The following words and terms, when used in this chapter, shall
have the following meanings, unless the context clearly indicates
(1) Act--Health and Safety Code, Chapter 254, titled
Freestanding Emergency Medical Care Facilities.
(2) Action plan--A written document that includes specific
measures to correct identified problems or areas of concern; identifies
strategies for implementing system improvements; and includes outcome
measures to indicate the effectiveness of system improvements in reducing,
controlling or eliminating identified problem areas.
(3) Administrator--A person who is a physician, is
a registered nurse, has a baccalaureate or postgraduate degree in
administration or a health-related field, or has one year of administrative
experience in a health-care setting.
(4) Advanced practice registered nurse (APRN)--A registered
nurse approved 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 freestanding emergency
medical care facility license from the department and who is legally
responsible for the operation of the freestanding emergency medical
care facility, whether by lease or ownership.
(7) Certified registered nurse anesthetist (CRNA)--A
registered nurse who has current certification from the Council on
Certification of Nurse Anesthetists and who is currently authorized
to practice as an advanced practice registered nurse by the Texas
Board of Nursing.
(8) Change of ownership--Change in the person legally
responsible for the operation of the facility, whether by lease or
(9) Department--The Department of State Health Services.
(10) Designated provider--A provider of health care
services, selected by a health maintenance organization, a self-insured
business corporation, a beneficial society, the Veterans Administration,
TRICARE, a business corporation, an employee organization, a county,
a public hospital, a hospital district, or any other entity to provide
health care services to a patient with whom the entity has a contractual,
statutory, or regulatory relationship that creates an obligation for
the entity to provide the services to the patient.
(11) Disposal--The discharge, deposit, injection, dumping,
spilling, leaking, or placing of any solid waste or hazardous waste
(containerized or uncontainerized) into or on any land or water so
that solid waste or hazardous waste or any constituent thereof may
enter the environment or be emitted into the air or discharge into
any waters, including groundwaters.
(12) Emergency care--Health care services provided
in a freestanding emergency medical care facility to evaluate and
stabilize a medical condition of a recent onset and severity, including
severe pain, psychiatric disturbances, or symptoms of substance abuse,
that would lead a prudent layperson possessing an average knowledge
of medicine and health to believe that the person's condition, sickness,
or injury is of such a nature that failure to get immediate medical
care could result in:
(A) placing the person's health in serious jeopardy;
(B) serious impairment to bodily functions;
(C) serious dysfunction of a bodily organ or part;
(D) serious disfigurement; or
(E) in the case of a pregnant woman, serious jeopardy
to the health of the woman or fetus.
(13) Facility--A freestanding emergency medical care
(14) Freestanding Emergency Medical Care Facility--A
facility that is structurally separate and distinct from a hospital
and which receives an individual and provides emergency care as defined
in paragraph (12) of this section.
(15) Hospital--A facility that is licensed under the
Texas Hospital Licensing Law, Health and Safety Code, Chapter 241,
or if exempt from licensure, certified by the United States Department
of Health and Human Services as in compliance with the conditions
of participation for hospitals in Title XVIII, Social Security Act
(42 United States Code, §§1395 et seq.), or owned and operated
by the state of Texas.
(16) Governing body--The governing authority of a freestanding
emergency medical care facility which is responsible for a facility's
organization, management, control, and operation, including appointment
of the medical staff; and includes the owner or partners for a freestanding
emergency medical care facility owned or operated by an individual
or partners or corporation.
(17) Freestanding emergency medical care facility administration--Administrative
body of a freestanding emergency medical care facility headed by an
individual who has the authority to represent the facility and who
is responsible for the operation of the facility according to the
policies and procedures of the facility's governing body.
(18) Licensed vocational nurse (LVN)--A person who
is currently licensed by the Texas Board of Nursing as a licensed
(19) Licensee--The person or governmental unit named
in the application for issuance of a facility license.
(20) Medical director--A physician who is board certified
or board eligible in emergency medicine, or board certified in primary
care with a minimum of two years of emergency care experience.
(21) Medical staff--A physician or group of physicians,
a podiatrist or group of podiatrists, and a dentist or group of dentists
who by action of the governing body of a facility are privileged to
work in and use the facilities.
(22) Owner--One of the following persons or governmental
unit which will hold or does hold a license issued under the Act 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.
(23) Patient--An individual who presents for diagnosis
(24) Person--An individual, firm, partnership, corporation,
association, or joint stock company, and includes a receiver, trustee,
assignee, or other similar representative of those entities.
(25) Physician--An individual licensed by the Texas
Medical Board and authorized to practice medicine in the State of
(26) Physician assistant--A person licensed as a physician
assistant by the Texas State Board of Physician Assistant Examiners.
(27) 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
(28) Premises--A building where patients receive emergency
services from a freestanding emergency medical care facility.
(29) 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 before
the on-site licensure inspection.
(30) Quality assessment and performance improvement
(QAPI)--An ongoing program that measures, analyzes, and tracks quality
indicators related to improving health outcomes and patient care emphasizing
a multidisciplinary approach. The program implements improvement plans
and evaluates the implementation until resolution is achieved.
(31) Registered nurse (RN)--A person who is currently
licensed by the Texas Board of Nursing as a registered nurse.
(32) SAFE-ready facility--A facility designated by
the Health and Human Services Commission as a sexual assault forensic
exam ready facility.
(33) Sexual assault forensic examiner--A certified
sexual assault nurse examiner or a physician with specialized training
on conducting a forensic medical examination.
(34) 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.
(35) Stabilize--To provide necessary medical treatment
of an emergency medical condition to ensure, within reasonable medical
probability, that the condition is not likely to deteriorate materially
from or during the transfer of the individual from a facility.
(36) Transfer--The movement (including the discharge)
of an individual outside a facility at the direction of and after
personal examination and evaluation by the facility physician. Transfer
does not include the movement outside a facility of an individual
who has been declared dead or who leaves the facility without the
permission of the facility physician.
(37) Transfer agreement--A referral, transmission or
admission agreement with a hospital licensed in this state.
(38) 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 healthcare facilities.
(39) Violation--Failure to comply with the Act, a rule
or standard, special license provision, or an order issued by the
commissioner of state health services or the commissioner's designee,
adopted or enforced under the Act.