OPINION In this interlocutory appeal,[1] appellant, City of Houston (the “City”), challenges the trial court’s order denying its motion to dismiss the negligence suit against it by appellee, Shirley Houston. In its sole issue, the City contends that the trial court erred in denying its motion to dismiss because Houston’s claim constitutes a health care liability claim[2] and she failed to serve it with a statutorily-required expert report.[3] We reverse and render. Background In her first amended petition, Houston alleges that on or about March 12, 2017, Houston, while in her home, “pressed her emergency Life Alert button after experiencing difficulty breathing.” In response, two Houston Fire Department (“HFD”) emergency medical technicians (“EMTs”) arrived at her home. The EMTs then “used a motor-operated gurney owned by” the City to transport Houston to an ambulance. According to Houston, the EMTs lowered the gurney and placed Houston on the gurney “in a laying position.” As Houston lay on the gurney, the EMTs raised it “to its highest height[,] without properly securing” Houston. While the EMTs transported Houston from her home to the ambulance outside, “the gurney suddenly gave way, tilted, and caused [Houston] to [be] drop[ped] on the ground.” Houston lay on the ground in pain for over twenty minutes before additional HFD personnel arrived. Houston alleges that, as a result of her fall, she “suffer[ed] severe, painful, and permanent injuries that require[d] [her] to undergo surgery.” Houston brings a negligence claim against the City, asserting that at all material times the HFD EMTs were acting within the course and scope of their employment or official duties and to advance the duties of their office or employment with the City. And the EMTs were negligent in failing to operate the gurney in a safe manner, failing to maintain a proper lookout, failing to secure Houston properly to the gurney, failing properly to secure the gurney, failing to monitor “the patient” while operating the gurney, and failing to use established protocols. According to Houston, each of those acts or omissions by the EMTs proximately caused Houston’s injuries and damages. The City answered, generally denying the allegations in Houston’s petition. The City then moved to dismiss Houston’s negligence claim against it, asserting that Houston had alleged a health care liability claim, she had failed to serve the statutorily-required expert report, and the trial court had to dismiss Houston’s claim.[4] In response, Houston argued that she was not required to serve an expert report because she had not alleged a health care liability claim and the City was not a health care provider. Houston attached to her supplemental response to the City’s motion to dismiss the HFD’s “EMS Patient Care Report,” which detailed the EMTs treatment of Houston on March 12, 2017. The trial court denied the City’s motion. Standard of Review We review a trial court’s decision on a motion to dismiss a health care liability claim for an abuse of discretion. See Am. Transitional Care Ctrs. of Tex., Inc. v. Palacios, 46 S.W.3d 873, 875 (Tex. 2001); Cage v. Methodist Hosp., 470 S.W.3d 596, 600 (Tex. App.—Houston [1st Dist.] 2015, no pet.). That said, whether a claim constitutes a health care liability claim is a question of law that we review de novo. Baylor Scott & White, Hillcrest Med. Ctr. v. Weems, 575 S.W.3d 357, 363 (Tex. 2019). In determining whether a claim constitutes a health care liability claim, we consider the entire record, including the pleadings, motions, and responses, and relevant evidence properly admitted. Loaisiga v. Cerda, 379 S.W.3d 248, 258 (Tex. 2012). Health Care Liability Claim In its sole issue, the City argues that the trial court erred in denying its motion to dismiss because Houston’s claim against it constitutes a health care liability claim and Houston failed to serve it with a statutorily-required expert report. Under the Texas Medical Liability Act (“TMLA”), a plaintiff whose claim constitutes a health care liability claim must serve an expert report, with a curriculum vitae for the expert whose opinion is offered, on a defendant physician or health care provider within 120 days of the filing of an answer by the defendant. TEX. CIV. PRAC. & REM. CODE ANN. § 74.351(a); see also Weems, 575 S.W.3d at 360–61. If the plaintiff fails to timely serve an expert report, then on the motion of a defendant physician or health care provider, the trial court must dismiss the plaintiff’s health care liability claim with prejudice. TEX. CIV. PRAC. & REM. CODE ANN. § 74.351(b); see also Weems, 575 S.W.3d at 360–61. Here, Houston did not serve an expert report on the City at any time, so if Houston’s negligence claim against the City constitutes a health care liability claim, her suit must be dismissed. See Weems, 575 S.W.3d at 360–61, 363 (because plaintiff did not serve expert report, if plaintiff asserted health care liability claim, suit must be dismissed with prejudice). The TMLA defines a “[h]ealth care liability claim” as: a cause of action against a health care provider or physician for treatment, lack of treatment, or other claimed departure from accepted standards of medical care, or health care, or safety or professional or administrative services directly related to health care, which proximately results in injury to or death of a claimant, whether the claimant’s claim or cause of action sounds in tort or contract. TEX. CIV. PRAC. & REM. CODE ANN. § 74.001(a)(13) (internal quotations omitted); see also Ross v. St. Luke’s Episcopal Hosp., 462 S.W.3d 496, 501 (Tex. 2015). Thus, we consider three basic elements in determining whether a plaintiff’s claim constitutes a health care liability claim: (1) whether the defendant is a physician or health care provider; (2) whether the claim at issue concerns treatment, lack of treatment, or a departure from accepted standards of medical care, or health care, or safety, or professional or administrative services directly related to health care; and (3) whether the defendant’s act or omission complained of proximately caused the injury to the plaintiff.[5] Rio Grande Valley Vein Clinic, P.A. v. Guerrero, 431 S.W.3d 64, 65 (Tex. 2014); see TEX. CIV. PRAC. & REM. CODE ANN. § 74.001(a)(13). The TMLA creates a rebuttable presumption that a plaintiff’s claim is a health care liability claim if it is brought against a physician or health care provider and “is based on facts implicating the defendant’s conduct during the course of a patient’s care, treatment, or confinement.” Loaisiga, 379 S.W.3d at 256. Health Care Provider The City argues that it constitutes a health care provider under the TMLA because the HFD, and its EMTs, which Houston alleges “were acting within the course and scope of their employment and in furtherance of their employment with” the City, constitute emergency medical services providers. See TEX. CIV. PRAC. & REM. CODE ANN. § 74.001(a)(11), (a)(12)(A). The TMLA defines a “[h]ealth care provider” as: any person, partnership, professional association, corporation, facility, or institution duly licensed, certified, registered, or chartered by the State of Texas to provide health care, including: . . . (vii) a health care institution . . . . Id. § 74.001(a)(12)(A) (emphasis added) (internal quotations omitted). A “[h]ealth care institution” includes “an emergency medical services provider.” Id. § 74.001(a)(11)(C) (internal quotations omitted); see also id. § 74.001(a)(8) (defining “[e]mergency medical services provider” (internal quotations omitted)). “Health care” is “any act or treatment performed or furnished, or that should have been performed or furnished, by any health care provider for, to, or on behalf of a patient during the patient’s medical care, treatment, or confinement.” Id. § 74.001(a)(10) (internal quotations omitted). Houston argues that the City cannot constitute a health care provider under the TMLA because the City is a political subdivision of the State and a “political subdivision of the [S]tate” is not one of the enumerated entities in the TMLA’s definition of a “[h]ealth care provider.” See id. § 74.001(a)(12)(A) (internal quotations omitted). The list of people and entities in the TMLA’s definition of a “health care provider” is not exclusive, and a person or entity not specifically enumerated may still constitute a health care provider under the TMLA. See Skloss v. Perez, No. 01-08-00484-CV, 2009 WL 40438, at *3–6 (Tex. App.—Houston [1st Dist.] Jan. 8, 2009, no pet.) (mem. op.) (“The list of health care providers in section 74.001(a)(12) does not specifically include a[] [licensed professional counselor]; however, the listis non-exhaustive.”); Christus Health v. Beal, 240 S.W.3d 282, 286–87 (Tex. App.— Houston [1st Dist.] 2007, no pet.), abrogated on other grounds by Tex. W. Oaks Hosp., LP v. Williams, 371 S.W.3d 171 (Tex. 2012); see also Strobel v. Marlow, 341 S.W.3d 470, 474–75 (Tex. App.—Dallas 2011, no pet.); House of Yahweh v. Johnson, 289 S.W.3d 345, 351 (Tex. App.—Eastland 2009, no pet.). And plaintiffs will sometimes assert health care liability claims against political subdivisions of the State. See, e.g., Tinnard v. Dallas Cty. Hosp. Dist., No. 05-13-01161-CV, 2015 WL 273123, at *1 (Tex. App.—Dallas Jan. 22, 2015, no pet.) (mem. op.); Cervantes v. McKellar, 424 S.W.3d 226, 229 (Tex. App.—Texarkana 2014, no pet.); Harris Cty. Hosp. Dist. v. Garrett, 232 S.W.3d 170, 173 (Tex. App.—Houston [1st Dist.] 2007, no pet.); Devereaux v. Harris Cty. Hosp. Dist., No. 01-05-00706-CV, 2007 WL 852618, at *1 (Tex. App.—Houston [1st Dist.] Mar. 22, 2007, no pet.) (mem. op.) (health care liability claims asserted against hospital district); see also Harris Cty. Hosp. Dist. v. Tomball Reg’l Hosp., 283 S.W.3d 838, 842 (Tex. 2009) (hospital district, such as Harris County Hospital District, constitutes political subdivision of State); Bansal v. Univ. of Tex. M.D. Anderson Cancer Ctr., 502 S.W.3d 347, 357 (Tex. App.—Houston [14th Dist.] 2016, pet. denied) (county and hospital district constitute political subdivisions of State); Dallas Cty. Hosp. Dist. v. Hospira Worldwide, Inc., 400 S.W.3d 182, 184–85, 184 n.1 (Tex. App.—Dallas 2013, no pet.) (county hospital district constitutes political subdivision of State). Further, plaintiffs routinely bring health care liability claims against emergency medical services providers, like the City through the HFD and its EMTs. See Columbia Valley Healthcare Sys., L.P. v. Zamarripa, 526 S.W.3d 453, 455–57 (Tex. 2017) (health care liability claim brought against Hidalgo County Emergency Medical Service); Coci v. Dower, 585 S.W.3d 652, 653–57 (Tex. App.—Eastland 2019, pet. denied) (no dispute that Heart of Texas EMS and its ambulance driver constituted health care providers); Taton v. Taylor, No. 02-18-00373-CV, 2019 WL 2635568, at *1, *4 (Tex. App.—Fort Worth June 27, 2019, no pet.) (mem. op.) (health care liability claim brought against CareFlite, emergency medical services provider, and its employee, who were hired to transport plaintiff in handicap accessible van; no dispute CareFlite and its employee constituted health care providers); Zamarripa v. Bay Area Health Care Grp., Ltd., No. 13-15-00024-CV, 2016 WL 6962009, at *1 (Tex. App.—Corpus Christi–Edinburg Nov. 22, 2016, pet. denied) (mem. op.) (health care liability claim brought against Hidalgo County Emergency Medical Service, which provided transport via ambulance); Good Shepherd Hosp., Inc. v. Masten, No. 12-13-00005-CV, 2014 WL 6792683, at *1, *5 & n.1 (Tex. App.—Tyler Dec. 3, 2014, pet. denied) (mem. op.) (noting defendant, which employed EMTs, owned ambulances, and provided emergency medical services, constituted health care provider); Care Ctr., Ltd. v. Sutton, No. 09-07-469-CV, 2008 WL 1745862, at *1 (Tex. App.—Beaumont Apr. 17, 2008, pet. denied) (mem. op.) (health care liability claim brought against emergency medical and ambulance service). In her first amended petition, Houston alleges that on March 12, 2017, while in her home, she “pressed her emergency Life Alert button after experiencing difficulty breathing.” In response, two HFD EMTs arrived at Houston’s home. According to Houston, at all material times, the HFD EMTs were acting within the course and scope of their employment or official duties and to advance the duties of their office or employment with the City. While at Houston’s home, the HFD EMTs “used a motor-operated gurney owned by” the City to transport Houston to an ambulance. The EMTs lowered the gurney and placed Houston on the gurney “in a laying position.” The EMTs then raised the gurney “to its highest height[,] without properly securing” Houston. As the EMTs transported Houston from her home to the ambulance outside, “the gurney suddenly gave way, tilted, and caused [Houston] to [be] drop[ped] on the ground.” Houston lay on the ground in pain for over twenty minutes before additional HFD personnel arrived. As a result of the fall, Houston “suffer[ed] severe, painful, and permanent injuries that require[d] [her] to undergo surgery.” Houston did not dispute in the trial court, and does not dispute on appeal, that the HFD and its EMTs constitute emergency medical services providers and that she was provided with “[h]ealth care” as defined by the TMLA. See TEX. CIV. PRAC. & REM. CODE ANN. § 74.001(a)(8), (a)(10) (internal quotations omitted), (a)(11), (a)(12)(A). For these reasons, we conclude that, within the context of this case, the City, through the HFD and its EMTs, constitutes a health care provider under the TMLA. See id. § 74.001(a)(11), (a)(12)(A). Claim Concerns Departure from Accepted Standards of Safety The City next argues that Houston’s claim against it constitutes a health care liability claim because it concerns a departure from the accepted safety standards, there is a substantive nexus between the safety standards allegedly violated and the providing of health care, and Houston has not rebutted the presumption that her claim constitutes a health care liability claim. As stated above, a “[h]ealth care liability claim” is a cause of action against a health care provider or physician for treatment, lack of treatment, or other claimed departure from accepted standards of medical care, or health care, or safety or professional or administrative services directly related to health care, which proximately results in injury to or death of a claimant, whether the claimant’s claim or cause of action sounds in tort or contract. Id. § 74.001(a)(13) (emphasis added) (internal quotations omitted); see also Ross, 462 S.W.3d at 501. “[S]afety” is not defined by the TMLA. However, the Texas Supreme Court has stated that “safety” is given its common meaning as “the condition of being untouched by danger; not exposed to danger; secure from danger, harm or loss.” Ross, 462 S.W.3d at 501 (internal quotations omitted). Using the statutory definition, an accepted safety-standard claim need not be directly related to the providing of health care to qualify as a health care liability claim. Id. at 504; see also Diversicare Gen. Partner, Inc. v. Rubio, 185 S.W.3d 842, 855 (Tex. 2005) (“[T]he Legislature’s inclusion within the scope of the [TMLA] of claims based on breaches of accepted standards of ‘safety’ expands the scope of the statute beyond what it would be if it only covered medical and health care.”). Instead, there need only be “a substantive nexus between the safety standards allegedly violated and the provision of health care.” Ross, 462 S.W.3d at 504; see also Cage, 470 S.W.3d at 602. This nexus depends on “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.” Ross, 462 S.W.3d at 505; see also Cage, 470 S.W.3d at 602. The Texas Supreme Court has set forth a list of non-exclusive considerations to help courts determine whether there is a substantive nexus between the safety standards allegedly violated and the providing of health care: Whether the alleged negligence occurred in the course of the defendant’s performing tasks with the purpose of protecting patients from harm; Whether the alleged injuries occurred in a place where patients were receiving care, so that the obligation of the provider to protect persons who require medical care was implicated; Whether the plaintiff was seeking or receiving health care when the alleged injuries occurred; Whether the plaintiff was providing or assisting in the providing of health care when the injuries occurred; Whether the alleged negligence arises from safety standards that are part of the professional duties owed by the health care provider; If an instrumentality was involved in the defendant’s alleged negligence, whether it was a type used in the providing of health care; or Whether the alleged negligence implicated safety-related requirements set for health care providers by governmental or accrediting agencies. See Ross, 462 S.W.3d at 505. When we examine these factors or considerations, we focus on the essence of the cause of action. Bain v. Capital Senior Living Corp., No. 05-14-00255-CV, 2015 WL 3958714, at *3 (Tex. App.—Dallas June 30, 2015, pet. denied) (mem. op.). Is the claim an ordinary negligence claim or is the claim a health care liability claim as contemplated by the Legislature when it provided for health care liability claims in the TMLA? See Tex. W. Oaks Hosp., 371 S.W.3d at 176. The pivotal issue is whether the safety standards implicated the defendant’s duties as a health care provider. See Ross, 462 S.W.3d at 505. In her first amended petition, Houston alleges that she, while in her home, “pressed her emergency Life Alert button after experiencing difficulty breathing.” In response, two HFD EMTs arrived at Houston’s home and placed Houston on a “motor-operated gurney” to transport her from her home to an ambulance. The EMTs lowered the gurney and placed Houston on the gurney “in a laying position.” The EMTs raised the gurney “to its highest height[,] without properly securing” Houston. As the EMTs transported Houston from her home to the ambulance outside, “the gurney suddenly gave way, tilted, and caused [Houston] to [be] drop[ped] on the ground.” The fall to the ground caused Houston to “suffer severe, painful, and permanent injuries that require[d] [her] to undergo surgery.” Houston brought a negligence claim against the City, asserting that the HFD EMTs were negligent in failing to operate the gurney in a safe manner, failing to maintain a proper lookout, failing to secure Houston properly to the gurney, failing properly to secure the gurney, failing to monitor “the patient,” Houston, while operating the gurney, and failing to use established protocols. The “EMS Patient Care Report” from the HFD, which Houston attached to her supplemental response to the City’s motion to dismiss, states that the HFD EMTs arrived at Houston’s home in an ambulance in response to a “[f]all [v]ictim” call. Upon arrival, the EMTs found Houston, a sixty-four-year old, lying on her left side on the floor. Houston’s chief complaint was “weakness.” Houston’s family members stated that Houston “ha[d] been falling more frequently for the past two weeks” and had swelling in her lower extremities. The EMTs took Houston’s vital signs, completed an “[a]ssessment [e]xam,” and obtained Houston’s “[m]edical [s]urgery history” and “medication allergies.” Houston told the EMTs that she needed help to get “off the floor,” and she agreed to be transported to a hospital by the EMTs. To take Houston from her home to the ambulance outside, the EMTs “loaded and secured” Houston to the ambulance’s “stretcher” because of certain conditions: an “uneven driveway,” “minimal lighting,” an “unseen pothole,” Houston’s weight, and “the stretcher being top heavy.” According to the report, as the HFD EMTs rolled Houston on the stretcher to the ambulance outside, the stretcher “tipped over” and Houston fell to the ground because she was “unsecured.” Upon falling, the EMTs assessed Houston. Houston stated that her left elbow hurt, and the EMTs observed an abrasion on her elbow. Additional HFD personnel were dispatched to Houston’s home, and upon their arrival, the EMTs “loaded” Houston on a “backboard,” and secured her onto the stretcher. The EMTs placed Houston in the back of the ambulance, cleaned and bandaged her left elbow abrasion, and provided her with oxygen. While transporting Houston to a hospital, the EMTs monitored and evaluated Houston and took her vital signs. Here, most of the Ross factors[6] favor concluding that Houston’s claim constitutes a health care liability claim. Ross, 462 S.W.3d at 504. As for the first and sixth factors, the HFD EMTs’ purported failures in using and operating the gurney, an instrumentality used in the providing of health care,[7] and in failing to properly secure Houston to the gurney, to maintain a proper lookout while operating the gurney, to monitor “the patient” while operating the gurney, and to use established protocols, constitute alleged negligence while performing a task aimed at protecting a patient from harm. See Tex. Health Res. v. Coming Attractions Bridal & Formal, Inc., 595 S.W.3d 659, 664–65 (Tex. 2020) (alleged failure to implement policies and procedures constituted alleged negligence in course of defendant health care provider performing tasks aimed at protecting patients from harm); Taylor, 2019 WL 2635568, at *5–7 (substantive nexus existed between allegedly violated safety standards and provision of health care where plaintiff injured while being transported in handicap accessible van and defendant health care provider failed to secure wheelchair in place or secure plaintiff to wheelchair prior to transport); Bain, 2015 WL 3958714, at *4 (alleged misuse of wheelchair lap belt so that plaintiff could be safely transported constituted “a task performed with the purpose of protecting [persons] from harm”). And as for the second and third factors, when Houston was injured, she was being transported by the HFD EMTs to an ambulance to be taken to a hospital. Houston’s own pleadings and evidence show that Houston called the HFD EMTs to her house through her “Life Alert button” because she was having trouble breathing. In response to Houston’s “[f]all [v]ictim” call, the HFD EMTs arrived at Houston’s home in an ambulance and found Houston inside her home lying on the floor on her left side and complaining of weakness. Houston’s family members reported that Houston had been falling often and experiencing swelling in her lower extremities. While at Houston’s home, the EMTs took Houston’s vital signs, completed an “[a]ssessment [e]xam,” and obtained Houston’s “[m]edical [s]urgery [h]istory” and “medication allergies.” Houston told the EMTs that she needed help and agreed to be transported to a hospital by ambulance. The EMTs then sought out a gurney to transport Houston to the ambulance outside. When Houston was placed in the back of the ambulance, she received oxygen, the EMTs monitored and evaluated Houston, and the EMTs again took her vital signs. Cf. Kindred Healthcare, Inc. v. Morales, 499 S.W.3d 475, 480 (Tex. App.—Houston [1st Dist.] 2016, no pet.) (considering whether plaintiff was seeking or receiving healthcare when he was injured). Houston argues that her claim cannot constitute a health care liability claim because her “injuries did not occur in a health care setting, a health care facility, or hospital” and she sustained her injuries “just outside her front door in her driveway.” That said, the location of where the health care is provided does not determine whether a claim constitutes a health care liability claim. See Ross, 462 S.W.3d at 504–05 (mere fact injury did not occur inside health care facility does not preclude claim from being health care liability claim); Tesoro v. Alvarez, 281 S.W.3d 654, 660 (Tex. App.—Corpus Christi–Edinburg 2009, no pet.) (location where health care performed or furnished not determinative of whether claim constitutes health care liability claim). And we note that Texas courts recognize health care liability claims arising from negligent acts or omissions while a plaintiff is being provided with health care in her home. See, e.g., Health Care Unlimited, Inc. v. Soto, No. 13-10-00633-CV, 2011 WL 2937429, at *1–3 (Tex. App.—Corpus Christi– Edinburg July 21, 2011, no pet.) (mem. op.); San Antonio Extended Med. Care, Inc. v. Vasquez, 327 S.W.3d 193, 195–96, 198–99 (Tex. App.—San Antonio 2010, pet. dism’d w.o.j.); Valdez v. Lopez Health Sys., Inc., No. 04-04-00023-CV, 2005 WL 1629803, at *1–2 (Tex. App.—San Antonio July 13, 2005, no pet.) (mem. op.); see also IPH Health Care Servs., Inc. v. Ramsey, No. 01-12-00390-CV, 2013 WL 1183307, at *1–15 (Tex. App.—Houston [1st Dist.] 2013, no pet.) (mem. op.) (reviewing expert report in case involving health care liability claim arising from home health care setting). Houston also argues that her claim cannot constitute a health care liability claim because “[s]he had yet to be admitted to a hospital” and “[s]he was never seen by a nurse or a physician.” Under the third Ross factor, the plaintiff need not be seeking or receiving health care specifically in a hospital or from “a nurse or physician.” Here, we are concerned with whether Houston, when she was injured, was seeking or receiving health care from the HFD EMTs, which she was. See TEX. CIV. PRAC. & REM. CODE ANN. § 74.001(a)(10) (“Health care” is “any act or treatment performed or furnished, or that should have been performed or furnished, by any health care provider for, to, or on behalf of a patient during the patient’s medical care, treatment, or confinement.” (internal quotations omitted)). In regard to the fifth factor, Houston’s allegations that the HFD EMTs failed to operate the gurney in a safe manner, failed to maintain a proper lookout, failed to secure Houston properly to the gurney, failed properly to secure the gurney, failed to monitor “the patient” while operating the gurney, and failed to use established protocols constitute negligence allegations “based on safety standards arising from professional duties.” See Tex. Health Res. v. Coming Attractions Bridal & Formal, Inc., 552 S.W.3d 335, 341 (Tex. App.—Dallas 2018), aff’d, 595 S.W.3d at 660–67; see also TEX. HEALTH & SAFETY CODE ANN. ch. 773 (“Emergency Medical Health Care Act”); id. § 773.002 (“The purpose of this chapter is to provide for the prompt and efficient transportation of sick and injured patients, after necessary stabilization, and to encourage public access to that transportation in each area of the state.”). Although not all of the Ross factors apply to this case, the factors that do apply show that Houston’s claim involves “a substantive nexus between the safety standards allegedly violated and the provision of health care.” Ross, 462 S.W.3d at 504; see also Cage, 470 S.W.3d at 602. Houston further argues that her claim cannot constitute a health care liability claim because “[e]xpert testimony is not needed to prove or refute” her claim. Although how much expert testimony from a health care professional is necessary to support a plaintiff’s claim is a relevant consideration in deciding whether a safety-standard claim constitutes a health care liability claim, whether medical expert testimony will be needed to establish a plaintiff’s claim does not determine the issue. See Tex. W. Oaks Hosp., 371 S.W.3d at 182; Pallares v. Magic Valley Elec. Coop., Inc., 267 S.W.3d 67, 74–75 (Tex. App.—Corpus Christi–Edinburg 2008, pet. denied). A claim may still be a health care liability claim even when expert testimony is not required. Tex. W. Oaks Hosp., 371 S.W.3d at 182; Sherman v. HealthSouth Specialty Hosp., Inc., 397 S.W.3d 869, 874–75 (Tex. App.—Dallas 2013, pet. denied). Houston also generally asserts that the City, as the health care provider and the movant for dismissal, failed to meet its burden to establish the applicability of the TMLA. But, as noted, the Texas Supreme Court has explained that the TMLA creates a rebuttable presumption that a plaintiff’s claim is a health care liability claim if it is brought against a health care provider and “is based on facts implicating the defendant’s conduct during the course of a patient’s care, treatment, or confinement.” Loaisiga, 379 S.W.3d at 256; see also In re Baylor Coll. of Med., Nos. 01-19-00105-CV, 01-19-00142-CV, 2019 WL 3418504, at *2 (Tex. App.—Houston [1st Dist.] July 30, 2019, orig. proceeding) (mem. op.). Under such circumstances, a plaintiff bears the burden of rebutting the presumption that her claim is a health care liability claim. Weems, 575 S.W.3d at 363. Here, the allegations in Houston’s first amended petition show that her claim is against a health care provider and is based on facts that implicate the defendant’s conduct during the course of a patient’s care, treatment, or confinement. See id. Thus, Houston bore the burden of rebutting the presumption that her claim against the City was a health care liability claim. See id. She has not done so. For these reasons, we conclude that Houston’s claim against the City constitutes a health care liability claim. In doing so, we note that our decision is in line with the decisions from other appellate courts. See Taton, 2019 WL 2635568, at *4–7 (claim constituted health care liability claim where plaintiff injured while being transported by emergency medical services provider’s employee in a handicap accessible van; plaintiff, who was in his wheelchair at time, alleged employee failed to remove bag from back of wheelchair, did not secure wheelchair into place in van, and did not secure plaintiff in wheelchair before transport; plaintiff fell and was injured during transport); Bain, 2015 WL 3958714, at *1–4 (claim constituted health care liability claim where plaintiff injured while being transported to doctor’s appointment by assisted living facility’s employee in van; plaintiff, who was in her wheelchair at time, alleged employee did not properly secure her to her wheelchair; plaintiff fell and was injured during transport); Sherman, 397 S.W.3d at 871–75 (claim constituted health care liability claim where plaintiff injured while being transported back home by hospital clinic employee in van; plaintiff, who was in her wheelchair at time, alleged employee did not anchor wheelchair to floor of van or secure plaintiff in wheelchair; plaintiff fell and was injured during transport); see also Nexion Health at Humble, Inc. v. Whitley, No. 14-09-00052-CV, 2009 WL 2589221, at *1 (Tex. App.—Houston [14th Dist.] Aug. 25, 2009, no pet.) (mem. op.) (health care liability claim where plaintiff, who was in wheelchair at time, was loaded into van to be transported to doctor’s appointment; plaintiff not properly secured and thrown out of wheelchair during transport).[8] As a result, because Houston’s claim constitutes a health care liability claim and Houston failed to serve the City with a statutorily-required expert report, we hold that the trial court erred in denying the City’s motion to dismiss. We sustain the City’s sole issue. Conclusion We reverse the trial court’s order denying the City’s motion to dismiss and render judgment dismissing Houston’s suit against the City with prejudice. Julie Countiss Justice Panel consists of Justices Kelly, Hightower, and Countiss.
