| (B) a limited liability company; (C) an individual; (D) a partnership if a partnership name is stated in a written partnership agreement or an assumed name certificate; (E) all partners in a partnership if a partnership name is not stated in a written partnership agreement or an assumed name certificate; or (F) all co-owners under any other business arrangement. (53) Patient--An individual receiving dialysis treatment or training from an end stage renal disease facility. (54) Patient plan of care--Documentation of the interactive process whereby the interdisciplinary team and the patient and/or family member or guardian develop and implement a plan, based on the assessments preformed by the interdisciplinary team members, to assist the end stage renal disease patient in managing the disease and its complications. (55) Pediatric patient--An individual from birth and continuing through 18 years of age. (56) Person--An individual, corporation, or other legal entity. (57) Physician--A physician licensed by the Texas Medical Board. (58) Physician assistant--A person licensed as a physician assistant by the Texas Medical Board. (59) Physician extender--A health care provider (advanced practice registered nurse or physician assistant) who is not a physician but who performs medical activities typically performed by a physician. (60) Presurvey conference--A conference held with department staff and the applicant or his or her representatives to review licensure standards and survey documents and provide consultation prior to the issuance of the license. The applicant's representatives shall include an individual who will be responsible for the day-to-day supervision of care by the facility. (61) Product water--Water produced by a water treatment system or by an individual component of a system. (62) Progress note--A record of an event dated and signed by facility staff, which summarizes facts about the patient's care and the patient's response during a given period of time. (63) Pyrogen--A fever producing substance. Pyrogens are most often lipopolysaccharides of gram-negative bacterial origin. (64) Quality assessment and performance improvement (QAPI)--An ongoing program which measures, analyzes, and tracks quality indicators related to improve health outcomes. The program implements improvement plans and evaluates the implementation until resolution is achieved. (65) Registered nurse (RN)--A person who is currently licensed by the Texas Board of Nursing as a registered nurse, or who holds a valid registered nursing license with multi-state licensure privilege from another compact state. (66) Self-care patients--In-center patients who perform all or part of their dialysis treatments. (67) Social worker--A person who: (A) is currently licensed as a social worker under the Occupations Code, Chapter 505, and holds a master's degree from a graduate school of social work accredited by the Council on Social Work Education; or (B) has worked for at least two years as a social worker, one year of which was in a dialysis facility or transplantation program prior to September 1, 1976, and has established a consultative relationship with a social worker who has a master's degree from a graduate school of social work accredited by the Council on Social Work Education. (68) Sorbent regeneration system--A system that regenerates dialysate by passing the dialysate through substances that restore the dialysate to a condition comparable to fresh dialysate. (69) Station--An area in the facility in which a patient receives in-center dialysis treatment, or dialysis instruction, (i.e., home hemodialysis training, or peritoneal dialysis training). (70) Statute--The Health and Safety Code, Chapter 251. (71) Supervising nurse (also may be known as the director of nursing)--A registered nurse who: (A) has at least 18 months experience as an RN, which includes at least 12 months experience in dialysis which has been obtained within the last 24 months; or (B) has at least 18 months experience as an RN, and holds a current certification from a nationally recognized board in nephrology nursing or hemodialysis. (72) Supervision--Authoritative procedural guidance by a qualified person for the accomplishment of a function or activity with initial direction and periodic inspection of the actual act of accomplishing the function or activity. Immediate supervision means the supervisor is actually observing the task or activity as it is performed. Direct supervision means the supervisor is on the premises but not necessarily immediately physically present where the task or activity is being performed. Indirect supervision means the supervisor is not on the premises but is accessible by two-way communication and able to respond to an inquiry when made, and is readily available for consultation. (73) Technical supervisor--The supervisor of the facility's mechanical, reuse and water treatment systems. (74) Training--The learning of tasks through on-the-job experience or instruction by an individual who has the capacity through education or experience to perform the task or activity to be delegated. (75) Ultrafilter--A membrane filter with a pore size in the range 0.001 to 0.05 micron (µm). Performance is usually rated in terms of a nominal molecular weight cut off (MWCO), which is defined as the smallest molecular weight species for which the filter membrane has more than 90% rejection. Ultrafilters with a nominal MWCO of 20,000 or less are generally adequate for endotoxin removal. (76) Water distribution systems--Components to include any storage tanks and piping used to distribute the product water from the purification cascade to or from its point of use, including individual hemodialysis machines, dialyzer reprocessing equipment, and dialysate concentrate preparation systems. (77) Water treatment system--A collection of water purification devices and associated piping, pumps, valves, gauges, etc., that together produce purified water for hemodialysis applications and deliver it to the point of use. (78) Working day--Any day of the calendar week excluding Saturday or Sunday or holidays.