The following words and terms, when used in this chapter, have
the following meanings, unless the context clearly indicates otherwise.
(1)Accessible and flexible services--Services that
are delivered in the least intrusive manner possible and are provided
in all settings where individuals live, work, and recreate.
(2)Administration of medication--The direct application
of any medication by injection, inhalation, ingestion, or any other
means to the body of a client. The preparation of medication is part
of the administration of medication and is the act or process of making
ready a medication for administration, including the calculation of
a client's medication dosage; altering the form of the medication
by crushing, dissolving, or any other method; reconstitution of an
injectable medication; drawing an injectable medication into a syringe;
preparing an intravenous admixture; or any other act required to render
the medication ready for administration.
(3)Administrative support site--A facility or site
where an agency performs administrative and other support functions
but does not provide direct home health, hospice, or personal assistance
services. This site does not require an agency license.
(4)Administrator--The person who is responsible for
implementing and supervising the administrative polices and operations
of a home and community support services agency and for administratively
supervising the provision of all services to agency clients on a day-to-day
basis.
(5)ADS--Alternative delivery site.
A facility or site, including a residential unit or an inpatient unit:
(A)that is owned or operated by an agency providing
hospice services;
(B)that is not the hospice's principal place of business,
which for the purposes of this definition, means it is not the parent
agency;
(C)that is located in the geographical area served
by the hospice; and
(D)from which the hospice provides hospice services.
(6)[(5)] Advanced practice nurse--A
registered nurse who is approved by the Texas Board of Nursing to
practice as an advanced practice nurse and who maintains compliance
with the applicable rules of the Texas Board of Nursing. See the Texas
Board of Nursing's definition of advanced practice nurse in Title
22, Texas Administrative Code, (22 TAC) [22 TAC] §221.1.
(7)[(6)] Advisory committee--A
committee, board, commission, council, conference, panel, task force,
or other similar group, or any subcommittee or other subgroup, established
for the purpose of obtaining advice or recommendations on issues or
policies that are within the scope of a person's responsibility.
(8)[(7)] Affiliate--With respect
to an applicant or license holder that is:
(A)a corporation--means each officer, director, and
stockholder with direct ownership of at least 5.0 percent, subsidiary,
and parent company;
(B)a limited liability company--means each officer,
member, and parent company;
(C)an individual--means:
(i)the individual's spouse;
(ii)each partnership and each partner thereof of which
the individual or any affiliate of the individual is a partner; and
(iii)each corporation in which the individual is an
officer, director, or stockholder with a direct ownership or disclosable
interest of at least 5.0 percent.
(D)a partnership--means each partner and any parent
company; and
(E)a group of co-owners under any other business arrangement--means
each officer, director, or the equivalent under the specific business
arrangement and each parent company.
(9)[(8)] Agency--A home and
community support services agency.
[(9)Alternate delivery site (ADS)--A
facility or site, including a residential unit or an inpatient unit:]
[(A)that is owned or operated by an agency providing
hospice services;]
[(B)that is not the hospice's principal place of business,
which for the purposes of this definition, means it is not the parent
agency;]
[(C)that is located in the geographical area served
by the hospice; and]
[(D)from which the hospice provides hospice services.]
(10)Applicant--The owner of an agency that is applying
for a license under the statute. This is the person in whose name
the license will be issued.
(11)Assistance with self-administration of medication--Any
needed ancillary aid provided to a client in the client's self-administered
medication or treatment regimen, such as reminding a client to take
a medication at the prescribed time, opening and closing a medication
container, pouring a predetermined quantity of liquid to be ingested,
returning a medication to the proper storage area, and assisting in
reordering medications from a pharmacy. Such ancillary aid includes
administration of any medication when the client has the cognitive
ability to direct the administration of their medication and would
self-administer if not for a functional limitation.
(12)Association--A partnership, limited liability
company, or other business entity that is not a corporation.
(13)Audiologist--A person who is currently licensed
under the Texas Occupations Code, Chapter 401, as an audiologist.
(14)Bereavement--The process by which a survivor of
a deceased person mourns and experiences grief.
(15)Bereavement services--Support services offered
to a family during bereavement. Services may be provided to persons
other than family members, including residents of a skilled nursing
facility, nursing facility, or intermediate care facility for individuals
with an intellectual disability or related conditions, when appropriate
and identified in a bereavement plan of care.
(16)Biologicals--A medicinal preparation made from
living organisms and their products, including serums, vaccines, antigens,
and antitoxins.
(17)Boarding home facility--An establishment defined
in Texas Health and Safety Code §260.001(2).
(18)Branch office--A facility or site in the service
area of a parent agency from which home health or personal assistance
services are delivered or where active client records are maintained.
This does not include inactive records that are stored at an unlicensed
site.
(19)Care plan--
(A)a written plan prepared by the appropriate health
care professional for a client of the home and community support services
agency; or
(B)for home dialysis designation, a written plan developed
by the physician, registered nurse, dietitian, and qualified social
worker to personalize the care for the client and enable long- and
short-term goals to be met.
(20)Case conference--A conference among personnel
furnishing services to the client to ensure that their efforts are
coordinated effectively and support the objectives outlined in the
plan of care or care plan.
(21)Certified agency--A home and community support
services agency, or portion of the agency, that:
(A)provides a home health service; and
(B)is certified by an official of the Department of
Health and Human Services as in compliance with conditions of participation
in Social Security Act, Title XVIII (42 United States Code (USC) §1395
et seq.).
(22)Certified home health services--Home health services
that are provided by a certified agency.
(23)CFR--Code of Federal Regulations. The regulations
and rules promulgated by agencies of the Federal government that address
a broad range of subjects, including hospice care and home health
services.
(24)CHAP--Community Health Accreditation Program,
Inc. An independent, nonprofit accrediting body that publicly certifies
that an organization has voluntarily met certain standards for home
and community-based health care.
(25)Chief financial officer--An individual who is
responsible for supervising and managing all financial activities
for a home and community support services agency.
(26)Client--An individual receiving home health, hospice,
or personal assistance services from a licensed home and community
support services agency. This term includes each member of the primary
client's family if the member is receiving ongoing services. This
term does not include the spouse, significant other, or other family
member living with the client who receives a one-time service (for
example, vaccination) if the spouse, significant other, or other family
member receives the service in connection with the care of a client.
(27)Clinical note--A dated and signed written notation
by agency personnel of a contact with a client containing a description
of signs and symptoms; treatment and medication given; the client's
reaction; other health services provided; and any changes in physical
and emotional condition.
(28)CMS--Centers for Medicare and Medicaid Services.
The federal agency that administers the Medicare program and works
in partnership with the states to administer Medicaid.
(29)Complaint--An allegation against an agency regulated
by DADS or against an employee of an agency regulated by DADS that
involves a violation of this chapter or the statute.
(30)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.
(31)Controlling person--A person with the ability,
acting alone or with others, to directly or indirectly influence,
direct, or cause the direction of the management, expenditure of money,
or policies of an agency or other person.
(A)A controlling person includes:
(i)a management company or other business entity that
operates or contracts with others for the operation of an agency;
(ii)a person who is a controlling person of a management
company or other business entity that operates an agency or that contracts
with another person for the operation of an agency; and
(iii)any other individual who, because of a personal,
familial, or other relationship with the owner, manager, or provider
of an agency, is in a position of actual control or authority with
respect to the agency, without regard to whether the individual is
formally named as an owner, manager, director, officer, provider,
consultant, contractor, or employee of the agency.
(B)A controlling person, as described by subparagraph
(A)(iii) of this paragraph, does not include an employee, lender,
secured creditor, or other person who does not exercise formal or
actual influence or control over the operation of an agency.
(32)Conviction--An adjudication of guilt based on
a finding of guilt, a plea of guilty, or a plea of nolo contendere.
(33)Counselor--An individual qualified under Medicare
standards to provide counseling services, including bereavement, dietary,
spiritual, and other counseling services to both the client and the
family.
(34)DADS--Department of Aging and Disability Services.
(35)Day--Any reference to a day means a calendar day,
unless otherwise specified in the text. A calendar day includes weekends
and holidays.
(36)Deficiency--A finding of noncompliance with federal
requirements resulting from a survey.
(37)Designated survey office--A DADS Home and Community
Support Services Agencies Program office located in an agency's geographic
region.
(38)Dialysis treatment record--For home dialysis designation,
a dated and signed written notation by the person providing dialysis
treatment which contains a description of signs and symptoms, machine
parameters and pressure settings, type of dialyzer and dialysate,
actual pre- and post-treatment weight, medications administered as
part of the treatment, and the client's response to treatment.
(39)Dietitian--A person who is currently licensed
under the laws of the State of Texas to use the title of licensed
dietitian or provisional licensed dietitian, or who is a registered
dietitian.
(40)Disaster--The occurrence or imminent threat of
widespread or severe damage, injury, or loss of life or property resulting
from a natural or man-made cause, such as fire, flood, earthquake,
wind, storm, wave action, oil spill or other water contamination,
epidemic, air contamination, infestation, explosion, riot, hostile
military or paramilitary action, or energy emergency. In a hospice
inpatient unit, a disaster also includes failure of the heating or
cooling system, power outage, explosion, and bomb threat.
(41)ESRD--End stage renal disease. [
(ESRD)--]For home dialysis designation, the stage of renal impairment
that appears irreversible and permanent and requires a regular course
of dialysis or kidney transplantation to maintain life.
(42)Functional need--Needs of the individual that
require services without regard to diagnosis or label.
(43)Habilitation--Habilitation services,
as defined by Texas Government Code §534.001, provided by an
agency licensed under this chapter.
(44)[(43)] Health assessment--A
determination of a client's physical and mental status through inventory
of systems.
(45)[(44)] Home and community
support services agency--A person who provides home health, hospice,
habilitation, or personal assistance services for pay or other
consideration in a client's residence, an independent living environment,
or another appropriate location.
(46)[(45)] Home health aide--An
individual working for an agency who meets at least one of the requirements
for home health aides as defined in §97.701 of this chapter (relating
to Home Health Aides).
(47)[(46)] Home health medication
aide--An unlicensed person issued a permit by DADS to administer medication
to a client under the Texas Health and Safety Code, Chapter 142, Subchapter
B.
(48)[(47)] Home health service--The
provision of one or more of the following health services required
by an individual in a residence or independent living environment:
(A)nursing, including blood pressure monitoring and
diabetes treatment;
(B)physical, occupational, speech, or respiratory
therapy;
(C)medical social service;
(D)intravenous therapy;
(E)dialysis;
(F)service provided by unlicensed personnel under
the delegation or supervision of a licensed health professional;
(G)the furnishing of medical equipment and supplies,
excluding drugs and medicines; or
(H)nutritional counseling.
(49)[(48)] Hospice--A person
licensed under this chapter to provide hospice services, including
a person who owns or operates a residential unit or an inpatient unit.
(50)[(49)] Hospice aide--A person
working for an agency licensed to provide hospice services who meets
the qualifications for a hospice aide as described in §97.843
of this chapter (relating to Hospice Aide Qualifications).
(51)[(50)] Hospice homemaker--A
person working for an agency licensed to provide hospice services
who meets the qualifications described in §97.845 of this chapter
(relating to Hospice Homemaker Qualifications).
(52)[(51)] Hospice services--Services,
including services provided by unlicensed personnel under the delegation
of a registered nurse or physical therapist, provided to a client
or a client's family as part of a coordinated program consistent with
the standards and rules adopted under this chapter. These services
include palliative care for terminally ill clients and support services
for clients and their families that:
(A)are available 24 hours a day, seven days a week,
during the last stages of illness, during death, and during bereavement;
(B)are provided by a medically directed interdisciplinary
team; and
(C)may be provided in a home, nursing facility, residential
unit, or inpatient unit according to need. These services do not include
inpatient care normally provided in a licensed hospital to a terminally
ill person who has not elected to be a hospice client. For the purposes
of this definition, the word "home" includes a person's "residence"
as defined in this section.
(53)[(52)] Independent living
environment--A client's residence, which may include a group home,
foster home, or boarding home facility, or other settings where a
client participates in activities, including school, work, or church.
(54)[(53)] Individual and family
choice and control--Individuals and families who express preferences
and make choices about how their support service needs are met.
Cont'd...
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