The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.

1. (1) Administrator--A nursing facility administrator licensed by the Texas Department of Human Services (DHS).

2. (2) Adverse action--Any action in which DHS:

   1. (A) terminates or suspends a contract between a person and DHS before the contract's stated expiration date;
   2. (B) denies payment, in whole or part, for any claim arising under a contract;
   3. (C) terminates or suspends payments, in whole or part, to a contractor;
   4. (D) demands payment or repayment for contract or rule violations;
   5. (E) directs one of its contractors to terminate or suspend a subcontract or payments to any subcontractor or provider of medical services;
   6. (F) reduces a contractor's block grant funds by 25% or more of the amount DHS reimburses if DHS plans to allocate the withheld funds to another contractor for similar services in the same geographic area, if the contractor alleges that the reduction was in violation of DHS rules, was discriminatory, or was without reasonable basis in law or fact; it does not apply to funding or contracts subject to DHS's competitive procurement rules;

   7. (G) denies, suspends, or revokes the license of a person:

      1. (i) operating a home and community support services agency;
      2. (ii) operating an adult day-care facility;
      3. (iii) operating an assisted living facility;
      4. (iv) operating a convalescent or nursing facility; or
      5. (v) operating an intermediate care facility for the mentally retarded;
   8. (H) terminates the certification of a facility providing intermediate or long-term care for the mentally retarded;
   9. (I) imposes civil, administrative, or monetary penalties against a convalescent or nursing facility;
   10. (J) imposes administrative penalties against a person, as defined in subparagraph (14)(B) of this section;
   11. (K) revokes, suspends, or refuses to renew an administrator's license; assesses an administrative penalty against an administrator; issues a written reprimand to an administrator; requires an administrator to participate in continuing education; or places an administrator on probation;
   12. (L) suspends a license or revokes a stay of an order suspending a license issued to any person by the Texas Department of Public Safety or the Texas Parks and Wildlife Department;
   13. (M) places a finding of abuse, neglect, or misappropriation of a resident's property by a nurse aide on the nurse aide registry;
   14. (N) denies, revokes, suspends, refuses to renew, or rescinds program approval of a medication aide permit;
   15. (O) places a finding of abuse, neglect, exploitation, or misappropriation of property of a resident or consumer of a facility by an employee on the employee misconduct registry;
   16. (P) excludes a person, as that term is defined in subparagraph (14)(B) of this section, from eligibility for a license to operate an institution;
   17. (Q) excludes a person who operates an assisted living facility for which a trustee has been appointed and for which emergency assistance funds are used, other than funds used to pay the expenses of the trustee;
   18. (R) imposes any adverse sanction, penalty, or other action to which a person has a statutory right to a formal hearing in accordance with the provisions of this subchapter; or
   19. (S) denies or withdraws approval of nurse aide training and competency evaluation program (NATCEP) in a nursing facility that participates only in the Medicaid program.
3. (3) Commissioner--The commissioner of the Texas Department of Human Services.
4. (4) Contract--Any written document or series of documents that obligates DHS to provide consideration to a person in exchange for goods or services from that person, or that obligates DHS to provide goods or services in exchange for consideration.
5. (5) Contractor--Any person with whom DHS has a written contract.

6. (6) 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, expenditure of money, or policies of an institution or other person, including:

   1. (A) a management company, landlord, or other business entity that operates or contracts with others for the operation of an institution;
   2. (B) any person who is a controlling person of a management company or other business entity that operates an institution or that contracts with another person for the operation of an institution; and
   3. (C) any other individual who, because of a personal, familial, or other relationship with the owner, manager, landlord, tenant, or provider of an institution, is in a position of actual control or authority with respect to the institution, without regard to whether the individual is formally named as an owner, manager, director, officer, provider, consultant, contractor, or employee of the facility, unless the individual does not exercise any formal or actual influence or control over the operation of an institution.
7. (7) Department--The Texas Department of Human Services (DHS).
8. (8) File--To submit a document with DHS's Hearings Department so that it is received and date-stamped.
9. (9) Hearings Department--The Hearings Department of DHS.
10. (10) Institution--An establishment that furnishes, in one or more facilities, food and shelter to four or more persons who are unrelated to the proprietor of the establishment, and provides minor treatment under the direction and supervision of a physician licensed by the Texas State Board of Medical Examiners, or other services that meet some need beyond the basic provision of food, shelter, and laundry.

11. (11) License--When used in conjunction with a hearing to suspend a license to operate a motor vehicle or a license to engage in recreational activity, this term shall mean a license, certificate, registration, permit, or other authorization that:

    1. (A) is issued by a licensing authority;
    2. (B) is subject before expiration to suspension, revocation, forfeiture, or termination by an issuing licensing authority; and

    3. (C) a person must obtain to:

       1. (i) operate a motor vehicle; or
       2. (ii) engage in a recreational activity, including hunting and fishing, for which a license or permit is required.
12. (12) Licensee--When used in conjunction with a hearing to suspend a license to operate a motor vehicle or a license to engage in recreational activity, this term shall mean the person whose license DHS seeks to suspend.
13. (13) Licensing authority--When used in conjunction with a hearing to suspend a license to operate a motor vehicle or a license to engage in recreational activity, this term shall mean the Texas Department of Public Safety or the Texas Parks and Wildlife Department.
14. (14) Order suspending a license--When used in conjunction with a hearing to suspend a license to operate a motor vehicle or a license to engage in recreational activity, this term shall mean an order issued by DHS directing a licensing authority to suspend a license.

15. (15) Person--The following terms apply to the definition of a person:

    1. (A) Except as defined in subparagraph (B) of this paragraph, a person is an individual, partnership, corporation, association, governmental subdivision or agency, or a public or private organization of any character.
    2. (B) When used in conjunction with a hearing to deny, suspend, or revoke a license as provided by §242.061 of the Texas Health and Safety Code, an administrative penalty hearing as provided by §242.066 of the Texas Health and Safety Code, or an exclusion hearing as provided by §242.0615 of the Texas Health and Safety Code, a person is the applicant; the partner, officer, director, or managing employee of the applicant; the licensee; the partner, officer, director, or managing employee of the licensee; the owner or the one who controls the owner of the physical plant of a facility in which an institution operates or is to operate; or a controlling person.
16. (16) Petitioner--A person seeking relief from an adverse action proposed or taken by DHS.
17. (17) Respondent--The Texas Department of Human Services.
18. (18) Service--Service under this section shall be in accordance with the rules for service in civil cases under the Texas Rules of Civil Procedure.
19. (19) SOAH--The State Office of Administrative Hearings.

Source Note:The provisions of this §357.481 adopted to be effective January 25, 2000, 25 TexReg 391; amended to be effective November 1, 2001, 26 TexReg 8356; amended to be effective March 1, 2003, 28 TexReg 1224; transferred effective September 1, 2004, as published in the Texas Register September 17, 2004, 29 TexReg 9013.