N.H. Admin. Code § He-P 819.03

Current through Register No. 45, November 7, 2024

Section He-P 819.03 - 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 clients without their informed consent.

(b) "Administrator" means the licensee or individual appointed by the licensee to be responsible for all aspects of the CMA.

(c) "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 as identified under RSA 137-J:35.

(d) "Applicant" means an, agency, partnership, corporation, government entity, association, or other legal entity seeking a license to operate a CMA pursuant to RSA 151.

(e) "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 819, or any other federal or state requirements.

(f) "Assessment" means an evaluation of the client to determine the care and services that are needed.

(g) "Branch office" means a location physically separate from the primary location that provides client services under the administration and supervision of the primary location of the CMA.

(h) "Care plan" means a written guide developed by the licensee, or its personnel, in consultation with the client, and the client's guardian, agent, or personal representative, as a result of the assessment process for the provision of care and services as required by He-P 819.15(b)(2).

(i) "Case management agency (CMA)" means an organization in consultation with the client in the client's place of residence, arranges for and coordinates the delivery of care and services to meet the physical, emotional, medical, nursing, financial, legal, and social services needs of the client.

(j) "Case manager" means a person who provides case management services for an eligible individual and who is responsible for the ongoing assessment, coordination and monitoring of services to a client and is employed by a case management agency.

(k) "Case management supervision" means the provision of professional oversight and guidance of case manager performance by:

(1) Monitoring and oversight of case manager interactions and courses of action with the individuals for whom the case manager provides case management services;

(2) Monitoring and oversight of a case manager's service implementation activities including a review of all complex clients at least once per quarter;

(3) Written evaluation of a case manager's performance at least annually;

(4) Identifying corrective action to improve a case manager's performance; and

(5) Teaching and training case managers to enhance quality of case management service delivery as well as providing current choices for independence (CFI) program information.

(l) "Change of ownership" means the transfer in the controlling interest of an established CMA to any individual, agency, partnership, corporation, government entity, association, or other legal entity.

(m) "Client" means any person admitted to or in any way receiving services from a CMA licensed in accordance with RSA 151 and He-P 819.

(n) "Client rights" means the privileges and responsibilities possessed by each client provided by RSA 151:21-b.

(o) "Client record" means a separate file maintained for each client, which includes all documentation required by RSA 151, He-P 819, and any other federal and state law.

(p) "Commissioner" means the commissioner of the New Hampshire department of health and human services or their designee.

(q) "Community residence" means a facility of 4 or more individuals that is both certified by the department under RSA 126-A and licensed by the department under RSA 151, and that is operating in accordance with He-M 1001 or He-M 1002.

(r) "Days" means calendar days unless otherwise specified in the rule.

(s) "Department" means the New Hampshire department of health and human services.

(t) "Direct care" means the provision of hands-on care or services to a client.

(u) "Directed plan of correction" means a plan developed and written by the department that specifies the actions the licensee shall take to correct identified deficiencies.

(v) "Emergency plan" means a document outlining the responsibilities of personnel in an emergency.

(w) "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 with RSA 151 or He-P 819.

(x) "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, or fraud.

(y) "Facility" means "facility" as defined in RSA 151:19, II.

(z) "Guardian" means a person appointed in accordance with RSA 464-A to make informed decisions relative to the client's health care and other personal needs.

(aa) "Inspection" means the process followed by the department to determine an applicant's or a licensee's compliance with RSA 151 and He-P 819 or to respond to allegations, pursuant to RSA 151:6, of non-compliance with RSA 151 and He-P 819.

(ab) "License" means the document issued to an applicant or licensee of an CMA which authorizes operation in accordance with RSA 151 and He-P 819, and includes the name of the licensee, the name of the business, the physical address, the license category, the effective date, and license number.

(ac) "License certificate" means the document issued by the department to an applicant or licensee that, in addition to the information contained on a license, includes the name of the administrator and the type(s) of services authorized that the CMA is licensed for.

(ad) "Licensed practitioner" means a:

(1) Medical doctor;

(2) Physician's assistant;

(3) Advanced practice registered nurse (APRN);

(4) Doctor of osteopathy; or

(5) Doctor of naturopathic medicine; or

(6) Any other practitioner with diagnostic and prescriptive powers licensed by the appropriate state licensing board.

(ae) "Licensed premises" means the building that comprises the physical location the department has approved for the licensee to conduct operations in accordance with its license. This term includes branch offices but does not include the private residences of a client receiving services from a CMA.

(af) "Licensing classification" means the specific category of services authorized by a license.

(ag) "Neglect" means an act or omission, which results or could result in the deprivation of essential services or supports necessary to maintain the mental, emotional or physical health and safety of a client.

(ah) "Owner" means any person, corporation, association, or any other legal entity, whether organized for profit or not, holding or claiming ownership of, or title to, a license.

(ai) "Personal representative" means a person designated in accordance with RSA 151:19 to assist the client for a specific, limited purpose or for the general purpose of assisting a client in the exercise of any rights.

(aj) "Personnel" means individual(s) who provide case management services to a client.

(ak) "Plan of correction (POC)" means a plan developed and written by the licensee, which specifies the actions that will be taken to correct 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.

(al) "Primary location" means the principle site for the CMA where the business office and administrative staff are located.

(am) "Procedure" means a licensee's written, standardized method of performing duties and providing services.

(an) "Psychosocial history" means information about an individual's past and present functioning in the areas of:

(1) Physical health and capabilities;

(2) Psychological health including emotional and coping abilities;

(3) Social environment, including interactive skills, activities, and supports;

(4) Decision making abilities;

(5) Social and family interactions;

(6) Employment and financial management;

(7) Financial considerations;

(8) Vocational interests and activities, including spiritual preferences; and

(9) Other areas of significance, including, but not limited to, substance abuse or misuse, and involvement with the behavioral health care system, the developmental disability system, or the legal system.

(ao) "Reportable incident" means an occurrence of any of the following while the client is either in the CMA or in the care of CMA personnel:

(1) The unanticipated death of the client; or

(2) An injury to a client that is of a suspicious nature 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.

(ap) "Service" means a specific activity performed by the licensee, either directly or indirectly, to benefit or assist a client.

(aq) "State Fire Code" means "New Hampshire Fire Code" or "state fire code" as defined in RSA 153:1, VI-a, namely, "the adoption by reference of the Life Safety Code NFPA 101 and the Uniform Fire Code NFPA 1, as published by the National Fire Protection Association and as amended by the state board of fire control and ratified by the general court pursuant to RSA 153:5. The provisions of any other national code, model code, or standard referred to within a code listed in this definition shall be included in the state fire code unless amended in accordance with RSA 153:5."

N.H. Admin. Code § He-P 819.03

Derived from Number 37, Filed September 14, 2023, Proposed by #13709, Effective 8/1/2023, Expires 8/1/2033.