26 Tex. Admin. Code § 553.3 - Definitions
The following words and terms, when used in this chapter, have the following meaning, unless the context clearly indicates otherwise.
(1) Abuse--
(A) For a person under 18 years of age who is
not and has not been married or who has not had the disabilities of minority
removed for general purposes, the term has the meaning in Texas Family Code
§
261.001(1),
which is an intentional, knowing, or reckless act or omission by an employee,
volunteer, or other individual working under the auspices of a facility or
program that causes or may cause emotional harm or physical injury to, or the
death of, a child served by the facility or program, as further described by
rule or policy; and
(B) For a
person other than one described in subparagraph (A) of this paragraph, the term
has the meaning in Texas Health and Safety Code §
260A.001(1),
which is:
(i) the negligent or willful
infliction of injury, unreasonable confinement, intimidation, or cruel
punishment with resulting physical or emotional harm or pain to a resident by
the resident's caregiver, family member, or other individual who has an ongoing
relationship with the resident; or
(ii) sexual abuse of a resident, including
any involuntary or nonconsensual sexual conduct that would constitute an
offense under Texas Penal Code §
21.08 (relating to
Indecent Exposure), or Texas Penal Code, Chapter 22 (relating to Assaultive
Offenses), committed by the resident's caregiver, family member, or other
individual who has an ongoing relationship with the resident.
(2) Accreditation
commission--Has the meaning given in Texas Health and Safety Code §
247.032.
(3) Actual harm--A negative outcome that
compromises a resident's physical, mental, or emotional well-being.
(4) Advance directive--Has the meaning given
in Texas Health and Safety Code §
166.002.
(5) Affiliate--With respect to:
(A) a partnership, each partner
thereof;
(B) a corporation, each
officer, director, principal stockholder, subsidiary, or person with a
disclosable interest, as the term is defined in this section; and
(C) a natural person:
(i) said person's spouse;
(ii) each partnership and each partner
thereof, of which said person or any affiliate of said person is a partner;
and
(iii) each corporation in which
said person is an officer, director, principal stockholder, or person with a
disclosable interest.
(6) Alzheimer's Assisted Living Disclosure
Statement form--The HHSC-prescribed form a facility uses to describe the nature
of care or treatment of residents with Alzheimer's disease and related
disorders.
(7) Alzheimer's disease
and related disorders--Alzheimer's disease and any other irreversible dementia
described by the Centers for Disease Control and Prevention (CDC), or the most
current edition of the Diagnostic and Statistical Manual of Mental
Disorders.
(8) Alzheimer's
facility--A Type B facility that is certified to provide specialized services
to residents with Alzheimer's disease or a related condition.
(9) Applicant--A person applying for a
license to operate an assisted living facility under Texas Health and Safety
Code, Chapter 247.
(10) Assisted
Living Facility Memory Care Disclosure Statement form--The HHSC-prescribed form
that a facility uses when the facility advertises, markets, or otherwise
promotes that it provides memory care services to residents with Alzheimer's
disease and related disorders.
(11)
Attendant--A facility employee who provides direct care to residents. This
employee may serve other functions, including cook, janitor, porter, maid,
laundry worker, security personnel, bookkeeper, activity director, and
manager.
(12) Authorized electronic
monitoring (AEM)--The placement of an electronic monitoring device in a
resident's room and using the device to make tapes or recordings after making a
request to the facility to allow electronic monitoring.
(13) Behavioral emergency--Has the meaning
given in §
553.261(g)(2) of
this chapter (relating to Coordination of Care).
(14) Certified ombudsman--Has the meaning
given in §
88.2 of this title (relating to
Definitions).
(15) CFR--Code of
Federal Regulations.
(16) 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.
(17) Commingles--The
laundering of apparel or linens of two or more individuals together.
(18) 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 a facility or other person. A controlling person includes:
(A) a management company, landlord, or other
business entity that operates or contracts with others for the operation of a
facility;
(B) any person who is a
controlling person of a management company or other business entity that
operates a facility or that contracts with another person for the operation of
an assisted living facility;
(C) an
officer or director of a publicly traded corporation that is, or that controls,
a facility, management company, or other business entity described in
subparagraph (A) of this paragraph but does not include a shareholder or lender
of the publicly traded corporation; and
(D) any other individual who, because of a
personal, familial, or other relationship with the owner, manager, landlord,
tenant, or provider of a facility, is in a position of actual control or
authority with respect to the facility, without regard to whether the
individual is formally named as an owner, manager, director, officer, provider,
consultant, contractor, or employee of the facility, except an employee,
lender, secured creditor, landlord, or other person who does not exercise
formal or actual influence or control over the operation of a
facility.
(19) Covert
electronic monitoring--The placement and use of an electronic monitoring device
that is not open and obvious, and about which the facility and HHSC have not
been informed by the resident, by the person who placed the device in the room,
or by a person who uses the device.
(20) Delegation--In the assisted living
facility context, written authorization by a registered nurse (RN) acting on
behalf of the facility for personal care staff to perform tasks of nursing care
in selected situations, where delegation criteria are met for the task. The
delegation process includes nursing assessment of a resident in a specific
situation, evaluation of the ability of the personal care staff, teaching the
task to the personal care staff, ensuring supervision of the personal care
staff in performing a delegated task, and re-evaluating the task at regular
intervals.
(21) Dietitian--A person
who currently holds a license or provisional license issued by the Texas
Department of Licensing and Regulation.
(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) Disclosure statement--An HHSC form for
prospective residents or their legally authorized representatives that a
facility must complete. The form contains information regarding the
preadmission, admission, and discharge process; resident assessment and service
plans; staffing patterns; the physical environment of the facility; resident
activities; and facility services.
(25) Electronic monitoring device--Video
surveillance cameras and audio devices installed in a resident's room, designed
to acquire communications or other sounds that occur in the room. An
electronic, mechanical, or other device used specifically for the nonconsensual
interception of wire or electronic communication is excluded from this
definition.
(26) Exploitation--
(A) For a person under 18 years of age who is
not and has not been married or who has not had the disabilities of minority
removed for general purposes, the term has the meaning in Texas Family Code
§
261.001(3),
which is the illegal or improper use of a child or of the resources of a child
for monetary or personal benefit, profit, or gain by an employee, volunteer, or
other individual working under the auspices of a facility or program as further
described by rule or policy; and
(B) For a person other than one described in
subparagraph (A) of this paragraph, the term has the meaning in Texas Health
and Safety Code §
260A.001(4),
which is the illegal or improper act or process of a caregiver, family member,
or other individual who has an ongoing relationship with the resident using the
resources of a resident for monetary or personal benefit, profit, or gain
without the informed consent of the resident.
(27) Facility--An entity required to be
licensed under the Assisted Living Facility Licensing Act, Texas Health and
Safety Code, Chapter 247.
(28) Fire
suppression authority--The paid or volunteer fire-fighting organization or
tactical unit that is responsible for fire suppression operations and related
duties once a fire incident occurs within its jurisdiction.
(29) Flame spread--The rate of fire travel
along the surface of a material. This is different than other requirements for
time-rated "burn through" resistance ratings, such as one-hour rated. Flame
spread ratings are Class A (0-25), Class B (26-75), and Class C
(76-200).
(30) Functional
disability--A mental, cognitive, or physical disability that precludes the
physical performance of self-care tasks, including health maintenance
activities and personal care.
(31)
Governmental unit--The state or any county, municipality, or other political
subdivision, or any department, division, board, or other agency of any of the
foregoing.
(32) Health care
professional--An individual licensed, certified, or otherwise authorized to
administer health care, for profit or otherwise, in the ordinary course of
business or professional practice. The term includes a physician, registered
nurse, licensed vocational nurse, licensed dietitian, physical therapist, and
occupational therapist.
(33) Health
maintenance activity (HMA)--Consistent with 22 TAC §
225.4(relating to Definitions), a
task that:
(A) may be exempt from delegation
based on an RN's assessment in accordance with §
553.263(c) of
this chapter (relating to Health Maintenance Activities); and
(B) requires a higher level of skill to
perform than personal care services and, in the context of an ALF, excludes the
following tasks:
(i) intermittent
catheterization; and
(ii)
subcutaneous, nasal, or insulin pump administration of insulin or other
injectable medications prescribed in the treatment of diabetes
mellitus.
(34) HHSC--The Texas Health and Human
Services Commission.
(35) Immediate
threat to the health or safety of a resident--A situation that causes, or is
likely to cause, serious injury, harm, or impairment to or the death of a
resident.
(36) Immediately
available--The capacity of facility staff to immediately respond to an
emergency after being notified through a communication or alarm system. The
staff are to be no more than 600 feet from the farthest resident and in the
facility while on duty.
(37)
Indirect ownership interest--Any ownership or membership interest in a person
that has a direct ownership interest in an applicant or license
holder.
(38) Isolated--A very
limited number of residents are affected, and a very limited number of staff
are involved, or the situation has occurred only occasionally.
(39) Key infectious agents--Bacteria,
viruses, and other microorganisms which cause the most common infections and
infectious diseases in long-term care facilities, and can be mitigated by
establishing, implementing, maintaining, and enforcing proper infection,
prevention, and control policies and procedures.
(40) Large facility--A facility licensed for
17 or more residents.
(41) Legally
authorized representative--A person authorized by law to act on behalf of a
person with regard to a matter described in this chapter, and may include a
parent, guardian, or managing conservator of a minor, or the guardian of an
adult.
(42) License holder--A
person that holds a license to operate a facility.
(43) Listed--Equipment, materials, or
services included in a list published by an organization concerned with
evaluation of products or services, that maintains periodic inspection of
production of listed equipment or materials or periodic evaluation of services,
and whose listing states that either the equipment, material, or service meets
appropriate designated standards or has been tested and found suitable for a
specified purpose. The listing organization must be acceptable to the authority
having jurisdiction, including HHSC or any other state, federal, or local
authority.
(44) Local code--A model
building code adopted by the local building authority where the facility is
constructed or located.
(45)
Management services--Services provided under contract between the owner of a
facility and a person to provide for the operation of a facility, including
administration, staffing, maintenance, or delivery of resident services.
Management services do not include contracts solely for maintenance, laundry,
transportation, or food services.
(46) Manager--The individual in charge of the
day-to-day operation of the facility.
(47) Managing local ombudsman--Has the
meaning given in §
88.2 of this title.
(48) Medication--
(A) Medication is any substance:
(i) recognized as a drug in the official
United States Pharmacopoeia, Official Homeopathic Pharmacopoeia of the United
States, Texas Drug Code Index or official National Formulary, or any supplement
to any of these official documents;
(ii) intended for use in the diagnosis, cure,
mitigation, treatment, or prevention of disease;
(iii) other than food intended to affect the
structure or any function of the body; and
(iv) intended for use as a component of any
substance specified in this definition.
(B) Medication includes both prescription and
over-the-counter medication, unless otherwise specified.
(C) Medication does not include devices or
their components, parts, or accessories.
(49) Medication administration--The direct
application of a medication or drug to the body of a resident by an individual
legally allowed to administer medication in the state of Texas.
(50) Medication assistance or
supervision--The assistance or supervision of the medication regimen by
facility staff. Refer to §
553.261(a) of
this chapter.
(51) Medication
(self- or self-administration of)--The capability of a resident to administer
the resident's own medication or treatments without assistance from the
facility staff.
(52) Memory care
services--Services provided by an assisted living facility to meet the needs of
residents with a diagnosis of Alzheimer's disease or related disorders or a
diagnosis of dementia.
(53)
Multidrug-resistant organisms--Bacteria and other microorganisms that have
developed resistance to multiple types of medicine used to act against the
microorganism.
(54) Neglect--
(A) For a person under 18 years of age who is
not and has not been married or who has not had the disabilities of minority
removed for general purposes, the term has the meaning in Texas Family Code
§
261.001(4),
which is a negligent act or omission by an employee, volunteer, or other
individual working under the auspices of a facility or program, including
failure to comply with an individual treatment plan, plan of care, or
individualized service plan, that causes or may cause substantial emotional
harm or physical injury to, or the death of, a child served by the facility or
program as further described by rule or policy; and
(B) For a person other than one described in
subparagraph (A) of this paragraph, the term has the meaning in Texas Health
and Safety Code §
260A.001(6),
which is the failure to provide for oneself the goods or services, including
medical services, which are necessary to avoid physical or emotional harm or
pain or the failure of a caregiver to provide such goods or services.
(55) NFPA 101--The 2012
publication titled NFPA 101 Life Safety Code published by the
National Fire Protection Association, Inc., 1 Batterymarch Park, Quincy,
Massachusetts 02169.
(56) Ombudsman
intern--Has the meaning given in §
88.2 of this title.
(57) Ombudsman program--Has the meaning given
in §
88.2 of this title.
(58) Online portal--A secure portal provided
on the HHSC website for licensure activities, including for an assisted living
facility applicant to submit licensure applications and information.
(59) Pattern of violation--Repeated, but not
widespread in scope, failures of a facility to comply with this chapter or a
rule, standard, or order adopted under Texas Health and Safety Code, Chapter
247 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.
(60) Person--Any individual, firm,
partnership, corporation, association, or joint stock association, and the
legal successor thereof.
(61)
Personal care services--Assistance with feeding, dressing, moving, bathing, or
other personal needs or maintenance; or general supervision or oversight of the
physical and mental well-being of a person who needs assistance to maintain a
private and independent residence in the facility or who needs assistance to
manage his or her personal life, regardless of whether a guardian has been
appointed for the person.
(62)
Personal care staff--An attendant whose primary employment function is to
provide personal care services.
(63) Physician--A practitioner licensed by
the Texas Medical Board.
(64)
Potential for minimal harm--A violation that has the potential for causing no
more than a minor negative impact on a resident.
(65) Practitioner--An individual who is
currently licensed in a state in which the individual practices as a physician,
dentist, podiatrist, or a physician assistant; or a registered nurse approved
by the Texas Board of Nursing to practice as an advanced practice registered
nurse.
(66) Private and unimpeded
access--Access to enter a facility or communicate with a resident outside of
the hearing and view of others, without interference or obstruction from
facility employees, volunteers, or contractors.
(67) Qualified medical personnel--An
individual who is licensed, certified, or otherwise authorized to administer
health care. The term includes a physician, registered nurse, and licensed
vocational nurse.
(68) Rapid
influenza diagnostic test--A test administered to a person with flu-like
symptoms that can detect the influenza viral nucleoprotein antigen.
(69) Resident--An individual accepted for
care in a facility.
(70)
Respite--The provision by a facility of room, board, and care at the level
ordinarily provided for permanent residents of the facility to a person for not
more than 60 days for each stay in the facility.
(71) Restraint 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.
(72)
Restraints--Chemical restraints are psychoactive drugs administered for the
purposes of discipline or convenience and are not required to treat the
resident's medical symptoms. Physical restraints are any manual method, or
physical or mechanical device, material, or equipment attached or adjacent to
the resident that restricts freedom of movement. Physical restraints include
restraint holds.
(73) RN
(registered nurse)--A person who holds a current and active license from the
Texas Board of Nursing to practice professional nursing, as defined in Texas
Occupations Code §
301.002(2).
(74) Safety--Protection from injury or loss
of life due to such conditions as fire, electrical hazard, unsafe building or
site conditions, and the hazardous presence of toxic fumes and
materials.
(75) Seclusion--The
involuntary separation of a resident from other residents and the placement of
the resident alone in an area from which the resident is prevented from
leaving.
(76) Service plan--A
written description of the medical care, supervision, or nonmedical care needed
by a resident.
(77) Short-term
acute episode--An illness of less than 30 days' duration.
(78) Small facility--A facility licensed for
16 or fewer residents.
(79) Stable
and predictable--A phrase describing the clinical and behavioral status of a
resident that is non-fluctuating and consistent and does not require the
regular presence of a registered or licensed vocational nurse.
(A) The phrase does not include within its
meaning a description of the clinical and behavioral status of a resident that
is expected to change rapidly or needs continuous or continual nursing
assessment and evaluation.
(B) The
phrase does include within its meaning a description of the condition of a
resident receiving hospice care within a facility where deterioration is
predictable.
(80)
Staff--Employees of an assisted living facility.
(81) Standards--The minimum conditions,
requirements, and criteria established in this chapter with which a facility
must comply to be licensed under this chapter.
(82) State Ombudsman--Has the meaning given
in §
88.2 of this title.
(83) Terminal condition--A medical diagnosis,
certified by a physician, of an illness that will result in death in six months
or less.
(84) Universal
precautions--An approach to infection control in which blood, any body fluids
visibly contaminated with blood, and all body fluids in situations where it is
difficult or impossible to differentiate between body fluids are treated as if
known to be infectious for HIV, hepatitis B, and other blood-borne
pathogens.
(85) Vaccine Preventable
Diseases--The diseases included in the most current recommendations of the
Advisory Committee on Immunization Practices of the CDC.
(86) Widespread in scope--A violation of
Texas Health and Safety Code, Chapter 247 or a rule, standard, or order adopted
under Chapter 247 that:
(A) is pervasive
throughout the services provided by the facility; or
(B) represents a systemic failure by the
facility that affects or has the potential to affect a large portion of or all
of the residents of the facility.
(87) Willfully interfere--To act or not act
to intentionally prevent, interfere with, impeded, or to attempt to
intentionally prevent, interfere with, or impede.
(88) Working day--Any 24-hour period, Monday
through Friday, excluding state and federal holidays.
Notes
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