SECTION 133.182. Definitions

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

(1) Attestation--A written statement, signed by the chief executive officer of the facility, verifying the results of a self-survey represent a complete and accurate assessment of the facility's capabilities required in this subchapter.

(2) Available--Relating to staff who can be contacted for consultation at all times without delay.

(3) Birth weight--The weight of the neonate recorded at time of birth.

(A) Low birth weight--Birth weight less than 2500 grams (5 lbs., 8 oz.);

(B) Very low birth weight (VLBW)--Birth weight less than 1500 grams (3 lbs., 5 oz.); and

(C) Extremely low birth weight (ELBW)--Birth weight less than 1000 grams (2 lbs., 3 oz.).

(4) CAP--Corrective Action Plan. A plan for the facility developed by the department that describes the actions required of the facility to correct identified deficiencies to ensure the applicable designation requirements are met.

(5) Department--The Texas Department of State Health Services.

(6) Designation--A formal recognition by the department of a facility's neonatal care capabilities and commitment for a period of three years.

(7) EMS--Emergency medical services. Services used to respond to an individual's perceived need for immediate medical care.

(8) Focused survey--A department-defined, modified facility survey by a department-approved survey organization or the department. The specific goal of this survey is to review designation requirements identified as not met to resolve a contingent designation or requirement deficiencies.

(9) Gestational age--The age of a fetus or embryo determined by the amount of time that has elapsed since the first day of the mother's last menstrual period or the corresponding age of the gestation as estimated by a physician through a more accurate method.

(10) High-risk infant--A newborn that has a greater chance of complications because of conditions that occur during fetal development, pregnancy conditions of the mother, or problems that may occur during labor or birth.

(11) Immediately--Able to respond without delay, commonly referred to as STAT.

(12) Infant--A child from birth to one year of age.

(13) Inter-facility transport--Transfer of a patient from one health care facility to another health care facility.

(14) Lactation consultant--A health care professional who specializes in the clinical management of breastfeeding.

(15) Maternal--Pertaining to the mother.

(16) NCPAP--Nasal continuous positive airway pressure.

(17) Neonatal Program Oversight--A multidisciplinary process responsible for the administrative oversight of the neonatal program and having the authority for approving the defined neonatal program's policies, procedures, and guidelines for all phases of neonatal care provided by the facility, to include defining the necessary staff competencies, monitoring to ensure neonatal designation requirements are met, and the aggregate review of the neonatal Quality Assessment and Performance Improvement (QAPI) initiatives and outcomes. Neonatal Program Oversight may be performed through the neonatal program's performance improvement committee, multidisciplinary oversight committee, or other structured means.

(18) Neonate--An infant from birth through 28 completed days.

(19) NMD--Neonatal Medical Director.

(20) NPM--Neonatal Program Manager.

(21) NRP--Neonatal Resuscitation Program. A resuscitation course developed and administered jointly by the American Heart Association and the American Academy of Pediatrics.

(22) On-site--At the facility and able to arrive at the patient bedside for urgent requests.

(23) PCR--Perinatal Care Region. The PCRs are established for descriptive and regional planning purposes. The PCRs are geographically divided by counties and are integrated into the existing 22 Trauma Service Areas (TSAs) and the applicable Regional Advisory Council (RAC) of the TSA provided in §157.122 of this title (relating to Trauma Services Areas) and §157.123 of this title (relating to Regional Emergency Medical Services/Trauma Systems).

(24) Perinatal--Of, relating to, or being the period around childbirth, especially the five months before and one month after birth.

(25) POC--Plan of Correction. A report submitted to the department by the facility detailing how the facility will correct any deficiencies cited in the neonatal designation site survey summary or documented in the self-attestation.

(26) Premature/prematurity--Birth at less than 37 weeks of gestation.

(27) QAPI Plan--Quality Assessment and Performance Improvement Plan. QAPI is a data-driven and proactive approach to quality improvement. It combines two approaches - Quality Assessment (QA) and Performance Improvement (PI). QA is a process used to ensure services are meeting quality standards and assuring care reaches a defined level. PI is the continuous study and improvement process designed to improve system and patient outcomes.

(28) RAC--Regional Advisory Council as described in §157.123 of this title.

(29) 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.

(30) Telehealth service--A health service, other than a telemedicine medical service, delivered by a health professional licensed, certified, or otherwise entitled to practice in this state and acting within the scope of the health professional's license, certification, or entitlement to a patient at a different physical location than the health professional using telecommunications or information technology as defined in Texas Occupations Code §111.001.

(31) Telemedicine medical service--A health care service delivered by a physician licensed in this state, or health professional acting under the delegation and supervision of a physician licensed in this state and acting within the scope of the physician's or health professional's license to a patient at a different physical location than the physician or health professional using telecommunications or technology as defined in Texas Occupations Code §111.001.

(32) TSA--Trauma Service Area as described in §157.122 of this title.

(33) Urgent--Requiring action or attention within 30 minutes of notification.

Source Note: The provisions of this §133.182 adopted to be effective June 9, 2016, 41 TexReg 4011; amended to be effective June 22, 2023, 48 TexReg 3226