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The following words and terms, when used in this chapter, have the following meanings unless the context clearly indicates otherwise. (1)Active Play--Any physical activity from which a minor derives amusement, entertainment, enjoyment, or satisfaction by taking a participatory rather than a passive role. Active play includes various forms of activities, from the exploration of objects and toys to the structured play of formal games, sports, and hobbies. (2)Actual census--The number of minors at a center at any given time. (3)Administration of medication--The direct application of a medication to the body of a minor by any route. This includes removing an individual or unit dose from a previously dispensed, correctly labeled container, verifying it with the medication order, giving the correct medication and the correct dose to the correct minor at the correct time by the correct route, and accurately recording the time and dose given. (4)Administrator--The person who is responsible for implementing and supervising the administrative polices and operations of a center and for administratively supervising the provision of services to minors and their parents on a day-to-day basis. (5)Adult minor--A minor who is 18 years of age or older or is emancipated, and has not been adjudged incompetent. (6)Affiliate--With respect to an applicant or license holder that is: (A)a corporation--means an officer, director, or stockholder with direct ownership or disclosable interest of at least five percent, a subsidiary, or a parent company; (B)a limited liability company--means an officer, member, or parent company; (C)an individual--means: (i)the individual's spouse; (ii)each partnership and each partner thereof of which an individual or any affiliate of an individual is a partner; and (iii)each corporation in which an individual is an officer, director, or stockholder with a direct ownership of at least five percent; (D)a partnership--means a partner or a parent company of the partnership; and (E)a group of co-owners under any other business arrangement means an officer, director, or the equivalent under the specific business arrangement or a parent company. (7)Applicant--A person who applies for a license under THSC Chapter 248A and this chapter. The applicant is the person in whose name DADS issues the license. (8)Audiologist--A person who has a valid license under Texas Occupations Code, Chapter 401, as an audiologist. (9)Basic services--Include: (A)the development, implementation, and monitoring of a comprehensive protocol of care that: (i)is provided to a medically dependent or technologically dependent minor; (ii)is developed in conjunction with the minor's parent; and (iii)specifies the medical, nursing, psychosocial, therapeutic, and developmental services required by the minor; and (B)the caregiver training needs of a medically dependent or technologically dependent minor's parent. (10)Behavioral emergency--A situation that occurs after which preventative, or de-escalating techniques are attempted and determined to be ineffective and it is immediately necessary to restrain a minor to prevent immediate probable death or substantial bodily harm to the minor or to others because the minor is attempting serious bodily harm or immediate physical harm to the minor or to others. (11)Business day--Any day except a national or state holiday listed in Texas Government Code §662.003(a) or (b). The term includes Saturday or Sunday if the center is open on that day. (12)Center--A prescribed pediatric extended care center. A facility operated for profit or on a nonprofit basis that provides nonresidential basic services to four or more medically dependent or technologically dependent minors who require the services of the facility and who are not related by blood, marriage, or adoption to the owner or operator of the facility. (13)Chemical restraint--The use of any chemical, including pharmaceuticals, through topical application, oral administration, injection, or other means, to restrict the free movement of all or a portion of a minor's body for the purpose of modifying or controlling the minor's behavior and which is not a standard treatment for a minor's medical or psychosocial condition. (14)Chief financial officer--An individual who is responsible for supervising and managing all financial activities for a center. (15)Clinical note--A notation of a contact with a minor or a minor's family member that is written and dated by any staff providing services on behalf of a center and that describes signs and symptoms of the minor, and treatments and medications administered to the minor, including the minor's reaction or response, and any changes in physical, emotional, psychosocial, or spiritual condition of the minor during a given period of time. (16)Commission--The Texas Health and Human Services Commission. (17)Commissioner--The commissioner of the Department of Aging and Disability Services (DADS). (18)Community disaster resources--A local, statewide, or nationwide emergency system that provides information and resources during a disaster, including weather information, transportation, evacuation and shelter information, disaster assistance and recovery efforts, evacuee and disaster victim resources, and resources for locating evacuated friends and relatives. (19)Complaint--An allegation against a center or involving services provided at a center that involves a violation of this chapter or THSC Chapter 248A. (20)Continuous face-to-face observation--Maintaining an in-person line of sight of a minor that is uninterrupted and free from distraction. (21)Contractor--An individual providing services ordered by a prescribing physician on behalf of a center that the center would otherwise provide by its employees. (22)Controlling person--A person who has the ability, acting alone or in concert with others, to directly or indirectly influence, direct, or cause the direction of the management of, expenditure of money for, or policies of a center or other person. (A)A controlling person includes: (i)a management company, landlord, or other business entity that operates or contracts with another person for the operation of a center; (ii)any person who is a controlling person of a management company or other business entity that operates a center or that contracts with another person for the operation of a center; and (iii)any other person who, because of a personal, familial, or other relationship with the owner, manager, landlord, tenant, or provider of a center, is in a position of actual control of or authority with respect to the center, regardless of whether the person is formally named as an owner, manager, director, officer, provider, consultant, contractor, or employee of the center. (B)Notwithstanding any other provision of this paragraph, a controlling person of a center or of a management company or other business entity described by subparagraph (A)(i) of this paragraph that is a publicly traded corporation or is controlled by a publicly traded corporation means an officer or director of the corporation. The term does not include a shareholder or lender of the publicly traded corporation. (C)A controlling person described by subparagraph (A)(iii) of this paragraph does not include a person, including an employee, lender, secured creditor, or landlord, who does not exercise any formal or actual influence or control over the operation of the center. (23)Conviction--An adjudication of guilt based on a finding of guilt, a plea of guilty, or a plea of nolo contendere. (24)DADS--Department of Aging and Disability Services. (25)Daily census--The number of minors served at a center during a center's hours of operation for a 24-hour period, starting at midnight. (26)Day--A calendar day, unless otherwise specified in the text. A calendar day includes Saturday, Sunday, and a holiday. (27)Dietitian--A person who has a valid license under the Licensed Dietitian Act, Texas Occupations Code, Chapter 701, as a licensed dietitian or provisional licensed dietitian, or who is registered as a dietitian by the Commission on Dietetic Registration of the American Dietetic Association. (28)Emergency situation--An impending or actual situation that: (A)interferes with normal activities of a center or minors at a center; (B)may: (i)cause injury or death to a minor or individual at the center; or (ii)cause damage to the center's property; (C)requires the center to respond immediately to mitigate or avoid injury, death, damage, or interference; and (D)does not include a situation that arises from the medical condition of a minor such as cardiac arrest, obstructed airway, or cerebrovascular accident. (29)Executive commissioner--The executive commissioner of the Texas Health and Human Services Commission. (30)Functional assessment--An evaluation of a minor's abilities, wants, interests, and needs related to self-care, communication skills, social skills, motor skills, play with toys or objects, growth, and development appropriate for age. (31)Health care provider--An individual or facility licensed, certified, or otherwise authorized to administer health care in the ordinary course of business or professional practice. (32)Health care setting--A location at which licensed, certified, or otherwise regulated health care is administered. (33)IDT--Interdisciplinary team. Individuals who work together to meet the medical, nursing, psychosocial, and developmental needs of a minor and a minor's parent's training needs. (34)Inactive medical record--A record for a minor who was admitted by a center to receive services and was subsequently discharged by the center. (35)Inspection--An on-site examination or audit of a center by DADS to determine compliance with THSC Chapter 248A and this chapter. (36)Isolation--The involuntary confinement of a minor in a room of a center for the purposes of infection control, assessment, and observation away from other minors in a room at the center. When in isolation, a minor is physically prevented from contact with other minors. (37)Joint training--Training provided by DADS to service providers and DADS inspectors on subjects that address the 10 most commonly cited violations of state law governing centers, as published in DADS annual reports. DADS determines the frequency of joint training. (38)Licensed assistant in speech-language pathology--A person who has a valid license under Texas Occupations Code, Chapter 401, as a licensed assistant in speech-language pathology and who provides speech language support services under the supervision of a licensed speech-language pathologist. (39)Licensed vocational nurse--LVN. A person who has a valid license under Texas Occupations Code, Chapter 301, as a licensed vocational nurse. (40)Life Safety Code--A publication of the National Fire Protection Association (NFPA), also known as NFPA 101, 2000 edition. (41)Local emergency management agencies--The local emergency management coordinator, fire, police, and emergency medical services. (42)Local emergency management coordinator--The person identified as the emergency management coordinator by the mayor or county judge for the geographical area in which a center is located. (43)Mechanical restraint--The use of any mechanical device, material, or equipment to restrict the free movement of all or a portion of a minor's body for the purpose of modifying or controlling the minor's behavior. (44)Medical director--A physician who has the qualifications described in §15.307 of this chapter (relating to Medical Director Qualifications and Conditions) and has the responsibilities described in §15.308 of this chapter (relating to Medical Director Responsibilities). (45)Medical record--A record composed first-hand for a minor who has or is receiving services at a center. (46)Medically dependent or technologically dependent--The condition of an individual who, because of an acute, chronic, or intermittent medically complex or fragile condition or disability, requires ongoing, technology-based skilled nursing care prescribed by a physician to avert death or further disability, or the routine use of a medical device to compensate for a deficit in a life-sustaining body function. The term does not include a controlled or occasional medical condition that does not require continuous nursing care, including asthma or diabetes, or a condition that requires an epinephrine injection. (47)Medication administration record--A record used to document the administration of a minor's medications and pharmaceuticals. (48)Medication list--A list that includes all prescriptions, over-the-counter pharmaceuticals, and supplements that a minor is prescribed or taking, including the dosage, preparation, frequency, and the method of administration. (49)Minor--An individual younger than 21 years of age who is medically dependent or technologically dependent. (50)Mitigation--An action taken to eliminate or reduce the probability of an emergency or public health emergency, or reduce an emergency's severity or consequences. (51)Nursing director--The individual responsible for supervising skilled services provided at a center and who has the qualifications described in §15.309 of this chapter (relating to the Nursing Director and Alternate Nursing Director Qualifications and Conditions). (52)Nutritional counseling--Advising and assisting an adult minor or a minor's parent or family on appropriate nutritional intake by integrating information from a nutrition assessment with information on food and other sources of nutrients and meal preparation consistent with cultural background and socioeconomic status, with the goal being health promotion, disease prevention, and nutrition education. The term includes: (A)dialogue with an adult minor or a minor's parent to discuss current eating habits, exercise habits, food budget, and problems with food preparation; (B)discussion of dietary needs to help an adult minor or the minor's parent understand why certain foods should be included or excluded from the minor's diet and to help with adjustment to the new or revised or existing diet plan; (C)a personalized written diet plan as ordered by the minor's physician, to include instructions for implementation; (D)providing the adult minor or the minor's parent with motivation to help them understand and appreciate the importance of the diet plan in getting and staying healthy; or (E)working with the adult minor or the minor's parent by recommending ideas for meal planning, food budget planning, and appropriate food gifts. (53)Occupational therapist--A person who has a valid license under Texas Occupations Code, Chapter 454, as an occupational therapist. (54)Occupational therapy assistant--A person who has a valid license under Texas Occupations Code, Chapter 454, as an occupational therapy assistant who assists in the practice of occupational therapy under the general supervision of an occupational therapist. (55)Operating hours--The days of the week and the hours of day a center is open for services to a minor as identified in a center's written policy as required by §15.201 of this chapter (relating to Operating Hours). (56)Overnight--The hours between 9:00 p.m. and 5:00 a.m. during the days of the week a center operates. (57)Over-the-counter pharmaceuticals--A drug or formulary for which a physician's prescription is not needed for purchase or administration. (58)Parent--A person authorized by law to act on behalf of a minor with regard to a matter described in this chapter. The term includes: (A)a biological, adoptive, or foster parent; (B)a guardian; (C)a managing conservator; and (D)a non-parent decision-maker as authorized by Texas Family Code §32.001. (59)Parent company--A person, other than an individual, who has a direct 100 percent ownership interest in the owner of a center. (60)Person--An individual, firm, partnership, corporation, association, or joint stock association, and the legal successor thereof. (61)Person with a disclosable interest--A person who owns at least a five percent interest in any corporation, partnership, or other business entity that is required to be licensed under THSC Chapter 248A. A person with a disclosable interest does not include a bank, savings and loan, savings bank, trust company, building and loan association, credit union, individual loan and thrift company, investment banking firm, or insurance company, unless these entities participate in the management of the center. (62)Personal care services--Services required by a minor, including: (A)bathing; (B)maintaining personal hygiene; (C)routine hair and skin care; (D)grooming; (E)dressing; (F)feeding; (G)eating; Cont'd...
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