The following words and terms, when used in this chapter, have
the following meanings, unless the context clearly indicates otherwise:
(1) Abandonment--Leaving a patient without appropriate
medical care once patient contact has been established, unless emergency
medical services personnel are following the medical director's protocols,
a physician directive, or the patient signs a release; or turning
the care of a patient over to an individual of lesser education when
advanced treatment modalities have been initiated.
(2) Accreditation--Formal recognition by a national
association of a provider's service or an education program based
on standards established by that association.
(3) Act--Emergency Health Care Act, Texas Health and
Safety Code Chapter 773.
(4) Active pursuit of department designation as a trauma
facility--An undesignated facility recognized by the department after
applying for designation as a trauma facility and has met the requirement
to be eligible for uncompensated trauma care funds.
(5) Acute Stroke-Ready Level IV stroke facility--A
hospital reviewed by a department-approved survey organization and
meeting the national stroke standards of care for an acute stroke-ready
facility as described in §157.133 of this chapter (relating to
Requirements for Stroke Facility Designation).
(6) Administrator of record (AOR)--The administrator
for an emergency medical services (EMS) provider who meets the requirements
of Texas Health and Safety Code §773.05712.
(7) Advanced emergency medical technician (AEMT)--An
individual certified by the department and minimally proficient in
performing the basic life support skills required to provide emergency
prehospital or interfacility care and initiating and maintaining under
medical supervision, certain advanced life support procedures, including
intravenous therapy and endotracheal or esophageal intubation.
(8) Advanced Level II stroke facility--A hospital that
completes a designation survey with a department-approved survey organization,
meets the national stroke standards for Non-Comprehensive Thrombectomy
Stroke Center, and meets the requirements of an Advanced Level II
stroke facility as defined by §157.133 of this chapter.
(9) Advanced Level III trauma facility--A hospital
surveyed by a department-approved survey organization that meets the
state requirements and American College of Surgeons (ACS) standards
for a Level III trauma facility as described in §157.125 of this
chapter (relating to Requirements for Trauma Facility Designation
Effective Through August 31, 2025) and §157.126 of this chapter
(relating to Trauma Facility Designation Requirements Effective on
September 1, 2025).
(10) Advanced life support (ALS)--Emergency prehospital
or interfacility care that uses invasive medical acts and includes
ALS assessment. The provision of advanced life support must be under
the medical supervision and control of a licensed physician.
(11) Advanced life support assessment--Assessment performed
by an AEMT or paramedic that qualifies as advanced life support based
upon initial dispatch information, when it could reasonably be believed
the patient was suffering from an acute condition that may require
advanced skills.
(12) Advanced life support vehicle--A vehicle designed
for transporting the sick and injured and meeting the requirements
of §157.11 of this chapter (relating to Requirements for an EMS
Provider License) as an ALS vehicle and having sufficient equipment
and supplies for providing an advanced level of care based on national
standards and the EMS provider's medical director-approved treatment
protocols.
(13) Advanced practice provider (APP)--A nurse practitioner
or physician assistant reviewed and credentialed by the facility and
may have additional credentialing to participate in the designation
program.
(14) Air ambulance provider--A person who operates,
maintains, or leases a fixed-wing or rotor-wing air ambulance aircraft,
equipped and staffed to provide a medical care environment on-board
appropriate to the patient's needs. The term air ambulance provider
is not synonymous with and does not refer to the Federal Aviation
Administration (FAA) air carrier certificate holder unless the air
ambulance provider maintains and controls the medical aspects consistent
with EMS provider licensure.
(15) Ambulance--A vehicle for transportation of the
sick or injured patient to, from, or between places of treatment for
an illness or injury and that provides out-of-hospital medical care
to the patient.
(16) American College of Surgeons (ACS)--The organization
that sets the national standards for trauma centers, trauma verification,
the National Trauma Data Standards (NTDS), National Trauma Data Bank
(NTDB), Trauma Quality Improvement Program (TQIP), and regional system
standards.
(17) Approved survey organization--An organization
that has received department authorization to conduct designation
surveys, meeting the department's designation survey guidelines and
expectations.
(18) Authorized ambulance vehicle--A vehicle authorized
to be operated by the licensed provider and meeting all criteria for
approval as described in §157.11(e) of this chapter.
(19) Bad debt--The unreimbursed cost for patient care
to a hospital providing trauma care.
(20) Basic Level IV trauma facility--A hospital managing
101 or more trauma patients meeting NTDB registry inclusion criteria
annually surveyed by a department-approved survey organization and
meeting the state requirements and ACS standards, or a hospital managing
100 or less trauma patients meeting NTDB registry inclusion criteria
annually surveyed by the department or a department-approved survey
organization, and meeting the state designation requirements for a
Level IV trauma facility as described in §157.125 and §157.126
of this chapter.
(21) Basic life support (BLS)--Emergency prehospital
or interfacility care that uses noninvasive medical acts. The provision
of basic life support will have sufficient equipment and supplies
for providing basic-level care based on national standards and the
EMS provider's medical director-approved treatment protocols.
(22) Basic life support (BLS) vehicle--A vehicle designed
for transporting the sick or injured and having sufficient equipment
and supplies for providing basic life support based on national standards
and the EMS provider's medical director-approved treatment protocols.
(23) Bypass--Direction given to prehospital emergency
medical services personnel by direct on-line medical control, or off-line
medical director protocols to bypass the nearest facility for the
most appropriate facility.
(24) Calculation of the costs of uncompensated trauma
care--A calculation of a hospital's total costs of uncompensated trauma
care for patients meeting the hospital's trauma activation guidelines
and meeting NTDB registry inclusion criteria determined by summing
its charges related to uncompensated trauma care as defined in §157.130
of this chapter (relating to Funds for Emergency Medical Services,
Trauma Facilities, and Trauma Care Systems, and the Designated Trauma
Facility and Emergency Services Account), then applying the cost-to-charge
ratio derived in accordance with generally accepted accounting principles.
(25) Candidate--An individual requesting emergency
medical services personnel certification, licensure, recertification,
or re-licensure from the department.
(26) Certificant--Emergency medical services personnel
with current certification from the department.
(27) Charity care--The unreimbursed cost to a hospital
providing health care services for an inpatient, emergency department,
transferred, or expired person classified by the hospital as "financially
indigent."
(28) Commissioner--The commissioner of the Texas Department
of State Health Services.
(29) Comprehensive Level I stroke facility--A hospital
surveyed by a department-approved survey organization meeting the
national standards of care for a Comprehensive Stroke Center, participates
in its local Regional Advisory Council (RAC), participates in the
regional stroke plan, and submits data to the department, as requested
as defined by §157.133 of this chapter.
(30) Comprehensive Level I trauma facility--A hospital
surveyed by a department-approved survey organization meeting the
state designation requirements and ACS standards for a Level I trauma
facility as described in §157.125 and §157.126 of this chapter.
(31) Concurrent performance improvement--Performance
improvement reviews occurring from prehospital, trauma activation,
or admission through to discharge. The primary level of review must
be completed within 14 days of discharge, 80 percent of the time.
Cont'd... |
