N.D. Admin. Code 75-02-05.2-01
1. "Certification of compliance" means a facility is in at least substantial compliance and is eligible to participate in medicaid as a nursing facility.
2. "Certification of noncompliance" means a facility is not in substantial compliance and is not eligible to participate in medicaid as a nursing facility.
3. "Deficiency" means the occurrence of a violation recorded by the survey agency, including a violation found during a standard survey, during an extended survey, or in response to a complaint, investigation, visit, or otherwise. A deficiency may include a violation that occurred at a time prior to the date of the survey or visit, even if the violation no longer exists at the time of the survey or visit.
4. "Department" means the department of human services.
5. "Enforcement action" means the process of imposing one or more remedies available under this chapter.
6."Facility" means an institution or a distinct part of an institution which:
a. Is primarily engaged in providing:
(1) Nursing care and related services for residents who require medical or nursing care;
(2) Rehabilitation services for the rehabilitation of injured, disabled, or sick persons; or
(3) On a regular basis, health-related care and services to individuals who because of mental or physical conditions require care and services above the level of basic care that can be made available only through an institutional facility;
b. Is required to have in effect a transfer agreement, meeting the requirements of 42 U.S.C. 1396 x(1), with one or more hospitals having agreements in effect under 42 U.S.C. 1395 cc;
c. Is required to meet the requirements for a nursing facility described in 42 U.S.C. 1396 r(b), (c), and (d); and
d. Is not primarily engaged in providing care and treatment of mental diseases.
7. "Medicaid agency" means the department of human services.
8. "New admission" means a resident is admitted to a facility on or after the effective date of a denial of payment remedy and, if previously admitted, has been discharged before the effective date of a denial of payment. A resident admitted before the effective date of the denial of payment and taking temporary leave is not considered a new admission.
9. "Noncompliance" means any deficiency that causes a facility not to be in substantial compliance.
10. "Regional office" means the health care financing administration's regional office responsible for program administration in North Dakota.
11. "Repeated noncompliance" means a facility has received three consecutive findings of substandard quality of care on three consecutive standard surveys. The consecutive findings need not be based on the exact tag number of a deficiency.
12. "Secretary" means the secretary of the United States department of health and human services.
13. "Substandard quality of care" means a facility has one or more deficiencies related to participation requirements for resident behavior and facility practices, quality of life, or quality of care that constitute immediate jeopardy to resident health or safety; a pattern of or widespread actual harm that is not immediate jeopardy; or a widespread potential for more than minimum harm, but less than immediate jeopardy, with no actual harm.
14. "Substantial compliance" means compliance with the participation requirements and includes any identified deficiencies posing no greater risk to resident health or safety than the potential for causing minimal harm.
15. "Survey agency" means the state department of health.
N.D. Admin Code 75-02-05.2-01
General Authority: NDCC 50-24.1-04
Law Implemented: 42 USC 1396 r(h)