(B) a regional director of DSHS if no physician has
been appointed by the local government.
(35) 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.
(36) Hearing--A contested case hearing held in accordance
with the APA and the formal hearing procedures in 1 TAC Chapter 357,
Subchapter I(relating to Hearings Under the Administrative Procedure
Act).
(37) HHSC--The Texas Health and Human Services Commission.
(38) HVAC--Heating, ventilating, and air-conditioning
system.
(39) ICF/IID--An Intermediate Care Facility for Individuals
with an Intellectual Disability or Related Conditions.
(40) IDT--Interdisciplinary Team.
(41) Immediate jeopardy to health and safety of a resident--A
situation in which immediate corrective action is necessary because
the facility's noncompliance with one or more federal requirements
has caused, or is likely to cause, serious injury, harm, impairment,
or death to a resident receiving care in the certified facility.
(42) 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 because of the
facility's noncompliance with one or more licensure requirements.
(43) Incident--An unusual or abnormal event or occurrence
in, at, or affecting the facility or the residents of the facility.
(44) Indirect ownership interest--Any ownership or
membership interest in a person who has a direct ownership interest
in an applicant or license holder.
(45) 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.
(46) Individual program plan (IPP)--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.
(47) Isolated--A situation in which a very limited
number of residents are affected and a very limited number of staff
are involved, or the situation has occurred only occasionally.
(48) Key infectious agents--Bacteria, viruses, and
other microorganisms that cause the most common infections and infectious
diseases in long-term care facilities, according to the CDC, and can
be prevented by establishing, implementing, maintaining, and enforcing
proper infection prevention and control policies and procedures.
(49) Legally authorized representative (LAR)--A person
authorized by law to act on behalf of a person regarding a matter
described in this chapter, and may include a parent, guardian, or
managing conservator of a minor, or the guardian of an adult.
(50) Large facility--A facility with a capacity of
17 or more residents.
(51) License--Approval from HHSC to establish or operate
a facility.
(52) License holder--A person who holds a license to
operate a facility.
(53) Licensed nurse--A licensed vocational nurse, registered
nurse, or advanced practice nurse.
(54) LIDDA--Local intellectual and developmental disability
authority.
(55) Life Safety Code--NFPA 101.
(56) 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, and sprinkler systems.
(57) 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.
(58) 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,
Chapter 121, Subchapter B.
(59) Licensed vocational nurse(LVN)--A person licensed
to practice vocational nursing in accordance with Texas Occupations
Code, Chapter 301.
(60) Metered dose inhaler--A device that delivers a
measured amount of medication as a mist that can be inhaled.
(61) Multidrug-resistant organisms--Bacteria and other
microorganisms that have developed resistance to multiple types of
medicine used to act against the microorganism.
(62) NAR--Nurse Aide Registry.
(63) 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.
(64) NFPA 10--NFPA 10, Standard for Portable Fire Extinguishers,
2010 Edition.
(65) NFPA 13--NFPA 13, Standard for the Installation
of Sprinkler Systems, 2010 Edition.
(66) NFPA 13D--NFPA 13D, Standard for the Installation
of Sprinkler Systems in One- and Two-Family Dwellings and Manufactured
Homes, 2010 Edition.
(67) NFPA 13R--NFPA 13R, Standard for the Installation
of Sprinkler Systems in Residential Occupancies up to and Including
Four Stories in Height, 2010 Edition.
(68) NFPA 25--NFPA 25, Standard for the Inspection,
Testing, and Maintenance of Water-Based Fire Protection Systems, 2011
Edition.
(69) NFPA 37--NFPA 37, Standard for the Installation
and Use of Stationary Combustion Engines and Gas Turbines, 2010 Edition.
(70) NFPA 70--NFPA 70, National Electrical Code, 2011
Edition.
(71) NFPA 72--NFPA 72, National Fire Alarm and Signaling
Code, 2010 Edition.
(72) NFPA 90A--NFPA 90A, Standard for the Installation
of Air-Conditioning and Ventilating Systems, 2012 Edition.
(73) NFPA 90B--NFPA 90B, Standard for the Installation
of Warm Air Heating and Air-Conditioning Systems, 2012 Edition.
(74) 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.
(75) 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.
(76) NFPA 101A--NFPA 101A, Guide on Alternative Approaches
to Life Safety, 2013 Edition.
(77) NFPA 220--NFPA 220, Standard on Types of Building
Construction, 2012 Edition.
(78) NFPA 701--NFPA 701, Standard Methods of Fire Tests
for Flame Propagation of Textiles and Films, 2010 Edition.
(79) Online Portal--Texas Unified Licensure Information
Portal (TULIP).
(80) Oral medication--Medication administered by way
or through the mouth, not including sublingual or buccal.
(81) 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.
(82) Person--An individual, firm, partnership, corporation,
association, or joint stock company, and any legal successor of those
entities.
(83) 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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