The following words and terms, when used in these sections, shall have the following meanings, unless the context clearly indicates otherwise.     
       (1) Act--Texas Ambulatory Surgical Center Licensing Act, Health and Safety Code, Chapter 243.      
       (2) Action plan--A written document that includes specific measures to correct identified problems or areas of concern; identifies strategies for implementing system improvements; and includes outcome measures to indicate the effectiveness of system improvements in reducing, controlling or eliminating identified problem areas.      
       (3) Administrator--A person who is a physician, is a registered nurse, has a baccalaureate or postgraduate degree in administration or a health-related field, or has one year of administrative experience in a health care setting.      
       (4) Advanced practice registered nurse (APRN)--A registered nurse approved by the Texas Board of Nursing to practice as an advanced practice registered nurse in Texas. The term includes a nurse practitioner, nurse midwife, nurse anesthetist, and clinical nurse specialist. The term is synonymous with "advanced nurse practitioner."      
       (5) Ambulatory Surgical Center (ASC)--A facility that primarily provides surgical services to patients who do not require overnight hospitalization or extensive recovery, convalescent time or observation. The planned total length of stay for an ASC patient shall not exceed 23 hours. Patient stays of greater than 23 hours shall be the result of an unanticipated medical condition and shall occur infrequently. The 23-hour period begins with the induction of anesthesia.      
       (6) Autologous blood units--Units of blood or blood products derived from the recipient.      
       (7) Available--Able to be physically present in the facility to assume responsibility for the delivery of patient care services within five minutes.      
       (8) 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.      
       (9) Change of ownership--                (A) a sole proprietor who transfers all or part of the ASC's ownership to another person or persons;                 (B) the removal, addition, or substitution of a person or persons as a general, managing, or controlling partner in an ASC owned by a partnership and the tax identification number of that ownership changes; or                 (C) a corporation that transfers all or part of the corporate stock which represents the ASC's ownership to another person or persons and the tax identification number of that ownership changes.        
       (10) Dentist--A person who is currently licensed under the laws of this state to practice dentistry.      
       (11) Department--The Department of State Health Services.      
       (12) Disposal--The discharge, deposit, injection, dumping, spilling, leaking, or placing of any solid waste or hazardous waste (whether containerized or uncontainerized) into or on any land or water so that such solid waste or hazardous waste or any constituent thereof may enter the environment or be emitted into the air or discharge into any waters, including ground waters.      
       (13) Extended observation--The period of time that a patient remains in the facility following recovery from anesthesia and discharge from the postanesthesia care unit, during which additional comfort measures or observation may be provided.      
       (14) Health care practitioners (qualified medical personnel)--Individuals currently licensed under the laws of this state who are authorized to provide services in an ASC.      
       (15) Licensed vocational nurse (LVN)--A person who is currently licensed by the Texas Board of Nursing as a licensed vocational nurse.      
       (16) Medicare-approved reference laboratory--A facility that has been certified and found eligible for Medicare reimbursement, and includes hospital laboratories which may be Joint Commission or American Osteopathic Association accredited or nonaccredited Medicare approved hospitals, and Medicare certified independent laboratories.      
       (17) Person--Any individual, firm, partnership, corporation, or association.      
       (18) Physician--An individual licensed by the Texas Medical Board and authorized to practice medicine in the State of Texas.      
       (19) Premises--A building where patients receive outpatient surgical services.      
       (20) Registered nurse (RN)--A person who is currently licensed by the Texas Board of Nursing as a registered nurse.      
       (21) Surgical technologist--A person who practices surgical technology as defined in Health and Safety Code, Chapter 259.      
       (22) Title XVIII--Title XVIII of the United States Social Security Act, 42 United States Code (USC), §§1395 et seq.      
     Source Note:        The provisions of this §135.2 adopted to be effective June 18, 2009, 34 TexReg 3948; amended to be effective November 25, 2010, 35 TexReg 10232