The following words and terms, when used in this chapter, shall
have the following meanings, unless the context clearly indicates
(1) Abortion--The use of any means to terminate the
pregnancy of a female known by the attending physician to be pregnant,
with the intention that the termination of the pregnancy by those
means will, with reasonable likelihood, cause the death of the fetus.
The term does not include birth control devices or oral contraceptives.
An abortion may be performed only by a physician licensed to practice
medicine in this state.
(2) Abortion facility--A place where abortions are
(3) Act--Texas Abortion Facility Reporting and Licensing
Act, Health and Safety Code, Chapter 245.
(4) Administrator--A person who:
(A) is delegated the responsibility for the implementation
and proper application of policies, programs, and services established
for the licensed abortion facility; and
(B) meets the qualifications established in §139.46(2)
of this title (relating to Licensed Abortion Facility Staffing Requirements
(5) Advanced practice registered nurse (APRN)--A registered
nurse approved by the Texas Board of Nursing to practice as an advanced
practice registered nurse on the basis of completion of an advanced
educational program. The term includes a nurse practitioner, nurse
midwife, nurse anesthetist, and clinical nurse specialist. The term
is synonymous with "advanced nurse practitioner."
(6) Affidavit--A written statement, sworn to or affirmed,
and witnessed by a witness whose signature and printed name appears
on the affidavit. "Notarized affidavit" in these rules means an affidavit
in which the statement is witnessed by a notary acting pursuant to
Government Code, Chapter 406.
(7) Affiliate--With respect to an applicant or owner
(A) a corporation--includes each officer, consultant,
stockholder with a direct ownership of at least 5.0%, subsidiary,
and parent company;
(B) a limited liability company--includes each officer,
member, and parent company;
(C) an individual--includes:
(i) the individual's spouse;
(ii) each partnership and each partner thereof of which
the individual or any affiliate of the individual is a partner; and
(iii) each corporation in which the individual is an
officer, consultant, or stockholder with a direct ownership of at
(D) a partnership--includes each partner and any parent
(E) a group of co-owners under any other business arrangement--includes
each officer, consultant, or the equivalent under the specific business
arrangement and each parent company.
(8) Applicant--The owner of an abortion facility which
is applying for a license under the Act. For the purpose of this chapter,
the word "owner" includes nonprofit organization.
(9) Certified registered nurse anesthetist (CRNA)--A
registered nurse who has current certification from the Council on
Certification of Nurse Anesthetists and who is currently authorized
to practice as an advanced practice registered nurse by the Texas
Board of Nursing.
(10) Change of ownership--A sole proprietor who transfers
all or part of the facility's ownership to another person or persons;
the removal, addition, or substitution of a person or persons as a
partner in a facility owned by a partnership; or a corporate sale,
transfer, reorganization, or merger of the corporation which owns
the facility if sale, transfer, reorganization, or merger causes a
change in the facility's ownership to another person or persons.
(11) Condition on discharge--A statement on the condition
of the patient at the time of discharge.
(12) Critical item--All surgical instruments and objects
that are introduced directly into the bloodstream or into other normally
sterile areas of the body.
(13) Decontamination--The physical and chemical process
that renders an inanimate object safe for further handling.
(14) Department--The Department of State Health Services.
(15) Director--The director of the Patient Quality
Care Unit of the department or his or her designee.
(16) Disinfection--The destruction or removal of vegetative
bacteria, fungi, and most viruses but not necessarily spores; the
process does not remove all organisms but reduces them to a level
that is not harmful to a person's health. There are three levels of
(A) high-level disinfection--kills all organisms, except
high levels of bacterial spores, and is effected with a chemical germicide
cleared for marketing as a sterilant by the United States Food and
(B) intermediate-level disinfection--kills mycobacteria,
most viruses, and bacteria with a chemical germicide registered as
a "tuberculocide" by the United States Environmental Protection Agency
(C) low-level disinfection--kills some viruses and
bacteria with a chemical germicide registered as a hospital disinfectant
by the EPA.
(17) Education and information staff--A professional
or nonprofessional person who is trained to provide information on
abortion procedures, alternatives, informed consent, and family planning
(18) Facility--A licensed abortion facility as defined
in this section.
(19) Fetus--An individual human organism from fertilization
(20) Health care facility--Any type of facility or
home and community support services agency licensed to provide health
care in any state or is certified for Medicare (Title XVIII) or Medicaid
(Title XIX) participation in any state.
(21) Health care worker--Any person who furnishes health
care services in a direct patient care situation under a license,
certificate, or registration issued by the State of Texas or a person
providing direct patient care in the course of a training or educational
(22) Hospital--A facility that is licensed under the
Texas Hospital Licensing Law, Health and Safety Code, Chapter 241,
or if exempt from licensure, certified by the United States Department
of Health and Human Services as in compliance with the conditions
of participation for hospitals in Title XVIII, Social Security Act
(42 United States Code, §§1395 et. seq.).
(23) Immediate jeopardy to health and safety--A situation
in which there is a high probability that serious harm or injury to
patients could occur at any time or already has occurred and may well
occur again, if patients are not protected effectively from the harm
or if the threat is not removed.
(24) Inspection--An on-site inspection by the department
in which a standard-by-standard evaluation is conducted.
(25) Licensed abortion facility--A place licensed by
the department under Health and Safety Code, Chapter 245, where abortions
(26) Licensed mental health practitioner--A person
licensed in the State of Texas to provide counseling or psychotherapeutic
(27) Licensed vocational nurse (LVN)--A person who
is currently licensed by the Texas Board of Nursing as a licensed
(28) Licensee--A person or entity who is currently
licensed as an abortion facility.
(29) Medical abortion--The use of a medication or combination
of medications to induce an abortion, with the purpose of terminating
the pregnancy of a woman known to be pregnant. Medical abortion does
not include forms of birth control.
(30) Medical consultant--A physician who is designated
to supervise the medical services of the facility.
(31) Nonprofessional personnel--Personnel of the facility
who are not licensed or certified under the laws of this state to
provide a service and shall function under the delegated authority
of a physician, registered nurse, or other licensed health professional
who assumes responsibility for their performance in the licensed abortion
(32) Noncritical items--Items that come in contact
with intact skin.
(33) Notarized copy--A copy attached to a notarized
affidavit which states that the attached copy(ies) are true and correct
copies of the original documents.
(34) Patient--A pregnant female on whom an abortion
is performed, but shall in no event be construed to include a fetus.
(35) Person--Any individual, firm, partnership, corporation,
(36) Physician--An individual licensed by the Texas
Medical Board and authorized to practice medicine in the State of
(37) Physician assistant--A person licensed as a physician
assistant by the Texas Physician Assistant Board.
(38) Plan of correction--A written strategy for correcting
a licensing violation. The plan of correction shall be developed by
the facility, and shall address the system(s) operation(s) of the
facility as the system(s) operation(s) apply to the deficiency.
(39) Post-procedure infection--An infection acquired
at or during an admission to a facility; there shall be no evidence
that the infection was present or incubating at the time of admission
to the facility. Post-procedure infections and their complications
that may occur after an abortion include, but are not limited to,
endometritis and other infections of the female reproductive tract,
laboratory-confirmed or clinical sepsis, septic pelvic thrombophlebitis,
and disseminated intravascular coagulopathy.
(40) Pregnant unemancipated minor certification form--The
document prepared by the Department of State Health Services and used
by physicians to certify the medical indications supporting the judgment
for the immediate abortion of a pregnant minor.
(41) Pre-inspection conference--A conference held with
department staff and the applicant or his or her representative to
review licensure standards, inspection documents, and provide consultation
prior to the on-site licensure inspection.
(42) Professional personnel--Patient care personnel
of the facility currently licensed or certified under the laws of
this state to use a title and provide the type of service for which
they are licensed or certified.
(43) Quality assurance--An ongoing, objective, and
systematic process of monitoring, evaluating, and improving the appropriateness,
and effectiveness of care.
(44) Quality improvement--An organized, structured
process that selectively identifies improvement projects to achieve
improvements in products or services.
(45) Registered nurse (RN)--A person who is currently
licensed by the Texas Board of Nursing as a registered nurse.
(46) Semicritical items--Items that come in contact
with nonintact skin or mucous membranes. Semicritical items may include
respiratory therapy equipment, anesthesia equipment, bronchoscopes,
(47) Standards--Minimum requirements under the Act
and this chapter.
(48) Sterile field--The operative area of the body
and anything that directly contacts this area.
(49) Sterilization--The use of a physical or chemical
procedure to destroy all microbial life, including bacterial endospores.
(50) Supervision--Authoritative procedural guidance
by a qualified person for the accomplishment of a function or activity
that includes initial direction and periodic inspection of the actual
act of accomplishing the function or activity.
(51) Surgical abortion--The use of instruments, aspiration,
and/or suction to induce an abortion, with the purpose of terminating
the pregnancy of a woman known to be pregnant.
(52) Third trimester certification form--The document
prepared by the Department of State Health Services and used by physicians
to certify the medical indications supporting the judgment for the
abortion of a viable fetus during the third trimester of pregnancy.
(53) Third trimester--A gestational period of not less
than 26 weeks (following last-menstrual period (LMP)).
(54) Unemancipated minor--A minor who is unmarried
and has not had the disabilities of minority removed under the Family
Code, Chapter 31.