The following words and terms, when used in this chapter, have
the following meanings unless the context clearly indicates otherwise.
(1) Active Play--Any physical activity from which a
minor derives amusement, entertainment, enjoyment, or satisfaction
by taking a participatory rather than a passive role. Active play
includes various forms of activities, from the exploration of objects
and toys to the structured play of formal games, sports, and hobbies.
(2) Actual census--The number of minors at a center
at any given time.
(3) Administration of medication--The direct application
of a medication to the body of a minor by any route. This includes
removing an individual or unit dose from a previously dispensed,
correctly labeled container, verifying it with the medication order,
giving the correct medication and the correct dose to the correct
minor at the correct time by the correct route, and accurately recording
the time and dose given.
(4) Administrator--The person who is responsible for
implementing and supervising the administrative polices and operations
of a center and for administratively supervising the provision of
services to minors and their parents on a day-to-day basis.
(5) Adult minor--A minor who is 18 years of age or
older or is emancipated, and has not been adjudged incompetent.
(6) Affiliate--With respect to an applicant or license
holder that is:
(A) a corporation--means an officer, director, or
stockholder with direct ownership or disclosable interest of at least
five percent, a subsidiary, or a parent company;
(B) a limited liability company--means an officer,
member, or parent company;
(C) an individual--means:
(i) the individual's spouse;
(ii) each partnership and each partner thereof of which
an individual or any affiliate of an individual is a partner; and
(iii) each corporation in which an individual is an
officer, director, or stockholder with a direct ownership of at least
(D) a partnership--means a partner or a parent company
of the partnership; and
(E) a group of co-owners under any other business arrangement
means an officer, director, or the equivalent under the specific business
arrangement or a parent company.
(7) Applicant--A person who applies for a license to
operate a center under THSC Chapter 248A and this chapter. The applicant
is the person in whose name HHSC issues the license.
(8) Audiologist--A person who has a valid license under
Texas Occupations Code, Chapter 401, as an audiologist.
(9) Basic services--Include:
(A) the development, implementation, and monitoring
of a comprehensive protocol of care that:
(i) is provided to a medically dependent or technologically
(ii) is developed in conjunction with the minor's parent;
(iii) specifies the medical, nursing, psychosocial,
therapeutic, and developmental services required by the minor; and
(B) the caregiver training needs of a medically dependent
or technologically dependent minor's parent.
(10) Behavioral emergency--A situation that occurs
after which preventative, or de-escalating techniques are attempted
and determined to be ineffective and it is immediately necessary to
restrain a minor to prevent immediate probable death or substantial
bodily harm to the minor or to others because the minor is attempting
serious bodily harm or immediate physical harm to the minor or to
(11) Business day--Any day except a national or state
holiday listed in Texas Government Code §662.003(a) or (b). The
term includes Saturday or Sunday if the center is open on that day.
(12) Center--A prescribed pediatric extended care center.
A facility operated for profit or on a nonprofit basis that provides
nonresidential basic services to four or more medically dependent
or technologically dependent minors who require the services of the
facility and who are not related by blood, marriage, or adoption to
the owner or operator of the facility.
(13) 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.
(14) Chemical restraint--The use of any chemical, including
pharmaceuticals, through topical application, oral administration,
injection, or other means, to restrict the free movement of all or
a portion of a minor's body for the purpose of modifying or controlling
the minor's behavior and which is not a standard treatment for a minor's
medical or psychosocial condition.
(15) Chief financial officer--An individual who is
responsible for supervising and managing all financial activities
for a center.
(16) Clinical note--A notation of a contact with a
minor or a minor's family member that is written and dated by any
staff providing services on behalf of a center and that describes
signs and symptoms of the minor, and treatments and medications administered
to the minor, including the minor's reaction or response, and any
changes in physical, emotional, psychosocial, or spiritual condition
of the minor during a given period of time.
(17) Commission--The Texas Health and Human Services
(18) Commissioner--The term referred to the commissioner
of DADS; it now refers to the executive commissioner of HHSC.
(19) 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.
(20) Complaint--An allegation against a center or involving
services provided at a center that involves a violation of this chapter
or THSC Chapter 248A.
(21) Continuous face-to-face observation--Maintaining
an in-person line of sight of a minor that is uninterrupted and free
(22) Contractor--An individual providing services ordered
by a prescribing physician on behalf of a center that the center would
otherwise provide by its employees.
(23) Controlling person--A person who has the ability,
acting alone or in concert with others, to directly or indirectly
influence, direct, or cause the direction of the management of, expenditure
of money for, or policies of a center or other person.
(A) A controlling person includes:
(i) a management company, landlord, or other business
entity that operates or contracts with another person for the operation
of a center;
(ii) any person who is a controlling person of a management
company or other business entity that operates a center or that contracts
with another person for the operation of a center; and
(iii) any other person who, because of a personal,
familial, or other relationship with the owner, manager, landlord,
tenant, or provider of a center, is in a position of actual control
of or authority with respect to the center, regardless of whether
the person is formally named as an owner, manager, director, officer,
provider, consultant, contractor, or employee of the center.
(B) Notwithstanding any other provision of this paragraph,
a controlling person of a center or of a management company or other
business entity described by subparagraph (A)(i) of this paragraph
that is a publicly traded corporation or is controlled by a publicly
traded corporation means an officer or director of the corporation.
The term does not include a shareholder or lender of the publicly
(C) A controlling person described by subparagraph
(A)(iii) of this paragraph does not include a person, including an
employee, lender, secured creditor, or landlord, who does not exercise
any formal or actual influence or control over the operation of the
(24) Conviction--An adjudication of guilt based on
a finding of guilt, a plea of guilty, or a plea of nolo contendere.
(25) DADS--The term referred to the Department of Aging
and Disability Services; it now refers to HHSC.
(26) Daily census--The number of minors served at a
center during a center's hours of operation for a 24-hour period,
starting at midnight.
(27) Day--A calendar day, unless otherwise specified
in the text. A calendar day includes Saturday, Sunday, and a holiday.
(28) Dietitian--A person who has a valid license under
the Licensed Dietitian Act, Texas Occupations Code, Chapter 701, as
a licensed dietitian or provisional licensed dietitian, or who is
registered as a dietitian by the Commission on Dietetic Registration
of the American Dietetic Association.
(29) Direct ownership interest--Ownership of equity
in the capital, stock, or profits of, or a membership interest in,
an applicant or license holder.
(30) Disclosable interest--Five percent or more direct
or indirect ownership interest in an applicant or license holder.
(31) Emergency situation--An impending or actual situation
(A) interferes with normal activities of a center or
minors at a center;
(i) cause injury or death to a minor or individual
at the center; or
(ii) cause damage to the center's property;
(C) requires the center to respond immediately to mitigate
or avoid injury, death, damage, or interference; and
(D) does not include a situation that arises from the
medical condition of a minor such as cardiac arrest, obstructed airway,
or cerebrovascular accident.
(32) Executive commissioner--The executive commissioner
of the Texas Health and Human Services Commission.
(33) Functional assessment--An evaluation of a minor's
abilities, wants, interests, and needs related to self-care, communication
skills, social skills, motor skills, play with toys or objects, growth,
and development appropriate for age.
(34) Health care provider--An individual or facility
licensed, certified, or otherwise authorized to administer health
care in the ordinary course of business or professional practice.
(35) Health care setting--A location at which licensed,
certified, or otherwise regulated health care is administered.
(36) HHSC--The Texas Health and Human Services Commission.
(37) IDT--Interdisciplinary team. Individuals who work
together to meet the medical, nursing, psychosocial, and developmental
needs of a minor and a minor's parent's training needs.
(38) Inactive medical record--A record for a minor
who was admitted by a center to receive services and was subsequently
discharged by the center.
(39) Indirect ownership interest--Any ownership or
membership interest in a person that has a direct ownership interest
in an applicant or license holder.
(40) Inspection--An on-site examination or audit of
a center by HHSC to determine compliance with THSC Chapter 248A and
(41) Isolation--The involuntary confinement of a minor
in a room of a center for the purposes of infection control, assessment,
and observation away from other minors in a room at the center. When
in isolation, a minor is physically prevented from contact with other
(42) Joint training--Training provided by HHSC to service
providers and HHSC inspectors on subjects that address the 10 most
commonly cited violations of state law governing centers, as published
in HHSC annual reports. HHSC determines the frequency of joint training.
(43) License--A license to operate a center issued
by HHSC under THSC, Chapter 248A, and this chapter. The term includes
initial, renewal, and temporary licenses unless specifically stated
(44) Licensed assistant in speech-language pathology--A
person who has a valid license under Texas Occupations Code, Chapter
401, as a licensed assistant in speech-language pathology and who
provides speech language support services under the supervision of
a licensed speech-language pathologist.
(45) License holder--A person that holds a license
to operate a center under THSC Chapter 248A and this chapter.
(46) Life Safety Code--A publication of the National
Fire Protection Association (NFPA), also known as NFPA 101, 2000 edition.
(47) Local emergency management agencies--The local
emergency management coordinator, fire, police, and emergency medical
(48) Local emergency management coordinator--The person
identified as the emergency management coordinator by the mayor or
county judge for the geographical area in which a center is located.
(49) LVN--Licensed vocational nurse. A person who has
a valid license under Texas Occupations Code, Chapter 301, as a licensed
(50) Mechanical restraint--The use of any mechanical
device, material, or equipment to restrict the free movement of all
or a portion of a minor's body for the purpose of modifying or controlling
the minor's behavior.