The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.     
       (1)  Agent--An individual not employed by a facility but working under the auspices of the facility, such as a volunteer, student, or consultant.      
       (2)  Allegation--A report by a person believing or having knowledge that a child has been or may be abused or neglected in a facility or that an elderly or disabled person has been or may be abused, neglected or exploited in a facility.      
       (3)  Caretaker--An owner, operator, manager, employee, or agent of a facility in which a patient or client is located.      
       (4)  Child--A person under 18 years of age who is not and has not been married or who has not had the disabilities of minority removed for general purposes.      
       (5)  Client--A child, disabled person or elderly person receiving services in a facility.      
       (6)  Clinical issues--Issues relating to unsafe practice by a licensed health care professional or a violation of a state law or rule relating to the licensure or practice of a licensed health care professional.      
       (7)  Confirmed--A finding that an allegation of abuse, neglect, or exploitation is supported by the preponderance of the evidence.      
       (8)  Department--The Texas Department of Health.      
       (9)  Disabled person--A person with a mental, physical, or developmental disability that substantially impairs the person's ability to provide adequately for the person's care or protection and who is either 18 years of age or older or who is under 18 years of age and has the disabilities of minority removed.      
       (10)  Elderly person--A person 65 years of age or older.      
       (11)  Facility--A facility providing health care services which is operated, licensed, certified, or registered by the department. Such facilities include licensed general or special hospitals, licensed private psychiatric hospitals, licensed special care facilities, licensed abortion facilities, licensed ambulatory surgical centers, licensed birthing centers, licensed end stage renal disease facilities, the two hospitals operated by the department, youth camps, and public health clinics operated by the department. This term includes any owner, operator, manager, employee, or agent of a facility.      
       (12)  Guardian--Anyone named as "guardian of the person" of a child, elderly person, or disabled person by a probate court order.      
       (13)  Inconclusive--A finding that an allegation of abuse, neglect, or exploitation leads to no conclusion or definite result due to a lack of witnesses or other relevant evidence.      
       (14)  Nonserious physical injury--Any injury determined not to be serious by the examining physician. Examples of nonserious injury may include superficial laceration, contusion, or abrasion.      
       (15)  Observable and material impairment--Discernable and substantial damage or deterioration.      
       (16)  Patient--A child, disabled person, or elderly person receiving health care services in a facility.      
       (17)  Perpetrator--The person who has committed an act of abuse or neglect of a child or abuse, neglect, or exploitation of an elderly or disabled person.      
       (18)  Perpetrator unknown--The term used to describe an incidence in which abuse, neglect, or exploitation is confirmed but positive identification of the responsible person can not be made and in which self injury has been eliminated as the cause.      
       (19)  Preponderance of evidence--The greater weight of evidence or evidence which is more credible and convincing to the mind.      
       (20)  Reporter--The person filing a report of abuse, neglect, or exploitation, either the:                (A) victim of alleged abuse, neglect, or exploitation;                 (B) a third party filing a report on behalf of the alleged victim; or                 (C) both.        
       (21)  Serious physical injury--An injury determined to be serious by the examining physician. Examples of serious injury may include fracture; dislocation of any joint; internal injury; any contusion larger than two and one-half inches in diameter; concussion; second or third degree burns; first degree scald burns greater than the percentage of the body involved or involving hands, feet, face or genitals; or multiple lacerations, contusions or abrasions.      
       (22)  Sexual abuse--Any sexual activity, including any involuntary or nonconsensual sexual conduct that would constitute an offense under the Penal Code, §21.08 (indecent exposure) or Chapter 22 (assaulting offenses), involving a facility and a patient or client. Sexual activity includes but is not limited to kissing, hugging, stroking, or fondling with sexual intent; oral sex or sexual intercourse; and request, suggestion or encouragement for the performance of sex.      
       (23)  Substantial harm--Real and significant physical injury or damage to a child that includes, but is not limited to, bruises, cuts, welts, skull or other bone fractures, brain damage, subdural hematoma, internal injuries, burns, scalds, wounds, poisoning, human bites, concussions, and dislocations and sprains.      
       (24)  Substantial risk--Real and significant possibility or likelihood.      
       (25)  Unconfirmed--A finding that an allegation of abuse, neglect or exploitation is not supported by the preponderance of the evidence.      
       (26)  Unfounded--A finding that an allegation of abuse, neglect, or exploitation is spurious or patently without factual basis.      
     Source Note:        The provisions of this §1.203 adopted to be effective November 16, 1995, 20 TexReg 9161; amended to be effective June 13, 1999, 24 TexReg 4230