N.M. Admin. Code § 8.370.22.7

Current through Register Vol. 35, No. 23, December 10, 2024

Section 8.370.22.7 - DEFINITIONS

For purposes of these regulations the following shall apply:

A."Abuse" means any act or failure to act performed intentionally, knowingly or recklessly that causes or is likely to cause harm to a patient/client, including:

(1) physical contact that harms or is likely to harm a patient/client of a home health agency;

(2) inappropriate use of a physical restraint, isolation or medication that harms or is likely to harm a patient/client;

(3) inappropriate use of a physical or chemical restraint, medication or isolation as punishment or in conflict with a physician's order;

(4) medically inappropriate conduct that causes or is likely to cause physical harm to a patient/client;

(5) medically inappropriate conduct that causes or is likely to cause great psychological harm to a patient/client;

(6) an unlawful act, a threat or menacing conduct directed toward a patient/client that results and might reasonably be expected to result in fear or emotional or mental distress to a patient/client.

B."Administrator/ director" means a qualified individual, on-site, appointed by the governing body who organizes and directs the agency's on-going functions, maintains liaison among the governing body, the group of professional personnel and other staff, employs qualified personnel, ensures adequate staff education, ensures the accuracy of public information materials and activities, and implements an effective budgeting and accounting system. A branch office must have a qualified onsite branch manager who receives direction and supervision from the parent home health agency's administrator/director.

C."Applicant" means the individual who, or organization which, applies for a license. If the applicant is an organization, then the individual signing the application on behalf of the organization must have authority from the organization. The applicant must be the owner.

D."Auxiliary work station" means a non-licensed, non-staffed convenience work station away from the licensed location of the home health agency's office.

E."Branch office" means a licensed location or site from which a home health agency provides services and is located sufficiently close that it is not impractical for it to receive direction and supervision from the parent home health agency on a day-by-day basis.

F."Bylaws" means a set of rules adopted by a home health agency for governing the agency's operation.

G."Clinical/service note" means a written notation dated and signed by a member of the health team that summarizes facts about care furnished and the patient/client's response during a given period of time.

H."Exploitation" of a patient/client consists of the act or process, performed intentionally, knowingly or recklessly, of using any patient/clients money or property, for another person's profit, advantage or benefit. Exploitation includes but is not limited to:

(1) manipulating the patient/client by whatever mechanism to give money or property to any agency staff or management member;

(2) misappropriation or misuse of monies belonging to a patient/client or the unauthorized sale, transfer or use of a patient/clients property;

(3) loans of any kind from patient/clients to agency staff or management;

(4) accepting monetary or other gifts from a patient/client or their family with a value in excess of $25 or gifts which exceed a total value of $300 in one year. All gifts received by agency operators, their families or staff of the agency must be documented and acknowledged by the person giving the gift and the recipient. Exception: Testamentary gifts, such as wills, are not, per se, considered financial exploitation.

I."Governing body" means the governing authority of a facility which has the ultimate responsibility for all planning, direction, control and management of the activities and functions of a home health agency licensed pursuant to these regulations.

J."Great psychological harm" means psychological harm that causes mental or emotional incapacitation for a prolonged period of time or that causes extreme behavioral change or severe physical symptoms that require psychological or psychiatric care.

K."Home health agency" means any business, entity or organization primarily engaged in providing medically directed acute, restorative, rehabilitative, maintenance, preventive or supportive services through professional or paraprofessional personnel to a patient/client in the patient/client's residence. This term does not apply to any individual, licensed practitioner providing services within the scope of their practice or to any business, entity or organization providing non-medically directed services in a patient/client's place of residence.

L."Home health aide" means a person who has successfully completed a course of training or demonstrated competency in assisting patient/clients to meet basic personal care needs. A home health aide provides medically directed personal care to patient/clients such as, but not limited to, taking and recording vital signs, bathing, grooming, feeding, ambulation, exercise, oral hygiene and skin care.

M."Home health services" means those medically directed therapeutic or supportive services provided by a home health agency to a patient/client in their place of residence.

N."Homemaker" means a person who has successfully demonstrated competency to provide household services such as cleaning, meal preparation, laundry, shopping and to assist a patient/client with activities of daily living.

O."Level of care" means the long term care assessment abstract which medically qualifies a patient/client for medicaid waiver services.

P."Licensed practical nurse" means a person licensed as a practical nurse in the state of New Mexico under the Nursing Practice Act, Sections 61-3-1 to 61-3-31 NMSA 1978.

Q."Licensee" means the person(s) who, or organization which, has an ownership or similar interest in the home health agency and in whose name a license for a home health agency has been issued and who is legally responsible for compliance with these regulations.

R."Licensing authority" means the New Mexico health care authority.

S."Medically directed services" means in home services that are provided in accordance with a patient/client's plan or level of care which is reviewed and approved by a physician at least annually.

T."Neglect" means subject to the patient/client's right to refuse treatment and subject to the caregiver's right to exercise sound medical discretion, the grossly negligent:

(1) failure to provide any treatment, services, care, medication or item that is necessary to maintain the health or safety of a patient/client;

(2) failure to take any reasonable precaution that is necessary to prevent damage to the health or safety of a patient/client;

(3) failure to carry out a duty to supervise properly or control the provision of any treatment, care, good, service or medication necessary to maintain the health or safety of a patient/client.

U."Occupational therapist" is a person who is licensed by the state of New Mexico as an occupational therapist, pursuant to Sections 61-12A-1 to 61-12A-24 NMSA 1978.

V."Occupational therapist assistant" is a person who is licensed by the state of New Mexico as a certified occupational therapist assistant, pursuant to Sections 61-12A-1 to 61-12A-24 NMSA 1978.

W."Parent home health agency" means an agency that develops and maintains responsibility for the operation and administrative control of branch office(s).

X."Patient/client" means a person who is receiving home health care services.

Y."Personal care attendant/provider" means a person who has successfully demonstrated competency to provide assistance with personal care such as bathing, grooming, bowel and bladder needs.

Z."Physical therapist" is a person who is licensed by the state of New Mexico as a physical therapist, pursuant to Sections 61-12-1 to 61-12-21 NMSA 1978.

AA."Physical therapist assistant" is a person who is licensed by the state of New Mexico as a physical therapist assistant, pursuant to Sections 61-12-1 to 61-12-21 NMSA 1978.

BB."Plan of care" means a written plan of treatment which sets forth each service that the home health agency agrees to provide to a patient/client.

CC."Plan of correction" means a plan written and signed by the licensee or representative addressing how and when the licensing authority's identified deficiencies will be corrected.

DD. "Physician" is a person who is a doctor of medicine, osteopathy or podiatry licensed to practice medicine.

EE."Policy" means a statement of principle that guides and determines present and future decisions and actions.

FF."Procedure" means the action(s) that must be taken in order to implement a policy.

GG."Professional personnel" means the staff of the agency or personnel under contract or agreement with the agency who require a license, registration or certification by the state of New Mexico.

HH."Quality improvement" means an on-going assessment program which addresses clinical care and program evaluation.

II."Registered nurse" means a person who holds a certificate of registration as a registered nurse in the state of New Mexico under the Nursing Practice Act, Sections 61-3-1 to 61-3-31 NMSA 1978.

JJ."Residence" means the place in New Mexico where a patient/client is residing at the time home health services are provided.

KK."Social worker" is a person who is licensed by the state of New Mexico as a social worker, pursuant to Sections 61-31-1 to 6131-25 NMSA 1978.

LL."Speech language pathologist" is a person licensed by the state of New Mexico to practice speech language pathology, pursuant to Sections 61-14B-1 to 61-14B-25 NMSA 1978.

MM."Supervision" means direction, guidance and oversight by a qualified person, within their sphere of competence, of an individual providing services in accordance with a patient/client's plan of care.

NN."Supportive services" means medically or non-medically directed assistance to patient/clients to meet basic activities of daily living.

OO."Therapeutic services" means a medically directed activity or activities to patients/clients based upon a knowledge of disease processes provided by a home health agency.

PP."Waive/waiver" means to refrain from pressing or enforcing compliance with a portion or portions of these regulations for a limited period of time in which the health, safety, or welfare of the patient/clients and staff are not in danger. Waivers are issued at the sole discretion of the licensing authority.

N.M. Admin. Code § 8.370.22.7

Adopted by New Mexico Register, Volume XXXV, Issue 12, June 25, 2024, eff. 7/1/2024