SECTION 133.202. Definitions

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

(1) ACLS--Advanced Cardiovascular Life Support. A resuscitation course that was developed and is administered by the American Heart Association.

(2) Antepartum--The period beginning on the date of conception and ending on delivery.

(3) 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.

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

(5) Board-eligible--A physician who has completed a residency or fellowship and is eligible for board certification according to the applicable medical board.

(6) 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.

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

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

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

(10) 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.

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

(12) 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.

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

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

(15) Intrapartum--During labor and delivery or childbirth.

(16) Inter-facility transport--Transfer of a patient from one healthcare facility to another healthcare facility.

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

(18) Maternal--Pertaining to the mother.

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

(20) MFM--Maternal Fetal Medicine.

(21) MMD--Maternal Medical Director.

(22) MPM--Maternal Program Manager.

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

(24) Obstetrics--Related to pregnancy, childbirth, and the postpartum period.

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

(26) 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).

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

(28) PASD--Placenta Accreta Spectrum Disorder. A disorder that includes placenta accreta, placenta increta, and placenta percreta.

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

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

(31) Postpartum--The six-week period following pregnancy or delivery.

(32) 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.

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

(34) Screening--Evaluation for the presence or absence of a disease or condition.

(35) 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.

(36) 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 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.

(37) 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.

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

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

Source Note: The provisions of this §133.202 adopted to be effective March 1, 2018, 43 TexReg 875; amended to be effective January 8, 2023, 47 TexReg 8986