Texas Register

TITLE 40 SOCIAL SERVICES AND ASSISTANCE
PART 1DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 97LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES
SUBCHAPTER AGENERAL PROVISIONS
RULE §97.2Definitions
ISSUE 09/08/2006
ACTION Proposed
Preamble No Rule Available

  (61)[(59)] Parent agency--An agency that develops and maintains administrative controls and provides supervision of branch offices and alternate delivery sites.

  (62)[(60)] Parent company--A person, other than an individual, who has a direct 100% ownership interest in the owner of an agency.

  (63)[(61)] Person--An individual, corporation, or association.

  (64)[(62)] Personal assistance services--Routine ongoing care or services required by an individual in a residence or independent living environment that enable the individual to engage in the activities of daily living or to perform the physical functions required for independent living, including respite services. The term includes:

    (A)personal care;

    (B)health-related services performed under circumstances that are defined as not constituting the practice of professional nursing by the Board of Nurse Examiners through a memorandum of understanding with DADS in accordance with Health and Safety Code, §142.016; and

    (C)health-related tasks provided by unlicensed personnel under the delegation of a registered nurse or that a registered nurse determines do not require delegation.

  (65)[(63)] Personal care--The provision of one or more of the following services required by an individual in a residence or independent living environment:

    (A)bathing;

    (B)dressing;

    (C)grooming;

    (D)feeding;

    (E)exercising;

    (F)toileting;

    (G)positioning;

    (H)assisting with self-administered medications;

    (I)routine hair and skin care; and

    (J)transfer or ambulation.

  (66)[(64)] Physical therapist--A person who is currently licensed under Occupations Code, Chapter 453, as a physical therapist.

  (67)[(65)] Physician--A person who holds a doctor of medicine or doctor of osteopathy degree and is currently licensed and practicing medicine under the laws of the state of Texas, Oklahoma, New Mexico, Arkansas, or Louisiana.

  (68)[(66)] Physician assistant--A person who is licensed under the Physician Assistant Licensing Act, Occupations Code, Chapter 204, as a physician assistant.

  (69)[(67)] Physician-delegated task--A task performed in accordance with the Occupations Code, Chapter 157, including orders signed by a physician that specify the delegated task, the individual to whom the task is delegated, and the client's name.

  (70)[(68)] Place of business--An office of a home and community support services agency that maintains client records or directs home health, hospice, or personal assistance services. This term includes a parent agency, a branch office, and an alternate delivery site. The term does not include an administrative support site.

  (71)[(69)] Plan of care--The written orders of a practitioner for a client who requires skilled services.

  (72)[(70)] Practitioner--A person who is currently licensed in a state in which the person practices as a physician, dentist, podiatrist, or a physician assistant, or a person who is a registered nurse registered with the Board of Nurse Examiners for the State of Texas as an advanced practice nurse.

  (73)[(71)] Presurvey conference--A conference held with DADS staff and the applicant or the applicant's representatives to review licensure standards and survey documents, and to provide consultation before the survey.

  (74)[(72)] Progress note--A dated and signed written notation by agency personnel summarizing facts about care and the client's response during a given period of time.

  (75)[(73)] Psychoactive treatment--The provision of a skilled nursing visit to a client with a psychiatric diagnosis under the direction of a physician that includes one or more of the following:

    (A)assessment of alterations in mental status or evidence of suicide ideation or tendencies;

    (B)teaching coping mechanisms or skills;

    (C)counseling activities; or

    (D)evaluation of the plan of care.

  (76)[(74)] Registered nurse (RN)--A person who is currently licensed under the Nursing Practice Act, Occupations Code, Chapter 301, as a registered nurse.

  (77)[(75)] Registered nurse delegation--Delegation by a registered nurse in accordance with:

    (A)22 TAC, Chapter 224 (concerning Delegation of Nursing Tasks by Registered Professional Nurses to Unlicensed Personnel for Clients with Acute Conditions or in Acute Care Environments); and

    (B)22 TAC, Chapter 225 (relating to RN Delegation to Unlicensed Personnel and Tasks Not Requiring Delegation in Independent Living Environments for Clients with Stable and Predictable Conditions).

  (78)[(76)] Residence--A place where a person resides, including a home, a nursing facility, a convalescent home, or a residential unit.

  (79)[(77)] Residential unit--A facility that provides living quarters and hospice services to clients admitted into the unit and that is in compliance with standards adopted under the Health and Safety Code, Chapter 142.

  (80)[(78)] Respiratory therapist--A person who is currently licensed under Occupations Code, Chapter 604, as a respiratory care practitioner.

  (81)[(79)] Respite services--Support options that are provided temporarily for the purpose of relief for a primary caregiver in providing care to individuals of all ages with disabilities or at risk of abuse or neglect.

  (82)[(80)] Section--A reference to a specific rule in this chapter.

  (83)[(81)] Service area--A geographic area established by an agency in which all or some of the agency's services are available.

  (84)[(82)] Skilled services--Services in accordance with a plan of care that require the skills of:

    (A)a registered nurse;

    (B)a licensed vocational nurse;

    (C)a physical therapist;

    (D)an occupational therapist;

    (E)a respiratory therapist;

    (F)a speech-language pathologist;

    (G)an audiologist;

    (H)a social worker; or

    (I)a dietitian.

  (85)[(83)] Social worker--A person who is currently licensed as a social worker under Occupations Code, Chapter 505.

  (86)[(84)] Speech-language pathologist--A person who is currently licensed as a speech-language pathologist under Occupations Code, Chapter 401.

  (87)[(85)] Statute--The Health and Safety Code, Chapter 142.

  (88)[(86)] Substantial compliance--A finding in which an agency receives no recommendation for enforcement action after a survey.

  (89)[(87)] Supervising nurse--The person responsible for supervising skilled services provided by an agency and who has the qualifications described in §97.244(c) [§97.244(b) ] of this chapter (relating to Administrator [Staffing ] Qualifications and Conditions and Supervising Nurse Qualifications ). This person may also be known as the director of nursing or similar title.

  (90)[(88)] Supervision--Authoritative procedural guidance by a qualified person for the accomplishment of a function or activity with initial direction and periodic inspection of the actual act of accomplishing the function or activity.

  (91)[(89)] Support services--Social, spiritual, and emotional care provided to a client and a client's family by a hospice.

  (92)[(90)] Survey--An on-site inspection or complaint investigation conducted by a DADS representative to determine if an agency is in compliance with the statute and this chapter or in compliance with applicable federal requirements or both.

  (93)[(91)] Terminal illness--An illness for which there is a limited prognosis if the illness runs its usual course.

  (94)[(92)] Unlicensed person--An individual who is not licensed as a health care professional. The term includes home health aides, medication aides permitted by DADS, and other individuals providing personal care or assistance in health services.

  (95)[(93)] Unsatisfied judgments--A failure to fully carry out the terms or meet the obligation of a court's final disposition on the matters before it in a suit regarding the operation of an agency.

  (96)[(94)] Violation--A finding of noncompliance with this chapter or the statute resulting from a survey.

  (97)[(95)] Volunteer--An individual who provides assistance to a home and community support services agency without compensation other than reimbursement for actual expenses.

  (98)[(96)] Working day--Any day except Saturday, Sunday, a state holiday, or a federal holiday.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on August 28, 2006

TRD-200604789

Kenneth L. Owens

General Counsel

Department of Aging and Disability Services

Earliest possible date of adoption: October 8, 2006

For further information, please call: (512) 438-3734



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