26 Tex. Admin. Code § 551.3 - Definitions
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise. Individual subchapters may have definitions that are specific to the subchapter.
(1) Active treatment--A
continuous program, which includes aggressive, consistent implementation of
specialized and generic training, treatment, health services, and related
services, that is directed toward:
(A)
acquisition of the behaviors necessary for the resident to function with as
much self-determination and independence as possible; and
(B) prevention or deceleration of regression
or loss of current optimal functional status.
(2) Actual harm--A negative outcome that
compromises a resident's physical, mental, or emotional well-being.
(3) Addition--The addition of floor space to
a facility.
(4) Administrator--The
administrator of a facility.
(5)
Administration of medication--Removing a unit or dose of medication from a
previously dispensed, properly labeled container; verifying the medication with
the medication order; giving the proper medication in the proper dosage to the
proper resident at the proper time by the proper administration route; and
recording the time of administration and dosage administered.
(6) Advanced practice nurse--A person
licensed to practice professional nursing in accordance with Texas Occupations
Code, Chapter 301, and authorized by the Texas Board of Nursing to practice as
an advanced practice nurse.
(7)
Applicant--A person applying for a license under Texas Health and Safety Code,
Chapter 252.
(8) Administrative
Procedure Act (APA)--Texas Government Code, Chapter 2001.
(9) Behavioral emergency--A situation in
which severely aggressive, destructive, violent, or self-injurious behavior
exhibited by a resident:
(A) poses a
substantial risk of imminent probable death of, or substantial bodily harm to,
the resident or others;
(B) has not
abated in response to attempted preventive de-escalatory or redirection
techniques;
(C) is not addressed in
a behavior therapy program; and
(D)
does not occur during a medical or dental procedure.
(10) Care and treatment--Services required to
maximize resident independence, personal choice, participation, health,
self-care, psychosocial functioning, and provide reasonable safety, all
consistent with the preferences of the resident.
(11) CDC--Centers for Disease Control and
Prevention.
(12) 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.
(13) CFR--Code of
Federal Regulations.
(14)
CMS--Centers for Medicare & Medicaid Services. The federal agency that
provides funding and oversight for the Medicare and Medicaid
programs.
(15) Communicable
disease--An illness due to an infectious agent or its toxic products that is
transmitted directly to a well person from an infected person or animal, or
indirectly through an intermediate plant or animal host, vector, or the
inanimate environment.
(16)
Controlled substance--A drug, substance, or immediate precursor as defined in
the Texas Controlled Substances Act, Texas Health and Safety Code, Chapter 481,
as amended, or the Federal Controlled Substances Act, United States Code, Title
21, Chapter 13, as amended.
(17)
Controlling person of an applicant, license holder, or facility--A person who,
acting alone or with others, has the ability to directly or indirectly
influence or direct the management, expenditure of money, or policies of an
applicant or license holder or of a facility owned by an applicant or license
holder.
(A) The term includes:
(i) a spouse of the applicant or license
holder;
(ii) an officer or
director, if the applicant or license holder is a corporation;
(iii) a partner, if the applicant or license
holder is a partnership;
(iv) a
trustee or trust manager, if the applicant or license holder is a
trust;
(v) a person who operates or
contracts with others to operate the facility;
(vi) a person who, because of a personal,
familial, or other relationship is in a position of actual control or authority
over the facility, without regard to whether the person is formally named as an
owner, manager, director, officer, provider, consultant, contractor, or
employee of the facility; and
(vii)
a person who would be a controlling person of an entity described in clauses
(i) - (vi) of this subparagraph, if that entity were the applicant or license
holder.
(B) The term 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 a
facility.
(18)
CPR--cardiopulmonary resuscitation.
(19) Dangerous drug--Any drug as defined in
the Texas Dangerous Drug Act, Texas Health and Safety Code, Chapter
483.
(20) Designee--A state agency
or entity with which HHSC contracts to perform specific, identified duties
related to the fulfillment of a responsibility prescribed by this
chapter.
(21) DFPS--Texas
Department of Family and Protective Services.
(22) Direct ownership interest--Ownership of
equity in the capital, stock, or profits of, or a membership interest in, an
applicant or license holder.
(23)
Disclosable interest--Five percent or more direct or indirect ownership
interest in an applicant or license holder.
(24) Drug (also referred to as medication)--A
drug is:
(A) any substance recognized as a
drug in the official United States Pharmacopeia, official Homeopathic
Pharmacopeia of the United States, or official National Formulary, or any
supplement to any of them;
(B) any
substance intended for use in the diagnosis, cure, mitigation, treatment, or
prevention of disease in a person;
(C) any substance (other than food) intended
to affect the structure or any function of the human body; or
(D) any substance intended for use as a
component of any substance specified in subparagraphs (A) - (C) of this
paragraph. It does not include devices or their components, parts, or
accessories.
(25)
DSHS--Texas Department of State Health Services.
(26) EMC--Emergency Management
Coordinator.
(27) EPC--Emergency
Preparedness Coordinator.
(28)
Emergency situation--an impending or actual situation that:
(A) may interfere with normal activities of a
facility or its residents;
(B) may
cause:
(i) injury or death to a resident or
staff member of the facility; or
(ii) damage to facility property;
(C) requires the facility 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 resident such
as cardiac arrest, obstructed airway, or cerebrovascular accident.
(29) EMR--Employee Misconduct
Registry.
(30) Establishment--A
place of business or a place where business is conducted which includes staff,
fixtures, and property.
(31)
Facility--A facility serving persons with an intellectual disability or related
conditions licensed under this chapter as described in §
551.2 of this chapter (relating to
Scope) and required to be licensed under Texas Health and Safety Code, Chapter
252, or the entity that operates such a facility; or, in Subchapters C, D, and
F of this chapter, a program provider that must comply with those subchapters
in accordance with §
261.212 of this title (relating to
Non-licensed Providers Meeting Licensure Standards).
(32) Governmental unit--A state or a
political subdivision of the state, including a county or
municipality.
(33) Guardian--A
person who is appointed guardian under Texas Estates Code, Chapter
1101.
(34) Health authority--A
physician designated to administer state and local laws relating to public
health under the Local Public Health Reorganization Act, Texas Health and
Safety Code, Chapter 121. The health authority may be:
(A) a local health authority appointed by the
local government jurisdiction; or
(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 licenseholder.
(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
(ii) normal access by a resident to a portion
of the resident's body.
(B) Physical guidance or prompting of brief
duration becomes a restraint if the resident resists the guidance or
prompting.
(84) Potential
for minimal harm--A violation that has the potential for causing no more than a
minor negative impact on a resident.
(85) Potential for more than minimal harm--A
violation that results in more than minimal physical, mental, or psychological
discomfort to the resident or has the potential to compromise the resident's
ability to reach and maintain the highest practicable physical, mental, and
psychosocial well-being as defined for the resident.
(86) Qualified intellectual disability
professional (QIDP)--A person who has at least one year of experience working
directly with persons with an intellectual disability or related conditions and
is one of the following:
(A) a doctor of
medicine or osteopathy;
(B) a
registered nurse; or
(C) an
individual who holds at least a bachelor's degree in one of the following
areas:
(i) occupational therapy;
(ii) physical therapy;
(iii) social work;
(iv) speech-language pathology or audiology;
(v) recreation or a specialty area
such as art, dance, music or physical education;
(vi) dietetics; or
(vii) human services, such as sociology,
special education, rehabilitation counseling, or psychology (as specified in
42 CFR §
483.430(b)(5)(x).
(87) Rapid influenza diagnostic test--A test
administered to a person with flu-like symptoms that can detect the influenza
viral nucleoprotein antigen.
(88)
Receiving facility--A facility that has agreed to receive the residents of
another facility who are evacuated due to an emergency.
(89) Relocation--The new physical location of
a facility.
(90) Remodeling--The
construction, removal, or relocation of walls and partitions, or construction
of foundations, floors, or ceiling-roof assemblies, including expanding of
safety systems (e.g.., sprinkler systems, fire alarm systems), that will change
the existing plan and use areas of the facility.
(91) Renovation--The restoration to a former
better state by cleaning, repairing, or rebuilding (e.g., routine maintenance,
repairs, equipment replacement, painting).
(92) Resident--A person who resides in a
facility.
(93) Restraint--A manual
method, or a physical or mechanical device, material, or equipment, attached or
adjacent to the resident's body that the resident cannot remove easily, that
restricts freedom of movement or normal access to the resident's body. This
term includes a personal hold.
(94)
Registered nurse (RN)--A person licensed to practice professional nursing in
accordance with Texas Occupations Code, Chapter 301.
(95) Seclusion--The involuntary separation of
a resident away from other residents and the placement of the resident alone in
an area from which the resident is prevented from leaving.
(96) Small facility--A facility with a
capacity of 16 or fewer residents.
(97)
(98) Standards--The minimum conditions,
requirements, and criteria with which a facility will have to comply to be
licensed under this chapter.
(99)
TIA--Tentative Interim Amendment.
(100) TAC--Texas Administrative
Code.
(101) Topical
medication--Medication applied to the skin, not including medication
administered in the eyes.
(102)
Universal precautions--The use of barrier precautions by facility staff to
prevent direct contact with blood or other body fluids that are visibly
contaminated with blood.
(103)
Vaccine preventable diseases--The diseases included in the most current
recommendations of the Advisory Committee on Immunization Practices of the
CDC.
(104) Violation--Any
noncompliance with Texas Health and Safety Code, Chapter 252, or any rule under
this chapter.
(105) Well-recognized
church or religious denomination--An organization which has been granted a
tax-exempt status as a religious association from the state or federal
government.
(106) Widespread in
scope--A violation that:
(A) is pervasive
throughout the services provided by the facility; or
(B) that affects or has the potential to
affect a large portion of or all the residents of the facility.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.