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 to
operate a center under THSC Chapter 248A and this chapter. The applicant
is the person in whose name HHSC [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)Change of ownership--An event that results in
a change to the federal taxpayer identification number of the license
holder of a facility. The substitution of a personal representative
for a deceased license holder is not a change of ownership.
(14)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.
(15)Chief financial officer--An individual who is
responsible for supervising and managing all financial activities
for a center.
(16)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.
(17)Commission--The Texas Health and Human Services
Commission.
(18)Commissioner--The term referred to the commissioner
of DADS; it now refers to the executive commissioner of HHSC.
(19)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.
(20)Complaint--An allegation against a center or involving
services provided at a center that involves a violation of this chapter
or THSC Chapter 248A.
(21)Continuous face-to-face observation--Maintaining
an in-person line of sight of a minor that is uninterrupted and free
from distraction.
(22)Contractor--An individual providing services ordered
by a prescribing physician on behalf of a center that the center would
otherwise provide by its employees.
(23)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.
(24)Conviction--An adjudication of guilt based on
a finding of guilt, a plea of guilty, or a plea of nolo contendere.
(25)DADS--The term referred to the Department
of Aging and Disability Services; it now refers to HHSC [
or its successor agency].
(26)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.
(27)Day--A calendar day, unless otherwise specified
in the text. A calendar day includes Saturday, Sunday, and a holiday.
(28)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.
(29)Direct ownership interest--Ownership of equity
in the capital, stock, or profits of, or a membership interest in,
an applicant or license holder.
(30)Disclosable interest--Five percent or more direct
or indirect ownership interest in an applicant or license holder.
(31)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.
(32)Executive commissioner--The executive commissioner
of the Texas Health and Human Services Commission.
(33)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.
(34)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.
(35)Health care setting--A location at which licensed,
certified, or otherwise regulated health care is administered.
(36)HHSC-- The Texas Health and Human
Services Commission.
(37)[(36)] 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.
(38)[(37)] Inactive medical
record--A record for a minor who was admitted by a center to receive
services and was subsequently discharged by the center.
(39)[(38)] Indirect ownership
interest--Any ownership or membership interest in a person that has
a direct ownership interest in an applicant or license holder.
(40)[(39)] Inspection--An on-site
examination or audit of a center by HHSC [DADS]
to determine compliance with THSC Chapter 248A and this chapter.
(41)[(40)] 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.
(42)[(41)] Joint training--Training
provided by HHSC [DADS] to service providers
and HHSC [DADS] inspectors on subjects that
address the 10 most commonly cited violations of state law governing
centers, as published in HHSC [DADS] annual
reports. HHSC [DADS] determines the frequency
of joint training.
(43)[(42)] License--A license
to operate a center issued by HHSC [DADS] under
THSC, Chapter 248A, and this chapter. The term
includes initial, renewal, and temporary licenses unless specifically
stated otherwise.
(44)[(43)] 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.
(45)[(44)] License holder--A
person that holds a license to operate a center under THSC Chapter
248A and this chapter.
[(45)][Licensed vocational nurse--LVN.
A person who has a valid license under Texas Occupations Code, Chapter
301, as a licensed vocational nurse.]
(46)Life Safety Code--A publication of the National
Fire Protection Association (NFPA), also known as NFPA 101, 2000 edition.
(47)Local emergency management agencies--The local
emergency management coordinator, fire, police, and emergency medical
services.
(48)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.
(49)LVN--Licensed vocational nurse.
A person who has a valid license under Texas Occupations Code, Chapter
301, as a licensed vocational nurse.
(50)[(49)] 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.
(51)[(50)] 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).
(52)[(51)] Medical record--A
record composed first-hand for a minor who has or is receiving services
at a center.
(53)[(52)] 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.
(54)[(53)] Medication administration
record--A record used to document the administration of a minor's
medications and pharmaceuticals.
(55)[(54)] 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.
(56)[(55)] Minor--An individual
younger than 21 years of age who is medically dependent or technologically
dependent.
(57)[(56)] 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.
(58)[(57)] 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).
(59)[(58)] 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
Cont'd...
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