Section He-P 807.03 - Definitions In this part, the following words have the following meanings, unless context clearly indicates otherwise:
(a) "Abuse" means any one of the following: (1) "Emotional abuse" means the misuse of power, authority, or both, verbal harassment, or confinement which results or could result in the mental anguish or emotional distress of clients; (2) "Physical abuse" means the misuse of physical force which results or could result in physical injury to clients; or (3) "Sexual abuse" means contact or interaction of a sexual nature involving clients without his or her informed consent;(b) "Activities of daily living (ADL) " means basic daily routine tasks such as eating, transferring, toileting, bathing, dressing, and medication management;(c) "Addition" means an increase in the building area, aggregate floor area, building height, or number of stories of a structure;(d) "Administer" means an act whereby one or more doses of a medication is instilled into the body, applied to the body of, or otherwise given to a person for immediate consumption or use by an individual authorized by law, including RSA 318-B and RSA 326-B;(e) "Administrator" means the individual appointed by the licensee to be responsible for all aspects of the daily operation of the licensed premise;(f) "Admission" means the point in time when a client, who has been accepted by a licensee for the provision of services, physically moves into the facility; (g) "Advance directive" means a directive allowing a person to give directions about future medical care or to designate another person to make medical decisions if he or she should lose the capacity to make health care decisions. The term "advance directive" shall include living wills and durable powers of attorney for health care, in accordance with RSA 137-J, or a surrogate decision-maker in accordance with RSA 137-J:35; (h) "Affiliated or related parties" means companies or individuals that serve as operators, landlords, management companies or advisors, real estate or consulting companies, members of limited liability companies, administrative services companies, lenders and companies providing financial guarantees, or captive or affiliated insurance companies;(i) "Agent" means an adult to whom authority to make health care decisions is delegated under an activated durable power of attorney for health care executed in accordance with RSA 137-J, or a surrogate decision-maker in accordance with RSA 137-J:35;(j) "Applicant" means an individual, agency, partnership, corporation, government entity, association, or other legal entity seeking a license to operate a RTRF pursuant to RSA 151;(k) "Area of non-compliance" means any action, failure to act, or other set of circumstances that cause a licensee to be out of compliance with RSA 151, He-P 807, or other federal or state requirements;(l) "Assessment" means an evaluation of the client to determine the care and services that are needed; (m) "Care plan" means a documented guide developed by the licensee, in consultation with the licensed practitioner, personnel, the client, and/or the client's guardian, agent or personal representative, if any, as a result of the assessment process for the provision of care and services. This term also includes "treatment plan";(n) "Change of ownership" means a change in the controlling interest of an established RTRF to a successor business entity;(o) "Chemical restraint" means any medication prescribed to control a client's behavior or emotional state without a supporting diagnosis or for the convenience of program personnel;(p) "Client" means any person admitted to or in any way receiving care, services or both from a RTRF licensed in accordance with RSA 151 and He-P 807;(q) "Client record" means documents maintained for each client, which includes all documentation required by RSA 151 and He-P 807, and all documentation compiled relative to the client as required by other federal or state laws;(r) "Commissioner" means the commissioner of the New Hampshire department of health and human services or his or her designee;(s) "Comprehensive evaluation" means a multi-disciplinary assessment of level of function by healthcare professionals licensed or certified in the field of rehabilitation;(t) "Contracted employee" means a temporary employee working under the direct supervision of the RTRF but employed by an outside agency;(u) "Core services" means those minimal services to be provided to any client by the licensee that shall be included in the basic rate; (v) "Critical incident stress management (CISM) " means an adaptive, short-term psychological helping process that focuses solely on an immediate and identifiable problem. Individuals undergoing CISM are able to discuss the situation that occurred and how it effects them and those around them allowing individuals to use this forum to acquire the tools necessary to hopefully limit post-traumatic stress related issues in their own lives and recognize it in others;(w) "Days" means calendar days unless otherwise specified in the rule;(x) "Department" means the New Hampshire department of health and human services;(y) "Direct care" means hands-on care and services to a client, including but not limited to medical, nursing, psychological, or rehabilitative treatments; (z) "Directed plan of correction" means a plan developed and written by the department that specifies the actions the licensee must take to correct identified areas of non-compliance; (aa) "Do not resuscitate order (DNR order) " means an order, signed by a licensed provider, that in the event of an actual or imminent cardiac or respiratory arrest, chest compression and ventricular defibrillation will not be performed, the client will not be intubated or manually ventilated, and there will be no administration of resuscitation drugs. This term also includes "do not attempt resuscitation order (DNAR order) ";(ab) "Emergency plan" means a document outlining the responsibilities of personnel in an emergency;(ac) "Enforcement action" means the imposition of an administrative fine, the denial of an application, or the revocation or suspension of a license in response to non-compliance RSA 151 or He-P 807;(ad) "Equipment" means any plumbing, heating, electrical, ventilating, air-conditioning, refrigerating, and fire protection equipment, and any elevators, dumbwaiters, escalators, boilers, pressure vessels, or other mechanical facilities or installations related to building services. This term includes fixtures;(ae) "Exploitation" means the illegal use of a client's person or property for another person's profit or advantage, or the breach of a fiduciary relationship through the use of a person or person's property for any purpose not in the proper and lawful execution of a trust, including, but not limited to, situations where a person obtains money, property, or services from a client through the use of undue influence, harassment, duress, deception or fraud;(af) "Facility" means "facility" as defined in RSA 151:19, II;(ag) "Guardian" means a person appointed in accordance RSA 464-A to make informed decisions relative to the client's health care and other personal needs;(ah) "Impaired" means when a physician or health care worker whose ability to function in his or her usual role has been reduced or otherwise compromised by any substances including but not limited to legally prescribed medications or alcohol;(ai) "Incident command system (ICS) " means a standardized on-scene emergency management system specifically designed to provide for the adoption of an integrated organizational structure that reflects the complexity and demands of single or multiple incidents, without being hindered by jurisdictional boundaries. ICS is the combination of facilities, equipment, personnel, procedures, and communications operating within a common organizational structure, designed to aid in the management of resources during incidents; (aj) "Infectious waste" means those items specified by Env-Sw 103.28;(ak) "Informed consent" means the decision by a person or his or her guardian, agent, or surrogate decision maker to agree to a proposed course of treatment, after the person has received full disclosure of the facts, including information about risks and benefits of the treatment and available alternatives, needed to make the decision intelligently;(al) "In-service" means an educational program, which is designed to increase the knowledge, skills, and overall effectiveness of personnel;(am) "Inspection" means the process followed by the department to determine an applicant or a licensee's compliance with RSA 151 and He-P 807 or to respond to allegations, pursuant to RSA 151:6, of non-compliance with RSA 151 and He-P 807;(an) "License" means the document issued by the department to an applicant at the start of operation as an RTRF, which authorizes operation of a RTRF in accordance with RSA 151 and He-P 807, and includes the name of the licensee, the name of the business, the physical address, the license category, the effective date, and license number;(ao) "License certificate" means the document issued by the department to an applicant or licensee that, contains the information on a license and includes the name of the administrator, the type(s) of services authorized and the number of beds that the RTRF is licensed for;(ap) "Licensed practitioner" means: (2) Physician's assistant;(3) Advanced practice registered nurse (APRN);(4) Doctor of osteopathy;(5) Doctor of naturopathic medicine; or(6) Any other practitioner with diagnostic and prescriptive powers licensed by the appropriate state licensing board;(aq) "Licensed premises" means the building, or buildings, that comprise the physical location that the department has approved for the licensee to conduct operations in accordance with its license;(ar) "Licensee" means any person or legal entity to which a license has been issued pursuant to RSA 151;(as) "Licensing classification" means the specific category of services authorized by a license;(at) "Life safety code" means the national Fire Protection Association (NFPA) 101, as adopted by the commissioner of the department of safety in Saf-C 6000 under RSA 153, and as amended pursuant to RSA 153:5, I, by the state fire marshal with the board of fire control;(au) "Mechanical restraint" means locked or secured RTRFs or units within a RTRF, or anklets, bracelets, or similar devices that cause a door to automatically lock when approached, thereby preventing a client from freely exiting the RTRF or unit within;(av) "Medication" means a substance available with or without a prescription, which is used as a curative or remedial substance;(aw) "Modification" means the reconfiguration of any space, the addition, relocation, elimination of any door or window, the addition or elimination of load-bearing elements, the reconfiguration or extension of any system, or the installation of any additional equipment. The term does not include repair or replacement of interior finishes;(ax) "Neglect" means an act or omission which results or could result in the deprivation of essential services or supports necessary to maintain the minimum mental, emotional or physical health and safety of any client; (ay) "Notice to correct" means a report issued pursuant to RSA 151:6-a, II, following a life safety code inspection when a facility is found to be out of compliance with applicable life safety rules or codes;(az) "Nursing care" means the provision of care or oversight of a physical, mental, or emotional condition or diagnosis by a nurse;(ba) "Orders" means a document, produced verbally, electronically, or in writing, by a licensed practitioner for medications, treatments, recommendations, or referrals, and signed by the licensed practitioner using terms such as authorized by, authenticated by, approved by, reviewed by, or any other term that denotes approval by the licensed practitioner; (bb) "Owner" means a person or organization who has controlling interest in the RTRF;(bc) "Patient rights" means the privileges and responsibilities possessed by each client provided by RSA 151:21. This term includes "resident rights";(bd) "Performance-based design" means a flexible, informed design approach that allows for design freedom while specifically addressing fire and life safety concerns of a specific building project, and that makes use of computer fire models or other fire engineering calculation methodologies, such as timed egress studies, to help assess if proposed fire safety solutions meet fire safety goals under specific conditions;(be) "Personal representative" means a person, other than the licensee of an employee of or a person having a direct or indirect ownership interest in, a facility, who is designated in writing by a client or client's legal guardian for a specific, limited purpose or for the general purpose of assisting the client in the exercise of any rights as defined in RSA 151:19, V; (bf) "Personnel" means individual(s) employed by the facility, volunteer(s), or independent contractor(s), who provide direct care or services to a client; (bg) "Physical restraint" means the use of any hands-on or other physically applied techniques to physically limit the client's freedom of movement, such as forced escorts, holding, prone restraints, or other containment techniques;(bh) "Plan of correction (POC) " means a plan developed and written by the licensee, which specifies the actions that will be taken to correct identified areas of non-compliance with applicable rules or codes identified at the time of a clinical or life safety inspection conducted pursuant to RSA 151:6-a or during the course of a complaint investigation conducted pursuant to RSA 151:6;(bi) "Point of care testing (POCT) " means laboratory testing performed using either manual methods or hand held instruments at or near the site of client care;(bj) "Procedure" means a licensee's written, standardized method of performing duties and providing services;(bk) "Pro re nata (PRN) medication" means medication taken as circumstances may require in accordance with a licensed practitioner's orders;(bl) "Protective care" means the provision of client monitoring services, including but not limited to:(1) Knowledge of client whereabouts; (2) Minimizing the likelihood of accident or injury; and(3) Other means of ensuring client safety;(bm) "Qualifications" means education, experience and skill requirements specified by the federal government, state government, an accredited professional review agency, or by policy of the licensee;(bn) "Qualified personnel" means facility staff that have been trained to adequately perform certain assigned tasks, such as housekeeping staff trained in infection control or kitchen staff trained in food safety protocols;(bo) "Reconstruction" means the reconfiguration of a space that affects an exit or a corridor shared by more than one occupant space, or the reconfiguration of a space such that the rehabilitation work area is not permitted to be occupied because existing means of egress and fire protection systems, or their equivalent, are not in place or continuously maintained; (bp) "Renovation" means the replacement in kind or strengthening of building elements, or upgrading of building elements, material, equipment, or fixtures, without involving the reconfiguration of spaces;(bq) "Repair" means the patching, restoration, or painting of materials, elements, equipment, or fixtures for the purpose of maintaining such materials, elements, equipment, or fixtures in good or sound condition;(br) "Reportable incident" means an occurrence of any of the following while the client is either in the RTRF or in the care of the RTRF personnel: (1) The unanticipated death of the client;(2) An injury to a client, that is indicative of potential abuse or neglect under circumstances where the injury was not observed by any person or the cause of the injury could not be explained by the client; or (3) The unexplained absence of a client from the RTRF who is determined to be a danger to themselves or others;(bs) "Residential treatment and rehabilitation facility" (RTRF) means a place, excluding hospitals as defined in RSA 151-C:2, which provides residential care, treatment and comprehensive specialized services relating to the individual's medical, physical, psychosocial, vocational, or educational needs;(bt) "Self administration of medication without assistance" means an act whereby the client takes his or her own medication(s) without the assistance of another person;(bu) "Self administration with supervision" means an act whereby the client takes his or her own medication(s) after being prompted by personnel, but without requiring physical assistance from others;(bv) "Self- directed medication administration" means an act whereby a client, who has a physical limitation that prohibits him or her from self-administration of medication without assistance, directs personnel to physically assist in the medication process, which does not include assisting with infusions, injections, or filling insulin syringes;(bw) "Service" means a specific activity performed by the licensee, either directly or indirectly, to benefit or assist a client;(bx) "Significant change" means a change in cognitive or physical capabilities that decreases a client's ability to care for himself beyond an episodic event;(by) "Therapeutic diet" means a diet ordered by a licensed practitioner or other licensed professional with prescriptive authority as part of the treatment for disease or clinical conditions, or to increase or decrease specific nutrients in the food consumed by the client;(bz) "Unexplained absence" means an incident involving a client leaving the premises of the RTRF without the knowledge of the RTRF personnel; and(ca) "Volunteer" means an unpaid person who assists with the provision of personal care services, food services, or activities, and who does not provide direct care or assist with direct care. This term does not include visitors or those persons who provide religious services or entertainment.N.H. Admin. Code § He-P 807.03
Amended by Volume XXXIX Number 10, Filed March 7, 2019, Proposed by #12727, Effective 2/20/2019, Expires 8/19/2019.Derived from Volume XL Number 2, Filed January 9, 2020, Proposed by #12962, Effective 12/31/2019, Expires 12/31/2029.