| (47) Family representative--An individual appointed
by the resident to represent the resident and other family members,
by formal or informal arrangement.
(48) Fiduciary agent--An individual who holds in trust
(49) Free choice--Unrestricted right to choose a qualified
provider of services.
(50) Goals--Long-term: general statements of desired
outcomes. Short-term: measurable time-limited, expected results that
provide the means to evaluate the resident’s progress toward
achieving long-term goals.
(51) Governmental unit--A state or a political subdivision
of the state, including a county or municipality.
(52) Health care provider--An individual, including
a physician, or facility licensed, certified, or otherwise authorized
to administer health care, in the ordinary course of business or professional
(53) Hearing--A contested case hearing held in accordance
with the Administrative Procedure Act, Texas Government Code, Chapter
2001, and the formal hearing procedures in 1 TAC Chapter 357, Subchapter
I (relating to Hearings Under the Administrative Procedure Act) and
Chapter 91 of this title (relating to Hearings Under the Administrative
(54) HHSC--The Texas Health and Human Services Commission.
(55) HIV--Human Immunodeficiency Virus.
(56) Incident--An abnormal event, including accidents
or injury to staff or residents, which is documented in facility reports.
An occurrence in which a resident may have been subject to abuse,
neglect, or exploitation must also be reported to HHSC.
(57) Indirect ownership interest--Any ownership or
membership interest in a person that has a direct ownership interest
in an applicant or license holder.
(58) Infection control--A program designed to prevent
the transmission of disease and infection in order to provide a safe
and sanitary environment.
(59) Inspection--Any on-site visit to or survey of
an institution by HHSC for the purpose of licensing, monitoring, complaint
investigation, architectural review, or similar purpose.
(60) Interdisciplinary care plan--See the definition
of "comprehensive care plan."
(61) Involuntary seclusion--Separation of a resident
from others or from the resident’s room or confinement to the
resident’s room, against the resident’s will or the will
of a person who is legally authorized to act on behalf of the resident.
Monitored separation from other residents is not involuntary seclusion
if the separation is a therapeutic intervention that uses the least
restrictive approach for the minimum amount of time, not exceed to
24 hours, until professional staff can develop a plan of care to meet
the resident’s needs.
(63) Legend drug or prescription drug--Any drug that
requires a written or telephonic order of a practitioner before it
may be dispensed by a pharmacist, or that may be delivered to a particular
resident by a practitioner in the course of the practitioner’s
(64) License holder--A person that holds a license
to operate a facility.
(65) Licensed health professional--A physician; physician
assistant; advanced practice registered nurse; physical, speech, or
occupational therapist; pharmacist; physical or occupational therapy
assistant; registered professional nurse; licensed vocational nurse;
licensed dietitian; or licensed social worker.
(66) Licensed nursing home (facility) administrator--A
person currently licensed by HHSC in accordance with Chapter 18 of
this title (relating to Nursing Facility Administrators).
(67) Licensed vocational nurse (LVN)--A nurse who is
currently licensed by the Texas Board of Nursing as a licensed vocational
(68) Life Safety Code--NFPA 101.
(69) Life safety features--Fire safety components required
by NFPA 101, including building construction, fire alarm systems,
smoke detection systems, interior finishes, sizes and thicknesses
of doors, exits, emergency electrical systems, and sprinkler systems.
(70) Life support--Use of any technique, therapy, or
device to assist in sustaining life. (See §19.419 of this chapter
(relating to Advance Directives)).
(71) Local authorities--Persons, including, but not
limited to, local health authority, fire marshal, and building inspector,
who may be authorized by state law, county order, or municipal ordinance
to perform certain inspections or certifications.
(72) Local health authority--The physician appointed
by the governing body of a municipality or the commissioner’s
court of the county to administer state and local laws relating to
public health in the municipality’s or county’s jurisdiction
as defined in Texas Health and Safety Code, §121.021.
(73) Long-term care-regulatory--HHSC Regulatory Services
Division, which is responsible for surveying nursing facilities to
determine compliance with regulations for licensure and certification
for Title XIX participation.
(74) Major injury--An injury that qualifies as a major
injury under NFPA 99.
(75) Manager--A person, other than a licensed nursing
home administrator, having a contractual relationship to provide management
services to a facility.
(76) 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 do not include
contracts solely for maintenance, laundry, or food service.
(77) MDS--Minimum data set. See Resident Assessment
(78) MDS nurse reviewer--A registered nurse employed
by HHSC to monitor the accuracy of the MDS assessment submitted by
a Medicaid-certified nursing facility.
(79) Medicaid applicant--A person who requests the
determination of eligibility to become a Medicaid recipient.
(80) Medicaid nursing facility vendor payment system--Electronic
billing and payment system for reimbursement to nursing facilities
for services provided to eligible Medicaid recipients.
(81) Medicaid recipient--A person who meets the eligibility
requirements of the Title XIX Medicaid program, is eligible for nursing
facility services, and resides in a Medicaid-participating facility.
(82) Medical director--A physician licensed by the
Texas Medical Board, who is engaged by the nursing home to assist
in and advise regarding the provision of nursing and health care.
(83) Medical power of attorney--The legal document
that designates an agent to make treatment decisions if the individual
designator becomes incapable.
(84) Medical-social care plan--See Interdisciplinary
(85) Medically related condition--An organic, debilitating
disease or health disorder that requires services provided in a nursing
facility, under the supervision of licensed nurses.
(86) Medication aide--A person who holds a current
permit issued under the Medication Aide Training Program as described
in Chapter 95 of this title (relating to Medication Aides--Program
Requirements) and acts under the authority of a person who holds a
current license under state law which authorizes the licensee to administer
(87) Misappropriation of funds--The taking, secretion,
misapplication, deprivation, transfer, or attempted transfer to any
person not entitled to receive any property, real or personal, or
anything of value belonging to or under the legal control of a resident
without the effective consent of the resident or other appropriate
legal authority, or the taking of any action contrary to any duty
imposed by federal or state law prescribing conduct relating to the
custody or disposition of property of a resident.
(88) MN--Medical necessity. A determination, made by
physicians and registered nurses who are employed by or contract with
the state Medicaid claims administrator, that a recipient requires
the services of a licensed nurse in an institutional setting to carry
out a physician's planned regimen for total care. A recipient's need
for custodial care in a 24-hour institutional setting does not constitute
(89) Neglect--The failure to provide goods or services,
including medical services that are necessary to avoid physical or
emotional harm, pain, or mental illness.
(90) NFPA--National Fire Protection Association.
(91) NFPA 99--NFPA 99, Health Care Facilities Code,
(92) NFPA 101--NFPA 101, Life Safety Code, 2012 Edition.
(93) NHIC--This term referred to the National Heritage
Insurance Corporation. It now refers to the state Medicaid claims
(94) Nonnursing personnel--Persons not assigned to
give direct personal care to residents; including administrators,
secretaries, activities directors, bookkeepers, cooks, janitors, maids,
laundry workers, and yard maintenance workers.
(95) Nurse aide--An individual who provides nursing
or nursing-related services to residents in a facility under the supervision
of a licensed nurse. This definition does not include an individual
who is a licensed health professional, a registered dietitian, or
someone who volunteers such services without pay. A nurse aide is
not authorized to provide nursing or nursing-related services for
which a license or registration is required under state law. Nurse
aides do not include those individuals who furnish services to residents
only as paid feeding assistants.
(96) Nurse aide trainee--An individual who is attending
a program teaching nurse aide skills.
(97) Nurse practitioner--An advanced practice registered
(98) Nurses’ station--A nurses' station is an
area designated as the focal point on all shifts for the administration
and supervision of resident-care activities for a designated number
of resident bedrooms.
(99) Nursing assessment--See definition of "comprehensive
assessment" and "comprehensive care plan."
(100) Nursing care--Services provided by nursing personnel
which include, but are not limited to, observation; promotion and
maintenance of health; prevention of illness and disability; management
of health care during acute and chronic phases of illness; guidance
and counseling of individuals and families; and referral to physicians,
other health care providers, and community resources when appropriate.
(101) Nursing facility/home--An institution that provides
organized and structured nursing care and service, and is subject
to licensure under Texas Health and Safety Code, Chapter 242. The
nursing facility may also be certified to participate in the Medicaid
Title XIX program. Depending on context, these terms are used to represent
the management, administrator, or other persons or groups involved
in the provision of care to the residents; or to represent the physical
building, which may consist of one or more floors or one or more units,
or which may be a distinct part of a licensed hospital.
(102) Nursing facility/home administrator--See the
definition of "licensed nursing home (facility) administrator."
(103) Nursing personnel--Persons assigned to give direct
personal and nursing services to residents, including registered nurses,
licensed vocational nurses, nurse aides, and medication aides. Unlicensed
personnel function under the authority of licensed personnel.
(104) Objectives--See definition of "goals."
(105) OBRA--Omnibus Budget Reconciliation Act of 1987,
which includes provisions relating to nursing home reform, as amended.
(106) Ombudsman--An advocate who is a certified representative,
staff member, or volunteer of the HHSC Office of the State Long Term
(107) Optometrist--An individual with the profession
of examining the eyes for defects of refraction and prescribing lenses
for correction who is licensed by the Texas Optometry Board.
(108) Paid feeding assistant--An individual who meets
the requirements of §19.1113 of this chapter (relating to Paid
Feeding Assistants) and who is paid to feed residents by a facility
or who is used under an arrangement with another agency or organization.
(109) PASARR or PASRR--Preadmission Screening and Resident
(110) Palliative Plan of Care--Appropriate medical
and nursing care for residents with advanced and progressive diseases
for whom the focus of care is controlling pain and symptoms while
maintaining optimum quality of life.
(111) Patient care-related electrical appliance--An
electrical appliance that is intended to be used for diagnostic, therapeutic,
or monitoring purposes in a patient care area, as defined in Standard
99 of the National Fire Protection Association.
(112) Person--An individual, firm, partnership, corporation,
association, joint stock company, limited partnership, limited liability
company, or any other legal entity, including a legal successor of
(113) Pharmacist--An individual, licensed by the Texas
State Board of Pharmacy to practice pharmacy, who prepares and dispenses
medications prescribed by a practitioner.