The following words and terms, when used in this chapter, have
the following meanings, unless the context clearly indicates otherwise.
Individual subchapters may have definitions that are specific to the
(1) Active treatment--A continuous program, which includes
aggressive, consistent implementation of specialized and generic training,
treatment, health services, and related services, that is directed
(A) acquisition of the behaviors necessary for the
resident to function with as much self-determination and independence
as possible; and
(B) prevention or deceleration of regression or loss
of current optimal functional status.
(2) Actual harm--A negative outcome that compromises
a resident's physical, mental, or emotional well-being.
(3) Addition--The addition of floor space to a facility.
(4) Administrator--The administrator of a facility.
(5) Administration of medication--Removing a unit or
dose of medication from a previously dispensed, properly labeled container;
verifying the medication with the medication order; giving the proper
medication in the proper dosage to the proper resident at the proper
time by the proper administration route; and recording the time of
administration and dosage administered.
(6) Advanced practice nurse--A person licensed to practice
professional nursing in accordance with Texas Occupations Code, Chapter
301, and authorized by the Texas Board of Nursing to practice as an
advanced practice nurse.
(7) Applicant--A person applying for a license under
Texas Health and Safety Code, Chapter 252.
(8) Administrative Procedure Act (APA)--Texas Government
Code, Chapter 2001.
(9) Behavioral emergency--A situation in which severely
aggressive, destructive, violent, or self-injurious behavior exhibited
by a resident:
(A) poses a substantial risk of imminent probable death
of, or substantial bodily harm to, the resident or others;
(B) has not abated in response to attempted preventive
de-escalatory or redirection techniques;
(C) is not addressed in a behavior therapy program;
(D) does not occur during a medical or dental procedure.
(10) Care and treatment--Services required to maximize
resident independence, personal choice, participation, health, self-care,
psychosocial functioning, and provide reasonable safety, all consistent
with the preferences of the resident.
(11) CDC--Centers for Disease Control and Prevention.
(12) 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.
(13) CFR--Code of Federal Regulations.
(14) CMS--Centers for Medicare & Medicaid Services.
The federal agency that provides funding and oversight for the Medicare
and Medicaid programs.
(15) Communicable disease--An illness due to an infectious
agent or its toxic products that is transmitted directly to a well
person from an infected person or animal, or indirectly through an
intermediate plant or animal host, vector, or the inanimate environment.
(16) Controlled substance--A drug, substance, or immediate
precursor as defined in the Texas Controlled Substances Act, Texas
Health and Safety Code, Chapter 481, as amended, or the Federal Controlled
Substances Act, United States Code, Title 21, Chapter 13, as amended.
(17) Controlling person of an applicant, license holder,
or facility--A person who, acting alone or with others, has the ability
to directly or indirectly influence or direct the management, expenditure
of money, or policies of an applicant or license holder or of a facility
owned by an applicant or license holder.
(A) The term includes:
(i) a spouse of the applicant or license holder;
(ii) an officer or director, if the applicant or license
holder is a corporation;
(iii) a partner, if the applicant or license holder
is a partnership;
(iv) a trustee or trust manager, if the applicant or
license holder is a trust;
(v) a person who operates or contracts with others
to operate the facility;
(vi) a person who, because of a personal, familial,
or other relationship is in a position of actual control or authority
over the facility, without regard to whether the person is formally
named as an owner, manager, director, officer, provider, consultant,
contractor, or employee of the facility; and
(vii) a person who would be a controlling person of
an entity described in clauses (i) - (vi) of this subparagraph, if
that entity were the applicant or license holder.
(B) The term 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 a facility.
(18) CPR--cardiopulmonary resuscitation.
(19) Dangerous drug--Any drug as defined in the Texas
Dangerous Drug Act, Texas Health and Safety Code, Chapter 483.
(20) Designee--A state agency or entity with which
HHSC contracts to perform specific, identified duties related to the
fulfillment of a responsibility prescribed by this chapter.
(21) DFPS--Texas Department of Family and Protective
(22) Direct ownership interest--Ownership of equity
in the capital, stock, or profits of, or a membership interest in,
an applicant or license holder.
(23) Disclosable interest--Five percent or more direct
or indirect ownership interest in an applicant or license holder.
(24) Drug (also referred to as medication)--A drug
(A) any substance recognized as a drug in the official
United States Pharmacopeia, official Homeopathic Pharmacopeia of the
United States, or official National Formulary, or any supplement to
any of them;
(B) any substance intended for use in the diagnosis,
cure, mitigation, treatment, or prevention of disease in a person;
(C) any substance (other than food) intended to affect
the structure or any function of the human body; or
(D) any substance intended for use as a component of
any substance specified in subparagraphs (A) - (C) of this paragraph.
It does not include devices or their components, parts, or accessories.
(25) DSHS--Texas Department of State Health Services.
(26) EMC--Emergency Management Coordinator.
(27) EPC--Emergency Preparedness Coordinator.
(28) Emergency situation--an impending or actual situation
(A) may interfere with normal activities of a facility
or its residents;
(B) may cause:
(i) injury or death to a resident or staff member of
the facility; or
(ii) damage to facility property;
(C) requires the facility 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 resident such as cardiac arrest, obstructed
airway, or cerebrovascular accident.
(29) EMR--Employee Misconduct Registry.
(30) Establishment--A place of business or a place
where business is conducted which includes staff, fixtures, and property.
(31) Facility--A facility serving persons with an intellectual
disability or related conditions licensed under this chapter as described
in §551.2 of this chapter (relating to Scope) and required to
be licensed under Texas Health and Safety Code, Chapter 252, or the
entity that operates such a facility; or, in Subchapters C, D, and
F of this chapter, a program provider that must comply with those
subchapters in accordance with §261.212 of this title (relating
to Non-licensed Providers Meeting Licensure Standards).
(32) Governmental unit--A state or a political subdivision
of the state, including a county or municipality.
(33) Guardian--A person who is appointed guardian under
Texas Estates Code, Chapter 1101.
(34) Health authority--A physician designated to administer
state and local laws relating to public health under the Local Public
Health Reorganization Act, Texas Health and Safety Code, Chapter 121.
The health authority may be:
(A) a local health authority appointed by the local
government jurisdiction; or
(B) a regional director of DSHS if no physician has
been appointed by the local government.
(35) Health care professional--A person licensed, certified,
or otherwise authorized to administer health care, for profit or otherwise.
The term includes a physician, licensed nurse, physician assistant,
podiatrist, dentist, physical therapist, speech therapist, and occupational
(36) Hearing--A contested case hearing held in accordance
with the APA and the formal hearing procedures in 1 TAC Chapter 357,
Subchapter I(relating to Hearings Under the Administrative Procedure
(37) HHSC--The Texas Health and Human Services Commission.
(38) HVAC--Heating, ventilating, and air-conditioning
(39) ICF/IID--An Intermediate Care Facility for Individuals
with an Intellectual Disability or Related Conditions.
(40) IDT--Interdisciplinary Team.
(41) Immediate jeopardy to health and safety of a resident--A
situation in which immediate corrective action is necessary because
the facility's noncompliance with one or more federal requirements
has caused, or is likely to cause, serious injury, harm, impairment,
or death to a resident receiving care in the certified facility.
(42) Immediate threat to the health or safety of a
resident--A situation that causes, or is likely to cause, serious
injury, harm, or impairment or death of a resident because of the
facility's noncompliance with one or more licensure requirements.
(43) Incident--An unusual or abnormal event or occurrence
in, at, or affecting the facility or the residents of the facility.
(44) Indirect ownership interest--Any ownership or
membership interest in a person who has a direct ownership interest
in an applicant or license holder.
(45) Inspection--Any on-site visit to or survey of
a facility by HHSC for the purpose of inspection of care, licensing,
monitoring, complaint investigation, architectural review, or similar
(46) Individual program plan (IPP)--A plan developed
by the interdisciplinary team of a facility resident that identifies
the resident's training, treatment, and habilitation needs, and describes
programs and services to meet those needs.
(47) Isolated--A situation in which a very limited
number of residents are affected and a very limited number of staff
are involved, or the situation has occurred only occasionally.
(48) Key infectious agents--Bacteria, viruses, and
other microorganisms that cause the most common infections and infectious
diseases in long-term care facilities, according to the CDC, and can
be prevented by establishing, implementing, maintaining, and enforcing
proper infection prevention and control policies and procedures.
(49) Legally authorized representative (LAR)--A person
authorized by law to act on behalf of a person regarding a matter
described in this chapter, and may include a parent, guardian, or
managing conservator of a minor, or the guardian of an adult.
(50) Large facility--A facility with a capacity of
17 or more residents.
(51) License--Approval from HHSC to establish or operate
(52) License holder--A person who holds a license to
operate a facility.
(53) Licensed nurse--A licensed vocational nurse, registered
nurse, or advanced practice nurse.
(54) LIDDA--Local intellectual and developmental disability
(55) Life Safety Code--NFPA 101.
(56) Life safety features--Fire safety components required
by the Life Safety Code such as building construction, fire alarm
systems, smoke detection systems, interior finishes, sizes and thicknesses
of doors, exits, emergency electrical systems, and sprinkler systems.
(57) Local authorities--A local health authority, fire
marshal, building inspector, etc., who may be authorized by state
law, county order, or municipal ordinance to perform certain inspections
(58) Local health authority--The physician having local
jurisdiction to administer state and local laws or ordinances relating
to public health, as described in the Texas Health and Safety Code,
Chapter 121, Subchapter B.
(59) Licensed vocational nurse(LVN)--A person licensed
to practice vocational nursing in accordance with Texas Occupations
Code, Chapter 301.
(60) Metered dose inhaler--A device that delivers a
measured amount of medication as a mist that can be inhaled.
(61) Multidrug-resistant organisms--Bacteria and other
microorganisms that have developed resistance to multiple types of
medicine used to act against the microorganism.