The following words and terms, when used in this chapter, have
the following meanings, unless the context clearly indicates otherwise.
(1) Accessible and flexible services--Services that
are delivered in the least intrusive manner possible and are provided
in all settings where individuals live, work, and recreate.
(2) Administration of medication--The direct application
of any medication by injection, inhalation, ingestion, or any other
means to the body of a client. The preparation of medication is part
of the administration of medication and is the act or process of making
ready a medication for administration, including the calculation of
a client's medication dosage; altering the form of the medication
by crushing, dissolving, or any other method; reconstitution of an
injectable medication; drawing an injectable medication into a syringe;
preparing an intravenous admixture; or any other act required to render
the medication ready for administration.
(3) Administrative support site--A facility or site
where an agency performs administrative and other support functions
but does not provide direct home health, hospice, or personal assistance
services. This site does not require an agency license.
(4) Administrator--The person who is responsible for
implementing and supervising the administrative polices and operations
of a home and community support services agency and for administratively
supervising the provision of all services to agency clients on a day-to-day
(5) ADS--Alternate delivery site. A facility or site,
including a residential unit or an inpatient unit:
(A) that is owned or operated by an agency providing
(B) that is not the hospice's parent agency;
(C) that is located in the geographical area served
by the hospice; and
(D) from which the hospice provides hospice services.
(6) Advanced practice nurse--An advanced practice registered
(7) Advanced practice registered nurse--A person licensed
by the Texas Board of Nursing as an advanced practice registered nurse.
The term is synonymous with "advanced practice nurse."
(8) Advisory committee--A committee, board, commission,
council, conference, panel, task force, or other similar group, or
any subcommittee or other subgroup, established for the purpose of
obtaining advice or recommendations on issues or policies that are
within the scope of a person's responsibility.
(9) Affiliate--With respect to an applicant or license
holder that is:
(A) a corporation--means each officer, director, and
stockholder with direct ownership of at least 5.0 percent, subsidiary,
and parent company;
(B) a limited liability company--means each officer,
member, and parent company;
(C) an individual--means:
(i) the individual's spouse;
(ii) each partnership and each partner thereof of which
the individual or any affiliate of the individual is a partner; and
(iii) each corporation in which the individual is an
officer, director, or stockholder with a direct ownership or disclosable
interest of at least 5.0 percent.
(D) a partnership--means each partner and any parent
(E) a group of co-owners under any other business arrangement--means
each officer, director, or the equivalent under the specific business
arrangement and each parent company.
(10) Agency--A home and community support services
(11) Applicant--The owner of an agency that is applying
for a license under the statute. This is the person in whose name
the license will be issued.
(12) Assistance with self-administration of medication--Any
needed ancillary aid provided to a client in the client's self-administered
medication or treatment regimen, such as reminding a client to take
a medication at the prescribed time, opening and closing a medication
container, pouring a predetermined quantity of liquid to be ingested,
returning a medication to the proper storage area, and assisting in
reordering medications from a pharmacy. Such ancillary aid includes
administration of any medication when the client has the cognitive
ability to direct the administration of their medication and would
self-administer if not for a functional limitation.
(13) Association--A partnership, limited liability
company, or other business entity that is not a corporation.
(14) Audiologist--A person who is currently licensed
under the Texas Occupations Code, Chapter 401, as an audiologist.
(15) Bereavement--The process by which a survivor of
a deceased person mourns and experiences grief.
(16) Bereavement services--Support services offered
to a family during bereavement. Services may be provided to persons
other than family members, including residents of a skilled nursing
facility, nursing facility, or intermediate care facility for individuals
with an intellectual disability or related conditions, when appropriate
and identified in a bereavement plan of care.
(17) Biologicals--A medicinal preparation made from
living organisms and their products, including serums, vaccines, antigens,
(18) Boarding home facility--An establishment defined
in Texas Health and Safety Code §260.001(2).
(19) Branch office--A facility or site in the service
area of a parent agency from which home health or personal assistance
services are delivered or where active client records are maintained.
This does not include inactive records that are stored at an unlicensed
(20) Care plan--
(A) a written plan prepared by the appropriate health
care professional for a client of the home and community support services
(B) for home dialysis designation, a written plan developed
by the physician, registered nurse, dietitian, and qualified social
worker to personalize the care for the client and enable long- and
short-term goals to be met.
(21) Case conference--A conference among personnel
furnishing services to the client to ensure that their efforts are
coordinated effectively and support the objectives outlined in the
plan of care or care plan.
(22) Certified agency--A home and community support
services agency, or portion of the agency, that:
(A) provides a home health service; and
(B) is certified by an official of the Department of
Health and Human Services as in compliance with conditions of participation
in Social Security Act, Title XVIII (42 United States Code (USC) §1395
(23) Certified home health services--Home health services
that are provided by a certified agency.
(24) CFR--Code of Federal Regulations. The regulations
and rules promulgated by agencies of the Federal government that address
a broad range of subjects, including hospice care and home health
(25) Change of ownership--An event that results in
a change to the federal taxpayer identification number of the license
holder of an agency. The substitution of a personal representative
for a deceased license holder is not a change of ownership.
(26) CHAP--Community Health Accreditation Program,
Inc. An independent, nonprofit accrediting body that publicly certifies
that an organization has voluntarily met certain standards for home
and community-based health care.
(27) Chief financial officer--An individual who is
responsible for supervising and managing all financial activities
for a home and community support services agency.
(28) Client--An individual receiving home health, hospice,
or personal assistance services from a licensed home and community
support services agency. This term includes each member of the primary
client's family if the member is receiving ongoing services. This
term does not include the spouse, significant other, or other family
member living with the client who receives a one-time service (for
example, vaccination) if the spouse, significant other, or other family
member receives the service in connection with the care of a client.
(29) Clinical note--A dated and signed written notation
by agency personnel of a contact with a client containing a description
of signs and symptoms; treatment and medication given; the client's
reaction; other health services provided; and any changes in physical
and emotional condition.
(30) CMS--Centers for Medicare & Medicaid Services.
The federal agency that administers the Medicare program and works
in partnership with the states to administer Medicaid.
(31) Complaint--An allegation against an agency regulated
by HHSC or against an employee of an agency regulated by HHSC that
involves a violation of this chapter or the statute.
(32) Community disaster resources--A local, statewide,
or nationwide emergency system that provides information and resources
during a disaster, including weather information, transportation,
evacuation, and shelter information, disaster assistance and recovery
efforts, evacuee and disaster victim resources, and resources for
locating evacuated friends and relatives.
(33) Controlling person--A person with the ability,
acting alone or with others, to directly or indirectly influence,
direct, or cause the direction of the management, expenditure of money,
or policies of an agency or other person.
(A) A controlling person includes:
(i) a management company or other business entity that
operates or contracts with others for the operation of an agency;
(ii) a person who is a controlling person of a management
company or other business entity that operates an agency or that contracts
with another person for the operation of an agency; and
(iii) any other individual who, because of a personal,
familial, or other relationship with the owner, manager, or provider
of an agency, is in a position of actual control or authority with
respect to the agency, without regard to whether the individual is
formally named as an owner, manager, director, officer, provider,
consultant, contractor, or employee of the agency.
(B) A controlling person, as described by subparagraph
(A)(iii) of this paragraph, does not include an employee, lender,
secured creditor, or other person who does not exercise formal or
actual influence or control over the operation of an agency.
(34) Conviction--An adjudication of guilt based on
a finding of guilt, a plea of guilty, or a plea of nolo contendere.
(35) Counselor--An individual qualified under Medicare
standards to provide counseling services, including bereavement, dietary,
spiritual, and other counseling services to both the client and the
(37) Day--Any reference to a day means a calendar day,
unless otherwise specified in the text. A calendar day includes weekends
(38) Deficiency--A finding of noncompliance with federal
requirements resulting from a survey.
(39) Designated survey office--An HHSC Home and Community
Support Services Agencies Program office located in an agency's geographic
(40) Dialysis treatment record--For home dialysis designation,
a dated and signed written notation by the person providing dialysis
treatment which contains a description of signs and symptoms, machine
parameters and pressure settings, type of dialyzer and dialysate,
actual pre- and post-treatment weight, medications administered as
part of the treatment, and the client's response to treatment.
(41) Dietitian--A person who is currently licensed
under the laws of the State of Texas to use the title of licensed
dietitian or provisional licensed dietitian, or who is a registered
(42) Direct ownership interest--Ownership of equity
in the capital, stock, or profits of, or a membership interest in,
an applicant or license holder.
(43) Disaster--The occurrence or imminent threat of
widespread or severe damage, injury, or loss of life or property resulting
from a natural or man-made cause, such as fire, flood, earthquake,
wind, storm, wave action, oil spill or other water contamination,
epidemic, air contamination, infestation, explosion, riot, hostile
military or paramilitary action, or energy emergency. In a hospice
inpatient unit, a disaster also includes failure of the heating or
cooling system, power outage, explosion, and bomb threat.
(44) Disclosable interest--Five percent or more direct
or indirect ownership interest in an applicant or license holder.
(45) ESRD--End stage renal disease. For home dialysis
designation, the stage of renal impairment that appears irreversible
and permanent and requires a regular course of dialysis or kidney
transplantation to maintain life.
(46) Functional need--Needs of the individual that
require services without regard to diagnosis or label.
(47) Habilitation--Habilitation services, as defined
by Texas Government Code §534.001, provided by an agency licensed
under this chapter.
(48) Health assessment--A determination of a client's
physical and mental status through inventory of systems.
(49) HHSC--Texas Health and Human Services Commission
or its designee.