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RULE §131.2Definitions

The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise.

  (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 by ownership.

  (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 facility.

  (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 vocational nurse.

  (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 or treatment.

  (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 Texas.

  (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 practice act.

  (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.

Source Note: The provisions of this §131.2 adopted to be effective June 1, 2010, 35 TexReg 4400; amended to be effective February 2, 2020, 45 TexReg 554

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