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) Actual harm--A negative outcome that compromises
a resident's physical, mental, or emotional well-being.
(2) Addition--The addition of floor space to a facility.
(3) Administrator--The administrator of a facility.
(4) 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.
(5) 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.
(6) Applicant--A person applying for a license under
Texas Health and Safety Code, Chapter 252.
(7) APA--The Administrative Procedure Act, Texas Government
Code, Chapter 2001.
(8) Attendant personnel--All persons who are responsible
for direct and non-nursing services to residents of a facility. (Nonattendant
personnel are all persons who are not responsible for direct personal
services to residents.) Attendant personnel come within the categories
of: administration, dietitians, medical records, activities, housekeeping,
laundry, and maintenance.
(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) 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.
(12) CMS--Centers for Medicare & Medicaid Services.
The federal agency that provides funding and oversight for the Medicare
and Medicaid programs. CMS was formerly known as the Health Care
Financing Administration (HCFA).
(13) Controlled substance--A drug, substance, or immediate
precursor as defined in the Texas Controlled Substance Act, Health
and Safety Code, Chapter 481, as amended, or the Federal Controlled
Substance Act of 1970, Public Law 91-513, as amended.
(14) 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 that 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.
(15) DADS--The term referred to the Department of Aging
and Disability Services; it now refers to HHSC.
(16) Dangerous drug--Any drug as defined in the Texas
Dangerous Drug Act, Health and Safety Code, Chapter 483.
(18) 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.
(19) Direct ownership interest--Ownership of equity
in the capital, stock, or profits of, or a membership interest in,
an applicant or license holder.
(20) Disclosable interest--Five percent or more direct
or indirect ownership interest in an applicant or license holder.
(21) 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 man;
(C) any substance (other than food) intended to affect
the structure or any function of the human body; and
(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.
(22) Establishment--A place of business or a place
where business is conducted which includes staff, fixtures, and property.
(23) Facility--A facility serving persons with an intellectual
disability or related conditions licensed under this chapter as described
in §90.2 of this chapter (relating to Scope) and required to
be licensed under the 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 §9.212 of this title (relating
to Non-licensed Providers Meeting Licensure Standards).
(24) Governmental unit--A state or a political subdivision
of the state, including a county or municipality.
(25) 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
(26) Hearing--A contested case hearing held in accordance
with the Administrative Procedure Act, Government Code, Chapter 2001,
and the formal hearing procedures in 1 TAC Chapter 357, Subchapter
(27) HHSC--The Texas Health and Human Services Commission.
(28) Immediate jeopardy to health and safety--A situation
in which immediate corrective action is necessary because the facility's
noncompliance with one or more requirements has caused, or is likely
to cause, serious injury, harm, impairment, or death to a resident
receiving care in the facility.
(29) 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.
(30) Incident--An unusual or abnormal event or occurrence
in, at, or affecting the facility or the residents of the facility.
(31) Indirect ownership interest--Any ownership or
membership interest in a person that has a direct ownership interest
in an applicant or license holder.
(32) 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
(33) IPP--Individual program plan. 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.
(34) Isolated--A very limited number of residents are
affected and a very limited number of staff are involved, or the situation
has occurred only occasionally.
(35) Large facility--Facilities with 17 or more resident
(36) Legal guardian--A person who is appointed guardian
under §693 of the Probate Code.
(37) Legally authorized representative--A person authorized
by law to act on behalf of a person with regard to a matter described
in this chapter, and may include a parent, guardian, or managing conservator
of a minor, or the guardian of an adult.
(38) License--Approval from HHSC to establish or operate
(39) License holder--A person that holds a license
to operate a facility.
(40) Licensed nurse--A licensed vocational nurse, registered
nurse, or advanced practice nurse.
(41) Life Safety Code--NFPA 101.
(42) 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, sprinkler systems,
(43) 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
(44) 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,
§§121.021 - 121.025.
(45) LVN--Licensed vocational nurse. A person licensed
to practice vocational nursing in accordance with Texas Occupations
Code, Chapter 301.
(46) Management services--Services provided under contract
between the owner of a facility and a person to provide for the operation
of a facility, including administration, staffing, maintenance, or
delivery of resident services. Management services shall not include
contracts solely for maintenance, laundry, or food services.
(47) Metered dose inhaler--A device that delivers a
measured amount of medication as a mist that can be inhaled.
(48) NFPA--The National Fire Protection Association.
If the term is immediately followed by a number, it is a reference
to a publication of NFPA, as referenced in NFPA 101.
(49) NFPA 99--NFPA 99, Health Care Facilities Code,
2012 Edition. A publication of the NFPA that provides minimum requirements
for the installation, testing, maintenance, performance, and safe
practices for health care facilities and for material, equipment,
and appliances, used for patient care in health care facilities. CMS
has incorporated NFPA 99, 2012 Edition, except Chapters 7, 8, 12,
and 13, by reference as a Condition of Participation in the ICF/IID
program for facilities that meet the definition of a health care occupancy.
Copies of NFPA 99 may be obtained from NFPA, 1 Batterymarch Park,
Quincy, MA 02169.
(50) NFPA 101--NFPA 101, Life Safety Code, 2012 Edition.
A publication of the NFPA that provides minimum requirements, with
due regard to function, for the design, operation, and maintenance
of buildings and structures for safety to life from fire. CMS has
incorporated NFPA 101, 2012 Edition, by reference as a Condition of
Participation in the ICF/IID program. Copies of NFPA 101 may be obtained
from NFPA, 1 Batterymarch Park, Quincy, MA 02169.
(51) Oral medication--Medication administered by way
or through the mouth and does not include sublingual or buccal.
(52) Pattern of violation--Repeated, but not widespread
in scope, failures of a facility to comply with Texas Health and Safety
Code, Chapter 252, or a rule, standard or order adopted under Chapter
(A) result in a violation; and
(B) are found throughout the services provided by the
facility or that affect or involve the same residents or facility
(53) Person--An individual, firm, partnership, corporation,
association, or joint stock company, and any legal successor of those
(54) Personal hold--
(A) A manual method, except for physical guidance
or prompting of brief duration, used to restrict:
(i) free movement or normal functioning of all or a
portion of a resident's body; or