Sec. 1002.001. DEFINITIONS  


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  • In this chapter:

    (1) "Board" means the board of directors of the Texas Institute of Health Care Quality and Efficiency established under this chapter.

    (2) "Commission" means the Health and Human Services Commission.

    (3) "Department" means the Department of State Health Services.

    (4) "Executive commissioner" means the executive commissioner of the Health and Human Services Commission.

    (5) "Health care collaborative" has the meaning assigned by Section 848.001, Insurance Code.

    (6) "Health care facility" means:

    (A) a hospital licensed under Chapter 241;

    (B) an institution licensed under Chapter 242;

    (C) an ambulatory surgical center licensed under Chapter 243;

    (D) a birthing center licensed under Chapter 244;

    (E) an end stage renal disease facility licensed under Chapter 251; or

    (F) a freestanding emergency medical care facility licensed under Chapter 254.

    (7) "Institute" means the Texas Institute of Health Care Quality and Efficiency established under this chapter.

    (8) "Potentially preventable admission" means an admission of a person to a hospital or long-term care facility that may have reasonably been prevented with adequate access to ambulatory care or health care coordination.

    (9) "Potentially preventable ancillary service" means a health care service provided or ordered by a physician or other health care provider to supplement or support the evaluation or treatment of a patient, including a diagnostic test, laboratory test, therapy service, or radiology service, that may not be reasonably necessary for the provision of quality health care or treatment.

    (10) "Potentially preventable complication" means a harmful event or negative outcome with respect to a person, including an infection or surgical complication, that:

    (A) occurs after the person's admission to a hospital or long-term care facility; and

    (B) may have resulted from the care, lack of care, or treatment provided during the hospital or long-term care facility stay rather than from a natural progression of an underlying disease.

    (11) "Potentially preventable event" means a potentially preventable admission, a potentially preventable ancillary service, a potentially preventable complication, a potentially preventable emergency room visit, a potentially preventable readmission, or a combination of those events.

    (12) "Potentially preventable emergency room visit" means treatment of a person in a hospital emergency room or freestanding emergency medical care facility for a condition that may not require emergency medical attention because the condition could be, or could have been, treated or prevented by a physician or other health care provider in a nonemergency setting.

    (13) "Potentially preventable readmission" means a return hospitalization of a person within a period specified by the commission that may have resulted from deficiencies in the care or treatment provided to the person during a previous hospital stay or from deficiencies in post-hospital discharge follow-up. The term does not include a hospital readmission necessitated by the occurrence of unrelated events after the discharge. The term includes the readmission of a person to a hospital for:

    (A) the same condition or procedure for which the person was previously admitted;

    (B) an infection or other complication resulting from care previously provided; or

    (C) a condition or procedure that indicates that a surgical intervention performed during a previous admission was unsuccessful in achieving the anticipated outcome.

Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 , Sec. 3.01, eff. September 28, 2011.