| (i) assess the individual's need for care in a NF;
(ii) assess the individual's need for specialized services;
and
(iii) identify alternate placement options.
(42) Physical abuse--Any of the following:
(A) an act or failure to act performed knowingly, recklessly,
or intentionally, including incitement to act, that caused physical
injury or death to a designated resident or placed a designated resident
at risk of physical injury or death;
(B) an act of inappropriate or excessive force or corporal
punishment, regardless of whether the act results in a physical injury
to a designated resident;
(C) the use of a restraint on a designated resident
not in compliance with federal and state laws and rules; or
(D) seclusion.
(43) Physical restraint--Any manual method used to
control a designated resident's behavior, except for physical guidance
or prompting of brief duration that a designated resident does not
resist, that restricts:
(A) the free movement or normal functioning of all
or a part of the designated resident's body; or
(B) normal access by a designated resident to a portion
of the designated resident's body.
(44) Plan of care--A written plan that includes:
(A) the IHSS required by the NF baseline or comprehensive
care plan;
(B) the frequency, amount, and duration of each IHSS
to be provided for the designated resident during a plan year; and
(C) the services and supports to be provided for the
designated resident through resources other than PASRR.
(45) Plan year--A 12-month period starting on the date
of the initial or annual IDT meeting. A revised or transfer plan of
care does not change the begin or end date of a plan year.
(46) Renewal plan of care--A plan of care developed
for a designated resident in accordance with §368.302(a) of this
chapter (relating to Renewal and Revision of a Plan of Care).
(47) Restraint--Any of the following:
(A) a physical restraint;
(B) a mechanical restraint; or
(C) a chemical restraint.
(48) Revised plan of care--An initial or renewal plan
of care that is revised during a plan year in accordance with §368.302(b)
of this chapter to add a new IHSS or change the frequency, amount,
or duration of an existing IHSS.
(49) Seclusion--The involuntary placement of a designated
resident alone in an area from which the designated resident is prevented
from leaving.
(50) Service provider agency--An entity that has a
contract with HHSC to provide IHSS for a designated resident.
(51) Sexual abuse--Any of the following:
(A) sexual exploitation of a designated resident;
(B) non-consensual or unwelcomed sexual activity with
a designated resident; or
(C) consensual sexual activity between a designated
resident and an individual service provider, staff member, volunteer,
or controlling person, unless a consensual sexual relationship with
an adult designated resident existed before the individual service
provider, staff member, volunteer, or controlling person became an
individual service provider, staff member, volunteer, or controlling
person.
(52) Sexual activity--An activity that is sexual in
nature, including kissing, hugging, stroking, or fondling with sexual
intent.
(53) Sexual exploitation--A pattern, practice, or scheme
of conduct against a designated resident that can reasonably be construed
as being for the purposes of sexual arousal or gratification of any
individual:
(A) which may include sexual contact; and
(B) does not include obtaining information about a
designated resident's sexual history within standard accepted clinical
practice.
(54) SPT--Service planning team, as defined in §303.102
of this title.
(55) Staff member--An employee or contractor of a service
provider agency.
(56) Surrogate decision maker--An actively involved
person who has been identified by an IDT in accordance with Texas
Health and Safety Code §313.004 and who is available and willing
to consent to medical treatment on behalf of the designated resident.
(57) TAC--Texas Administrative Code.
(58) TMHP--Texas Medicaid and Healthcare Partnership.
(59) Transfer plan of care--An initial or renewal plan
of care that is revised during a plan year in accordance with §368.501
of this chapter (relating to Transfer between Service Provider Agencies)
to change the service provider agency selected by the designated resident
or LAR.
(60) Transition plan--A plan, defined in §303.102
of this title.
(61) Vendor hold--A temporary suspension of payments
that are due to a service provider agency under a contract.
(62) Verbal or emotional abuse--Any act or use of verbal
or other communication, including gestures:
(A) to:
(i) harass, intimidate, humiliate, or degrade a designated
resident; or
(ii) threaten a designated resident with physical or
emotional harm; and
(B) that:
(i) results in observable distress or harm to the designated
resident; or
(ii) is of such a serious nature that a reasonable
individual would consider it harmful or a cause of distress.
(63) Volunteer--An individual who works for a service
provider agency without compensation, other than reimbursement for
actual expenses.
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