26 Tex. Admin. Code § 509.2 - Definitions
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise.
(1) Act--Texas Health and
Safety Code Chapter 254, titled Freestanding Emergency Medical Care
Facilities.
(2) Action plan--A
written document that includes specific measures to correct identified problems
or areas of concern; identifies strategies for implementing system
improvements; and includes outcome measures to indicate the effectiveness of
system improvements in reducing, controlling, or eliminating identified problem
areas.
(3) Administrator--A person
who is a physician, is a registered nurse, has a baccalaureate or postgraduate
degree in administration or a health-related field, or has one year of
administrative experience in a health-care setting.
(4) Advanced practice registered nurse
(APRN)--A registered nurse authorized by the Texas Board of Nursing to practice
as an advanced practice registered nurse in Texas. The term includes a nurse
practitioner, nurse midwife, nurse anesthetist, and clinical nurse specialist.
The term is synonymous with "advanced nurse practitioner."
(5) Adverse event--An event that results in
unintended harm to the patient by an act of commission or omission rather than
by the underlying disease or condition of the patient.
(6) Applicant--A person who seeks a
freestanding emergency medical care facility license from the Texas Health and
Human Services Commission (HHSC) and who is legally responsible for operation
of the freestanding emergency medical care facility, whether by lease or
ownership.
(7) Certified registered
nurse anesthetist (CRNA)--A registered nurse who has current certification from
the Council on Certification of Nurse Anesthetists and is currently authorized
to practice as an advanced practice registered nurse by the Texas Board of
Nursing.
(8) Change of
ownership--Change in the person legally responsible for operation of the
facility, whether by lease or by ownership.
(9) Designated provider--A provider of health
care services selected by a health maintenance organization, a self-insured
business corporation, a beneficial society, the Veterans Administration,
TRICARE, a business corporation, an employee organization, a county, a public
hospital, a hospital district, or any other entity to provide health care
services to a patient with whom the entity has a contractual, statutory, or
regulatory relationship that creates an obligation for the entity to provide
the services to the patient.
(10)
Disposal--Discharge, deposit, injection, dumping, spilling, leaking, or placing
any solid waste or hazardous waste (containerized or uncontainerized) into or
on any land or water so that solid waste or hazardous waste, or any constituent
thereof, may enter the environment or be emitted into the air or discharge into
any waters, including groundwaters.
(11) Emergency care--Health care services
provided in a freestanding emergency medical care facility to evaluate and
stabilize medical conditions of a recent onset and severity, including severe
pain, that would lead a prudent layperson possessing an average knowledge of
medicine and health to believe that the person's condition, sickness, or injury
is of such a nature that failure to get immediate medical care could result in:
(A) placing the person's health in serious
jeopardy;
(B) serious impairment to
bodily functions;
(C) serious
dysfunction of a bodily organ or part;
(D) serious disfigurement; or
(E) in the case of a pregnant woman, serious
jeopardy to the health of the woman or fetus.
(12) Facility--A freestanding emergency
medical care facility.
(13)
Freestanding emergency medical care facility--A facility that is structurally
separate and distinct from a hospital and which receives an individual and
provides emergency care as defined in this section.
(14) Freestanding emergency medical care
facility administration--The administrative body of a freestanding emergency
medical care facility headed by an individual who has the authority to
represent the facility and who is responsible for operation of the facility
according to the policies and procedures of the facility's governing
body.
(15) Governing body--The
governing authority of a freestanding emergency medical care facility that is
responsible for a facility's organization, management, control, and operation,
including appointment of the medical staff; and includes the owner or partners
for a freestanding emergency medical care facility owned or operated by an
individual or partners or corporation.
(16) HHSC--Texas Health and Human Services
Commission.
(17) Legally authorized
representative (LAR)--Means:
(A) a parent or
legal guardian if the patient is a minor;
(B) a legal guardian if the patient has been
adjudicated incapacitated to manage the patient's personal affairs;
(C) an agent of the patient authorized under
a medical power of attorney;
(D) an
attorney ad litem appointed for the patient;
(E) a person authorized to consent to medical
treatment on behalf of the patient under Texas Health and Safety Code Chapter
313;
(F) a guardian ad litem
appointed for the patient;
(G) a
personal representative or heir of the patient, as defined by Texas Estates
Code Chapter 22, if the patient is deceased;
(H) an attorney retained by the patient or by
the patient's legally authorized representative; or
(I) a person exercising a power granted to
the person in the person's capacity as an attorney-in-fact or agent of the
patient by a statutory durable power of attorney that is signed by the patient
as principal.
(18)
Licensed vocational nurse (LVN)--A person who is currently licensed by the
Texas Board of Nursing as a licensed vocational nurse.
(19) Licensee--The person or governmental
unit named in the application for issuance of a facility license.
(20) Medical director--A physician who is
board certified or board eligible in emergency medicine, or board certified in
primary care with a minimum of two years of emergency care
experience.
(21) Medical staff--A
physician or group of physicians, podiatrist or group of podiatrists, and
dentist or group of dentists who by action of the governing body of a facility
are privileged to work in and use the facility.
(22) Owner--One of the following persons or
governmental unit that will hold, or does hold, a license issued under the Act
in the person's name or the person's assumed name:
(A) a corporation;
(B) a governmental unit;
(C) a limited liability company;
(D) an individual;
(E) a partnership, if a partnership name is
stated in a written partnership agreement, or an assumed name
certificate;
(F) all partners in a
partnership if a partnership name is not stated in a written partnership
agreement, or an assumed name certificate; or
(G) all co-owners under any other business
arrangement.
(23)
Patient--An individual who presents for diagnosis or treatment.
(24) Person--An individual, firm,
partnership, corporation, association, or joint stock company, including a
receiver, trustee, assignee, or other similar representative of such an
entity.
(25) Physician--An
individual licensed by the Texas Medical Board and authorized to practice
medicine in the state of Texas.
(26) Physician assistant--An individual
licensed as a physician assistant by the Texas State Board of Physician
Assistant Examiners.
(27)
Practitioner--A health care professional licensed in the state of Texas, other
than a physician, podiatrist, or dentist. A practitioner shall practice in a
manner consistent with their underlying practice act.
(28) Prelicensure conference--A conference
held between HHSC staff and the applicant or the applicant's representative to
review licensure rules and survey documents and provide consultation before the
on-site licensure inspection.
(29)
Premises--A building where patients receive emergency services from a
freestanding emergency medical care facility.
(30) Quality assessment and performance
improvement (QAPI)--An ongoing program that measures, analyzes, and tracks
quality indicators related to improving health outcomes and patient care
emphasizing a multidisciplinary approach. The program implements improvement
plans and evaluates the implementation until resolution is achieved.
(31) Registered nurse (RN)--An individual who
is currently licensed by the Texas Board of Nursing as a registered
nurse.
(32) Sexual assault
survivor--An individual who is a victim of a sexual assault, regardless of
whether a report is made, or a conviction is obtained in the
incident.
(33) Stabilize--To
provide necessary medical treatment of an emergency medical condition to
ensure, within reasonable medical probability, that the condition is not likely
to deteriorate materially from or during the transfer of the individual from a
facility.
(34) Transfer--Movement
(including the discharge) of an individual outside a facility at the direction
of and after personal examination and evaluation by the facility physician.
Transfer does not include movement outside a facility of an individual who has
been declared dead or who leaves the facility against the advice of a
physician.
(35) Transfer
agreement--A referral, transmission, or admission agreement with a
hospital.
(36) Universal
precautions--Procedures for disinfecting and sterilizing reusable medical
devices and appropriate use of infection control, including hand washing, use
of protective barriers, and use and disposal of needles and other sharp
instruments, as those procedures are defined by the Centers for Disease Control
and Prevention (CDC) of the United States Department of Health and Human
Services. This term includes standard precautions as defined by CDC, which are
designed to reduce the risk of transmission of bloodborne and other pathogens
in healthcare facilities.
(37)
Violation--Failure to comply with the Act, another statute relating to the
licensure or operation of a freestanding emergency medical care facility, a
rule or standard, or an order issued by the executive commissioner of HHSC or
the executive commissioner's designee, adopted or enforced under the
Act.
Notes
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