In Ross v. St. Luke's Episcopal Hospital, No. 13-0439, 462 S.W.3d 496 (Tex. May 1, 2015), the plaintiff, Lezlea Ross, had visited a hospital and, while departing the facility through its lobby, slipped and fell in an area near the exit doors where the floor was being cleaned and buffed. Ross subsequently sued the hospital, seeking personal-injury damages under a premises-liability negligence theory. The hospital moved to dismiss Ross's suit for failure to serve a TMLA expert report, arguing (like Seton here) that Ross's claims were "for . . . other claimed departure from accepted standards of . . . safety." Availing itself of the opportunity to resolve confusion among lower courts, the supreme court clarified that "for a safety standards-based claim to be an HCLC there must be a substantive nexus between the safety standards allegedly violated and the provision of health care." "The pivotal issue," the court explained, "is whether the standards on which the claim is based implicate the defendant's duties as a health care provider, including its duties to provide for patient safety." It is not enough, in other words, merely that the defendant is a health care provider or that the alleged injury-producing conduct occurred in a health care setting. The supreme court also provided the following "non-exclusive considerations" to help guide the inquiry: Did the alleged negligence of the defendant occur in the course of the defendant's performing tasks with the purpose of protecting patients from harm; Did the injuries occur in a place where patients might be during the time they were receiving care, so that the obligation of the provider to protect persons who require special, medical care was implicated; At the time of the injury was the claimant in the process of seeking or receiving health care; At the time of the injury was the claimant providing or assisting in providing health care; Is the alleged negligence based on safety standards arising from professional duties owed by the health care provider; If an instrumentality was involved in the defendant's alleged negligence, was it a type used in providing health care; or Did the alleged negligence occur in the course of the defendant's taking action or failing to take action necessary to comply with safety-related requirements set for health care providers by governmental or accrediting agencies? Applying this analysis to the record in Ross, the supreme court deemed it "clear that the answer to each consideration is 'no.'" It explained: "The record does not show that the cleaning and buffing of the floor near the exit doors was for the purpose of protecting patients. Nor does the record reflect that the area where Ross fell was one where patients might be during their treatment so that the hospital's obligation to protect patients was implicated by the condition of the floor at that location. Ross was not seeking or receiving health care, nor was she a health care provider or assisting in providing health care at the time she fell. There is no evidence the negligence alleged by Ross was based on safety standards arising from professional duties owed by the hospital as a health care provider. There is also no evidence that the equipment or materials used to clean and buff the floor were particularly suited to providing for the safety of patients, nor does the record demonstrate that the cleaning and buffing of the floor near the exit doors was to comply with a safety-related requirement set for health care providers by a governmental or accrediting authority." "Under this record," the court concluded, "Ross's claim is based on safety standards that have no substantive relationship to the hospital's providing of health care, so it is not an HCLC and . . . she was not required to serve an expert report to avoid dismissal of her suit." The Court explained that a safety standards-based claim against a health care provider constitutes a health care liability claim under Chapter 74 if there is "a substantive nexus between the safety standards allegedly violated and the provision of health care." In other words, "the pivotal issue in a safety standards-based claim is whether the standards on which the claim is based implicate the defendant's duties as a health care provider, including its duties to provide for patient safety." Id.