for
medical necessity for admission into the Texas Medicaid Nursing Facility
Program.
(8) Advanced practice registered nurse--A person licensed
as a registered nurse and approved to practice as an advanced practice
registered nurse by the Texas Board of Nursing.
(9) Adverse event--An untoward, undesirable, and usually
unanticipated event that causes death or serious injury, or the risk
of death or serious injury.
(10) Alzheimer's Disclosure Statement for Nursing Facilities--The
HHSC-prescribed form a facility uses to describe the nature of care
or treatment of residents with Alzheimer's disease and related disorders.
(11) Alzheimer's disease and related disorders--Alzheimer's
disease and any other irreversible dementia described by the Centers
for Disease Control and Prevention or the most current edition of
the Diagnostic and Statistical Manual of Mental Disorders.
(12) Applicant--A person or governmental unit, as those
terms are defined in the Texas Health and Safety Code, Chapter 242,
applying for a license under that chapter.
(13) Attending physician--A physician, currently licensed
by the Texas Medical Board, who is designated by the resident or resident
representative as having primary responsibility for the treatment
and care of the resident.
(14) Authorized electronic monitoring--The placement
of an electronic monitoring device in a resident's room and using
the device to make tapes or recordings after making a request to the
facility to allow electronic monitoring.
(15) Barrier precautions--Precautions including the
use of gloves, masks, gowns, resuscitation equipment, eye protectors,
aprons, face shields, and protective clothing for purposes of infection
control.
(16) Care and treatment--Services required to maximize
resident independence, personal choice, participation, health, self-care,
psychosocial functioning, and reasonable safety, all consistent with
the preferences of the resident.
(17) Certification--The determination by HHSC that
a nursing facility meets all the requirements of the Medicaid or Medicare
programs.
(18) Certified facility--A facility that meets the
requirements of the Medicare program, the Medicaid program, or both.
(19) Certified Ombudsman--Has the meaning given in §88.2
of this title (relating to Definitions).
(20) CFR--Code of Federal Regulations.
(21) 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.
(22) Chemical restraints--Any drug administered for
the purpose of discipline or convenience, and not required to treat
the resident's medical symptoms.
(23) CMS--Centers for Medicare & Medicaid Services.
(24) Complaint--Any allegation received by HHSC other
than an incident reported by the facility. Such allegations include,
but are not limited to, abuse, neglect, exploitation, or violation
of state or federal standards.
(25) Completion date--The date an RN assessment coordinator
signs an MDS assessment as complete.
(26) Comprehensive assessment--An interdisciplinary
description of a resident's needs and capabilities including daily
life functions and significant impairments of functional capacity,
as described in §554.801(2) of this chapter (relating to Resident
Assessment).
(27) Comprehensive care plan--A plan of care prepared
by an interdisciplinary team that includes measurable short-term and
long-term objectives and timetables to meet the resident's needs developed
for each resident after admission. The plan addresses at least the
following needs: medical, nursing, rehabilitative, psychosocial, dietary,
activity, and resident's rights. The plan includes strategies developed
by the team, as described in §554.802(c)(2) of this chapter (relating
to Comprehensive Person-Centered Care Planning), consistent with the
physician's prescribed plan of care, to assist the resident in eliminating,
managing, or alleviating health or psychosocial problems identified
through assessment. Planning includes:
(A) goal setting;
(B) establishing priorities for management of care;
(C) making decisions about specific measures to be
used to resolve the resident's problems; and
(D) assisting in the development of appropriate coping
mechanisms.
(28) Controlling person--A person with the ability,
acting alone or in concert with others, to directly or indirectly,
influence, direct, or cause the direction of the management, expenditure
of money, or policies of a nursing facility or other person. A controlling
person does not include a person, such as an employee, lender, secured
creditor, or landlord, who does not exercise any influence or control,
whether formal or actual, over the operation of a facility. A controlling
person includes:
(A) a management company, landlord, or other business
entity that operates or contracts with others for the operation of
a nursing facility;
(B) any person who is a controlling person of a management
company or other business entity that operates a nursing facility
or that contracts with another person for the operation of a nursing
facility;
(C) an officer or director of a publicly traded corporation
that is, or that controls, a facility, management company, or other
business entity described in subparagraph (A) of this paragraph but
does not include a shareholder or lender of the publicly traded corporation;
and
(D) any other individual who, because of a personal,
familial, or other relationship with the owner, manager, landlord,
tenant, or provider of a nursing facility, is in a position of actual
control or authority with respect to the nursing facility, without
regard to whether the individual is formally named as an owner, manager,
director, officer, provider, consultant, contractor, or employee of
the facility.
(29) Covert electronic monitoring--The placement and
use of an electronic monitoring device that is not open and obvious,
and the facility and HHSC have not been informed about the device
by the resident, by a person who placed the device in the room, or
by a person who uses the device.
(30) DADS--The term referred to the Department of Aging
and Disability Services; it now refers to HHSC.
(31) Dentist--A practitioner licensed to practice dentistry
by the Texas State Board of Dental Examiners.
(32) DHS--This term referred to the Texas Department
of Human Services; it now refers to HHSC.
(33) Dietitian--A qualified dietitian is one who is
qualified based upon either:
(A) registration by the Commission on Dietetic Registration
of the Academy of Nutrition and Dietetics; or
(B) licensure, or provisional licensure, as a dietitian
under Texas Occupations Code, Chapter 701 and one year of supervisory
experience in dietetic service of a health care facility.
(34) Direct ownership interest--Ownership of equity
in the capital, stock, or profits of, or a membership interest in,
an applicant or license holder.
(35) Disclosable interest--Five percent or more direct
or indirect ownership interest in an applicant or license holder.
(36) Distinct part--That portion of a facility certified
to participate in the Medicaid Nursing Facility program or as a SNF
in the Medicare program.
(37) Drug (also referred to as medication)--Any of
the following:
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