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RULE §551.3Definitions

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 subchapter.

  (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; and

    (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.

  (17) Department--HHSC.

  (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 is:

    (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 therapist.

  (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 I.

  (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 purpose.

  (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 beds.

  (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 a facility.

  (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, etc.

  (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 or certifications.

  (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 252 that:

    (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 employees.

  (53) Person--An individual, firm, partnership, corporation, association, or joint stock company, and any legal successor of those entities.

  (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


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