Section He-P 811.03 - Definitions(a) "Abuse" means any one of the following: (1) "Emotional abuse" means the misuse of power, authority, or both, verbal harassment, or unreasonable 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; and (3) "Sexual abuse" means contact or interaction of a sexual nature involving a vulnerable adult as defined in RSA 161-F:43, II(c) , or, in the case of sexual abuse of a minor, as defined in RSA 169-C:3VII-b, XXV.(b) "Addition" means an increase in the building area, aggregate floor area, building height, or number of stories of a structure.(c) "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.(d) "Administrator" means the person responsible for the management of the licensed premises who is licensed by the state of New Hampshire pursuant to RSA 151 and who reports to and is accountable to the governing body.(e) "Admitted" means accepted by a licensee for the provision of services to a client.(f) "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" includes 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.(g) "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, captive or affiliated insurance companies. (h) "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 identified under RSA-J:34-37.(i) "Applicant" means an individual, agency, partnership, corporation, government entity, association, or other legal entity seeking a license pursuant to RSA 151.(j) "Area of non-compliance" means any action or failure to act that cause(s) a licensee to be out of compliance with RSA 151, He-P 803, or other applicable federal and state requirements.(k) "Assessment" means a systematic data collection which enables facility personnel to plan care that allows the client to reach his or her highest practicable level of physical, mental, and psychosocial functioning.(l) "Care plan or treatment plan" means a documented guide developed by the licensee, in consultation with personnel, the client, and the client's guardian, agent, or personal representative, if any, as a result of the assessment process, for the provision of care and services to a client.(m) "Change of ownership" means the transfer of a controlling interest of the licensed entity to an individual or successor business entity.(n) "Chemical restraint" means any medication that is used for discipline or staff convenience, in order to alter a client's behavior such that the client requires a lesser amount of effort or care, and is not in the client's best interest, and not required to treat medical symptoms. (o) "Client" means any person admitted to or receiving care, services, or both from a health care facility licensed in accordance with RSA 151 and He-P 811.(p) "Client record" means documents maintained for each person receiving care and services, which includes all documentation required by RSA 151, He-P 811, and all documentation compiled relative to the client as required by other federal and state requirements.(q) "Commissioner" means the commissioner of the department of health and human services or his or her designee.(r) "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. (s) "Days" means calendar days, unless otherwise specified.(t) "Department" means the New Hampshire department of health and human services.(u) "Dialysis" means the passage of a solute through a membrane. (v) "Direct care" means hands on care or services to a client, including but not limited to medical, nursing, psychological, or rehabilitative treatments.(w) "Direct care personnel" means any person providing hands-on care or services to a client.(x) "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.(y) "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) ". (z) "Elopement" means when a client who is cognitively, physically, mentally, emotionally, or chemically impaired or cognitively intact, wanders away, walks away, runs away, escapes, or otherwise leaves a facility unsupervised or unnoticed without knowledge of the licensee's personnel.(aa) "Emergency" means an unexpected occurrence or set of circumstances, which require immediate, remedial attention.(ab) "Emergency plan" means a document outlining the responsibilities of personnel in an emergency.(ac) "End stage renal disease dialysis center (ESRDDC) " means a facility which provides hemodialysis or peritoneal dialysis on an outpatient basis and any other acute or chronic dialysis related procedures as approved by their governing body.(ad) "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 811.(ae) "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, not to include portable refrigerators. This term includes "fixtures".(af) "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.(ag) "Facility" means "facility" as defined in RSA 151:19, II.(ah) "Governing body" means a group of designated person(s) functioning as a governing body that appoints the administrator and is legally responsible for establishing and implementing policies regarding management and operation of the facility.(ai) "Guardian" means a person appointed in accordance with RSA 463, RSA 464-A, or the laws of another state, to make informed decisions over the client's person and/or estate.(aj) "Hemodialysis" means removal of toxic substances from the blood of persons for whom one or both kidneys are defective or absent by passing it through tubes made of semi permeable membranes which are continually bathed by solution which selectively remove unwanted material.(ak) "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.(al) "Infectious waste" means those items specified by Env-Sw 904.(am) "Informed consent" means the decision by a client, his or her guardian, agent, or surrogate decision-maker to agree to a proposed course of treatment, after the client, guardian, agent, or surrogate decision-maker 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.(an) "Inspection" means the process used by the department to determine an applicant or a licensee's compliance with RSA 151, He-P 811, and all other federal and state requirements or to respond to allegations pursuant to RSA 151:6, of non-compliance with RSA 151 or He-P 811. (ao) "License" means the document issued by the department to an applicant at the start of operation as an ESRDDC which authorizes operation as an ESRDDC in accordance with RSA 151 and He-P 811, and includes the name of the licensee, the name of the business, the physical address, the license classification, the effective date, and the license number.(ap) "License certificate" means the document issues by the department to an applicant or licensee that contains the information on a license and includes the name of the administrator and the type(s) of services authorized. (aq) "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 New Hampshire licensing board.(ar) "Licensed premises" means the building(s) that comprises the physical location that the department has approved for the licensee to conduct operations in accordance with its license. (as) "Licensee" means any person or legal entity to which a license has been issued pursuant to RSA 151.(at) "Licensing classification" means the specific category of services authorized by a license.(au) "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.(av) "Medical director" means a physician board certified in internal medicine or pediatrics with a board approved training program in nephrology and licensed in New Hampshire pursuant to RSA 329 who is responsible for the implementation of client care policies and the coordination of medical care in the facility.(aw) "Medication" means a substance available with or without a prescription, which is used as a curative, remedial, or palliative, supportive substance.(ax) "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.(ay) "Neglect" means an act or omission, which results or could result in the deprivation of essential services necessary to maintain the mental, emotional, or physical health and safety of a client.(az) "Nursing care" means the provision of oversight of a client's physical, mental, or emotional condition or diagnosis as confirmed by a licensed practitioner. (ba) "Orders" means a document, produced verbally, electronically, or in writing, by a licensed practitioner for medications, treatments, and 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 any person, corporation, association, or any other legal entity who has controlling interest in the facility.(bc) "Parenteral" means any non-oral means of administration, but is generally interpreted as relating to injecting directly into the body, bypassing the skin and mucous membranes. The common parenteral routes are intramuscular (IM), subcutaneous (SC) and intravenous (IV) .(bd) "Patient or client rights" means the privileges and responsibilities possessed by each client provided by RSA 151:21. (be) "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. (bf) "Peritoneal dialysis" is a type of dialysis which uses the lining of the abdomen (peritoneum) as the membrane through which fluid and dissolved substances are exchanged with the blood. It is used to remove excess fluid, correct electrolyte problems, and remove toxins in those with kidney failure.(bg) "Personal representative" means a person, other than the licensee of, an employee of, or a person having a direct or indirect ownership interest in the licensed facility, who is designated in accordance with RSA 151:19, V, to assist the client for a specific, limited purpose or for the general purpose of assisting the client in the exercise of any rights.(bh) "Personnel" means an individual(s), who is employed by the licensed facility, a volunteer, or an independent contractor, who provide direct care or services to a client(s) . (bi) "Physical restraint" means the use of any hands-on or other physically applied techniques to physically limit the client's freedom of movement. (bj) "Physician" means medical doctor or doctor of osteopathy licensed in the state of New Hampshire pursuant to RSA 329 or a doctor of naturopathic medicine licensed in accordance with RSA 328-E.(bk) "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.(bl) "Pro re nata (PRN) medication" means medication administered as circumstances may require in accordance with licensed practitioner's orders.(bm) "Procedure" means a licensee's written, standardized method of performing duties and providing services.(bn) "Qualified personnel" means personnel that have been trained and have demonstrated competency to adequately perform tasks which they are assigned such as, nursing staff, clinical staff, housekeeping staff trained in infection control, and 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) "Service" means a specific activity performed by the licensee, either directly or indirectly, to benefit or assist a client.(bs) "Significant change" means a decline or improvement in a client's status that: (1) Will not normally resolve itself without further intervention by personnel or by implementing standard disease-related clinical interventions;(2) Impacts more than one area of the client's health status; and(3) Requires interdisciplinary review and/or revision of the care plan.(bt) "State monitoring" means the placement of individuals by the department at an ESRDDC to monitor the operation and conditions of the facility.(bu) "Reportable incident" means an occurrence of any of the following while the client is either in the ESRDDC or in the care of ESRDDC personnel: (1) The unanticipated death of a client that is not related to their diagnosis or underlying condition; (2) An unexplained accident or other circumstance that is of a suspicious nature of potential abuse or neglect where the injury was not observed or the cause of the injury could not be explained and has resulted in an injury that requires treatment in an emergency room by a licensed practitioner; or(3) An elopement from the ESRDDC or other circumstances that resulted in the notification and/or involvement of law enforcement or safety officials.(bv) "Volunteer" means an unpaid person who assists with the provision of care services, or activities, and who does not provide direct care or assist with direct care. This term does not include visitors or those persons or organized groups who provide religious services or entertainment.N.H. Admin. Code § He-P 811.03
Amended by Volume XXXIX Number 32, Filed August 8, 2019, Proposed by #12827, Effective 7/20/2019, Expires 1/16/2020.Amended by Volume XL Number 7, Filed February 13, 2020, Proposed by # 12985, Effective 1/29/2020, Expires 1/29/2030.