Section He-P 830.03 - 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; 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) "Administration of medication" means the provision of one or more doses of medication to clients by licensed nurses or other personnel qualified by law or rule to administer medication.(f) "Administrator" means the individual appointed by the licensee to be responsible for all aspects of the daily operation of the licensed premise.(g) "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.(h) "Admission agreement" means the document signed by the client and the facility administrator detailing what both the client and the facility agree to do.(i) "Adult" means persons 18 years or older.(j) "Advance directive(s)" 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.(k) "Adverse reaction" means a physical or mental negative change after taking medication.(l) "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.(m) "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-J:34-37.(n) "Ambulatory" means an individual who is able to walk about and is not bedridden.(o) "Applicant" means an individual, agency, partnership, corporation, government entity, association, or other legal entity seeking a license to operate a psychiatric residential treatment program (PRTP) pursuant to RSA 151.(p) "Area of non-compliance" means any action, failure to act, or other set of circumstances that cause a license to be out of compliance with RSA 151, He-P 830, or other federal or state requirements.(q) "Assessment" means an evaluation of the client to determine the care and services that are needed.(r) "Change of ownership" means change in the controlling interest of an established PRTP to an individual or successor business entity.(s) "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.(t) "Child" means "child" as defined in RSA 170-E:25, I.(u) "Client" means any person admitted to or in any way receiving care, services or both from an PRTP licensed in accordance with RSA 151 and He-P 830.(v) "Client record" means documents maintained for each client, which includes all documentation required by RSA 151 and He-P 830, and all documentation compiled relative to the client as required by other federal or state laws.(w) "Commissioner" means the commissioner of the department of health and human services or his or her designee.(x) "Contracted employee" means a temporary employee working under the direct supervision of the PRTF but employed by an outside agency.(y) "Core services" means those services provided by the licensee that are included in the basic rate.(z) "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 affects 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. (aa) "Days" means calendar days, unless otherwise specified.(ab) "Department" means the New Hampshire department of health and human services.(ac) "Direct care" means the provision of services to a patient that require some degree of interaction between the patient and the health care provider including but not limited to assessment, performing procedures, teaching, and implementation of a treatment plan.(ad) "Direct care personnel" means any person providing direct care to a client.(ae) "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.(af) "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 resident 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).(ag) "Elopement" means when a resident 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.(ah) "Emergency" means an unexpected occurrence or set of circumstances, which require immediate remedial attention.(ai) "Emergency plan" means a document outlining the responsibilities of personnel in an emergency.(aj) "Employee" means anyone employed by the PRTP and for whom the facility has direct supervisory authority.(ak) "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 830.(al) "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.(am) "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.(an) "Facility" means "facility" as defined in RSA 151:19, II.(ao) "Guardian" means a person appointed in accordance with RSA 464-A to make informed decisions relative to the client's health care and personal needs.(ap) "Health care occupancy" means an occupancy used for purposes of medical or other treatment of care of 4 or more persons where such occupants are mostly incapable of self-preservation due to age, physical or mental disability, or because of security measures not under the occupant's control.(aq) "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.(ar) "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.(as) "Infection Control Risk Assessment (ICRA)" means a determination of the potential risk of transmission of various infectious agents in the facility. A classification of those risks, and a list of required practices for mitigating those risks during construction or renovation.(at) "Infectious waste" means those items specified by Env-Sw 103.28.(au) "Informed consent" means the decision by a client, his or her guardian or agent, or surrogate decision maker to agree to a proposed course of treatment, after the client, guardian or 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.(av) "In-service" means an educational program, which is designed to increase the knowledge, skills, and overall effectiveness of personnel.(aw) "Inspection" means the process followed by the department to determine an applicant's or a licensee's compliance with RSA 151 and He-P 830 or to respond to allegations, pursuant to RSA 151:6, of non-compliance with RSA 151 or He-P 830.(ax) "Involuntary admission" means an order of involuntary commitment made pursuant to RSA l35-C:34-54 by a probate court.(ay) "Involuntary emergency admission" means an order of emergency involuntary admission made pursuant to RSA 135-C:27-33.(az) "License" means the document issued by the department to an applicant at the start of operation as a PRTP which authorizes operation as a PRTP in accordance with RSA 151 and He-P 830, 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.(ba) "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, the type(s) of services authorized and the number of beds that the PRTP is licensed for.(bb) "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.(bc) "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. (bd) "Licensee" means any person or legal entity to which a license has been issued pursuant to RSA 151.(be) "Licensing classification" means the specific category of services authorized by a license.(bf) "Life safety code" means the National Fire Protection Association (NFPA) 101, as adopted pursuant to RSA 153:1, VI-a and amended in Saf-FMO 300 by the fire marshal with the board of fire control, pursuant to RSA 153:5.(bg) "Mechanical restraint" means locked or secured PRTPs or units within a PRTP, or anklets, bracelets, or similar devices that cause a door to automatically lock when approached, thereby preventing a client from freely exiting the PRTP or unit within.(bh) "Medical director" means a psychiatrist 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.(bi) "Medication" means a substance available with or without a prescription, which is used as a curative or remedial substance.(bj) "Mental illness" means "mental illness" as defined in RSA 135-C:2, X, namely "a substantial impairment of emotional processes, or of the ability to exercise conscious control of one's actions, or of the ability to perceive reality or to reason, when the impairment is manifested by instances of extremely abnormal behavior or extremely faulty perceptions. It does not include impairment primarily caused by: (2) Intellectual disability;(3) Continue or non-continuous periods of intoxication caused by substances such as alcohol or drugs; or(4) Dependence upon or addiction to any substance such as alcohol or drugs".(bk) "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.(bl) "Neglect" means an act or omission, which results or could result in the deprivation of essential services necessary to maintain the minimum mental, emotional, or physical health and safety of any client.(bm) "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.(bn) "Nutritional requirements" means the necessary food and liquid intake required to maintain acceptable parameters of nutritional status.(bo) "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.(bp) "Over-the-counter medications" means non-prescription medications.(bq) "Owner" means a person or organization who has controlling interest in the PRTP.(br) "Patient rights" means the privileges and responsibilities possessed by each client provided by RSA 151:21.(bs) "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.(bt) "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 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 by RSA 151:19, V.(bu) "Personnel" means individual(s) employed by the facility, volunteer(s), or independent contractor(s), who provide direct care or services to a client.(bv) "Physical restraint" means the use of any hands-on or other physically applied techniques to physically limit the client's freedom of movement, which includes but are not limited to forced escorts, holding, prone restraints, or other containment techniques.(bw) "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.(bx) "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. (by) "Procedure" means a licensee's written, standardized method of performing duties and providing services.(bz) "Pro re nata (PRN) medication" means medication taken as circumstances may require in accordance with licensed practitioner's orders. (ca) "Protective care" means the provision of client monitoring services, including but not limited to:(1) Knowledge of client whereabouts; and(2) Minimizing the likelihood of accident or injury.(cb) "Psychiatric residential treatment program (PRTP)" means a non-hospital-based program which provides 24 hour, intensive short term, intermediate and long term psychiatric treatment and care to persons who have psychiatric symptoms and disorders or are in an acute phase of their mental illness. This definition includes the term "psychiatric residential treatment facility (PRTF)".(cc) "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.(cd) "Qualified personnel" means facility staff that have been trained to adequately perform certain assigned tasks, such as housekeeping staff trained in infection control, and kitchen staff trained in food safety protocols.(ce) " 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.(cf) "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.(cg) "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. (ch) "Reportable incident" means an occurrence of any of the following while the client is either in the PRTF or in the care of the PRTF 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 PRTF who is determined to be a danger to themselves or others.(ci) "Self-evacuate" means the client can initiate and complete movement from any location in the facility to an exit with or without staff assistance.(cj) "Service" means a specific activity performed by the licensee, either directly or indirectly, to benefit or assist a client.(ck) "Short term" means that a client is expected to remain in the facility less than 14 days.(cl) "Significant change" means a visible or observable change in functional, cognitive, or daily activity ability or limitations of the client.(cm) "Stock medications" means medications, to be determined by the medical director, that are kept onsite for use by clients and to be administered as ordered by the medical director or the clients' licensed provider.(cn) "Surrogate decision-maker" means a health care proxy or an agent, who is an advocate for incompetent patients.(co) "Supervision" means the process by which the client is guided and assisted in the activities and behaviors necessary to achieve and maintain his or her maximum independence.(cp) "Therapeutic diet" means a diet ordered by a licensed practitioner as part of the treatment for disease or clinical conditions.(cq) "Treatment plan" means a documented guide developed, as a result of the assessment process, for the provision of care and services to a client.(cr) "Unexplained absence" means an incident involving a client leaving the premises of the PRTP without the knowledge of the PRTP personnel.(cs) "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 830.03
#6154, eff 12-29-95, EXPIRED: 12-29-03
New. #10059, eff 12-23-11
Amended by Volume XL Number 2, Filed January 9, 2020, Proposed by #12952, Effective 12/21/2019, Expires 6/18/2020.Amended by Volume XLI Number 19, Filed May 13, 2021, Proposed by #13195, Effective 4/24/2021, Expires 4/24/2031.