Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 175 - HEALTH CARE FACILITIES AND SERVICES LICENSURE
Chapter 16 - HOSPICE SERVICES
Section 175-16-002 - DEFINITIONS
Abuse means any knowing, intentional, or negligent act or omission on the part of a person which results in physical, sexual, verbal, or mental abuse, unreasonable confinement, cruel punishment, exploitation, or denial of essential care, treatment, or services to a patient.
Activities of daily living (See definition of "Care".)
Administrator means the operating officer for the hospice and may include titles such as administrator, chief executive officer, manager, superintendent, director, or similar designation.
Apartment means a portion of a building that contains: living and sleeping areas; storage room(s); separate room(s) containing a toilet, lavatory, and bathtub or shower; and a kitchen area with a sink, cooking, and refrigeration appliances.
Applicant means the individual, government, corporation, partnership, limited liability company, or other form of business organization who applies for a license.
Attending physician means the physician named by the patient or designee in the hospice records. The attending physician has primary responsibility for the patient's care and treatment.
Basic therapeutic care means basic health care procedures, including, but not limited to, measuring vital signs, applying hot and cold applications and non sterile dressings, and assisting with, but not administering internal and external medications which are normally self-administered. Basic therapeutic care does not include health care procedures which require the exercise of nursing or medical judgment.
Bereavement counseling means counseling services provided to the individual and his or her family prior to the patient's death and to the family after the individual's death.
Bereavement services means services provided under the supervision of a qualified professional including a plan of care for bereavement service that reflects family needs and a clear delineation of services to be provided for not less than one year following the death of the hospice patient.
Biological means any virus, therapeutic serum, toxin, antitoxin, or analogous product applicable to the prevention, treatment, or cure of disease or injuries of humans.
Care means the exercise of concern or responsibility for the comfort, welfare, and habilitation of persons, including a minimum amount of supervision and assistance with or the provision of personal care, activities of daily living, health maintenance activities, or other supportive services. For the purposes of this chapter:
1. Activities of daily living means transfer, ambulation, exercise, toileting, eating, self-administered medication, and similar activities;
2. Health maintenance activities means noncomplex interventions which can safely be performed according to exact directions, which do not require alteration of the standard procedure, and for which the results and patient responses are predictable; and
3. Personal care means bathing, hair care, nail care, shaving, dressing, oral care, and similar activities.
Caregiver means any person acting as an agent on behalf of a patient or any person aiding and assisting a patient.
Chemical restraint means a drug or medication when it is used as a restraint to manage the patient's behavior or restrict the patient's freedom of movement and is not a standard treatment or dosage for the patient's condition.
Complaint means an expression of concern or dissatisfaction.
Completed application means an application that contains all the information specified in 175 NAC 16-003 and includes all required attachments, documentation, and the licensure fee.
Department means the Division of Public Health of the Department of Health and Human Services.
Designee means a person who is authorized by law or the patient to act on his or her behalf, for example, a parent of a minor child, a legal guardian, a conservator, or an attorney in fact named in a durable power of attorney for health care.
Device means an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including any component, or part, or accessory, which is prescribed by a medical practitioner and dispensed by a pharmacist or other person authorized by law to do so.
Direction and monitoring means, for the purpose of medication administration, the acceptance of responsibility for observing and taking appropriate action regarding any desired effects, side effects, interactions and contraindications associated with the medication. Direction and monitoring can be done by a:
1. Competent individual for himself or herself;
2. Caretaker; or
3. Licensed health care professional.
Director means the Director of-Public Health of the Division of Public Health.
Drug means substances as defined in Neb. Rev. Stat. § 38-2819.
Dwelling means a building that contains: living and sleeping areas; storage rooms(s); separate room(s) containing a toilet, lavatory, and bathtub or shower; and a kitchen area with a sink and cooking and refrigeration appliances.
Employee means an employee of the hospice or, if the hospice is a subdivision of an agency or organization, an employee of the agency or organization who is appropriately trained and assigned to the hospice. Employee also refers to a volunteer under the jurisdiction of the hospice.
Existing facility means a licensed health care facility or a facility whose construction or remodeling plans were approved by the Department prior to the effective date of 175 NAC 16.
Exploitation means the taking of property of a patient by means of undue influence, breach of a fiduciary relationship, deception, extortion, or by any unlawful means.
Five rights means getting the right drug to the right recipient in the right dosage by the right route at the right time.
Food code means the Nebraska Food Code, as defined in Neb. Rev. Stat. § 81-2,244.01 and as published by the Nebraska Department of Agriculture, except for compliance and enforcement provisions.
Foreign when applied to corporations means all those created by authority other than that of the State of Nebraska.
Governing authority means, depending on the organizational structure, an owner(s), a board of directors or other governing members of the licensee, or state, county, or city officials appointed by the licensee.
Grievance means a written expression of dissatisfaction which may or may not be the result of an unresolved complaint.
Health care means any treatment, procedure, or intervention to diagnose, cure, care for, or treat the effects of disease, injury, and degenerative conditions.
Health care service means an adult day service, a home health agency, a hospice or hospice service, or a respite care service.
Health maintenance activities (See definition of "Care".)
Home health agency means a person or any legal entity which provides skilled nursing care or a minimum of one other therapeutic service as defined by the Department on a full-time, part-time, or intermittent basis to persons in a place of temporary or permanent residence used as the person's home.
Home health aide means a person who is employed by a home health agency or hospice to provide personal care, assistance with the activities of daily living, and basic therapeutic care to the patients of the home health agency or hospice.
Homemaker means a person employed by, or a volunteer of, a hospice to provide domestic services including, but not limited to, meal preparation, laundry, light housekeeping, errands, and chore services as defined by hospice policy.
Hospice or hospice service means a person or legal entity which provides home care, palliative care, or other supportive services to terminally ill persons and their families.
Hospice inpatient facility means a facility in which the hospice provides inpatient care directly for respite and general inpatient care.
Hospice interdisciplinary team means the attending physician, hospice medical director, licensed professional registered nurse, certified social worker, pastoral or other counselor, and, as determined by the interdisciplinary plan of care, providers of special services, such as mental health services, pharmacy services, home health aides, trained volunteers, dietary services, and any other appropriate health services, to meet the physical, psychosocial, spiritual, and economic needs which are experienced during the final stages of illness, dying, and bereavement.
Hospice patient means a patient who is diagnosed as terminally ill with a medical prognosis that his or her life expectancy is six months or less if the illness runs its normal course and who with informed consent is admitted into a hospice program.
Hospice volunteer means an individual specifically trained and supervised to provide support and supportive services to the hospice patient and hospice patient's family under the supervision of a designated hospice volunteer coordinator. This does not apply to any volunteers working on behalf of a hospice licensed under the Health Care Facility Licensure Act who, as part of their volunteer duties, provide care.
Inpatient means a person who receives 24-hour care or is to receive care and is admitted to the hospital or inpatient facility by a physician.
Licensed health care professional means an individual for whom administration of medication is included in the scope of practice.
Licensed medical nutrition therapist means a person who is licensed to practice medical nutrition therapy pursuant to the Uniform Credentialing Act and who holds a current license issued by the Department pursuant to Neb. Rev. Stat. § 38-1801 to 38-1816.
Licensed nurse means a person licensed as a registered nurse or as a practical nurse under the provisions of the Nurse Practice Act, Neb. Rev. Stat. §§ 38-2201 to 38-2236 and Title 172 NAC 99.
Licensee means the individual, government, corporation, partnership, limited liability company or other form of business organization legally responsible for the operation of the hospice and to whom the Department has issued a license.
Medical director means a hospice employee or contracted person who is a doctor of medicine or osteopathy who is responsible for the overall coordination of medical care in the hospice.
Medical practitioner means any licensed physician, osteopathic physician, dentist, podiatrist, optometrist, chiropractor, physician assistant, certified registered nurse anesthetist, advanced practice registered nurse, or certified nurse midwife.
Medication means any prescription or non-prescription drug intended for treatment or prevention of disease or to effect body functions in humans.
Medication administration includes but is not limited to:
1. Providing medications for another person according to the five rights;
2. Recording medication provision; and
3. Observing, monitoring, reporting, and otherwise taking appropriate actions regarding desired effects, side effects, interactions, and contraindications associated with the medication.
Medication aide means an individual who is listed on the medication aide registry operated by the Department as provided in 172 NAC 95 and 96.
Medication provision means the component of the administration of medication that includes giving or applying a dose of medication to an individual and includes helping an individual in giving or applying the medication to himself or herself.
Mental abuse means humiliation, harassment, threats of punishment, deprivation, or other actions causing mental anguish.
Multiple locations means those locations from which the hospice provides the same full range of hospice core services that is required of the hospice issued the license.
NAC means Nebraska Administrative Code.
Neglect means failure to provide care, treatment, or services necessary to avoid physical harm or mental anguish or a patient.
New construction means a facility or a distinct part of a facility in which care and treatment is to be provided and which is enlarged, remodeled, or altered in any fashion or is built from the ground up on or after the effective date of 175 NAC 16.
New facility means a facility or distinct part of a facility in which care and treatment is to be provided and which is not currently licensed as a health care facility. New facility also includes those facilities which were previously licensed for care and treatment in another licensure category and seek licensure in a different license category.
Palliative care means treatment directed at controlling pain, relieving other physical and emotional symptoms, and focusing on the special needs of the hospice patient and hospice patient's family as they experience the dying process rather than treatment aimed at cure or prolongation of life.
Personal care (See definition of "Care".)
Physical abuse means hitting, slapping, pinching, kicking, or other actions causing injury to the body.
Physical restraint means any manual method or physical or mechanical device, material, or equipment attached or adjacent to the patient's body that s/he cannot remove easily and that restricts freedom of movement or normal access to his or her own body.
Physician means any person licensed to practice medicine in this state as provided in Neb. Rev. Stat. §§ 38-2001 to 38-2062.
Premises means a facility, the facility's grounds, and each building or grounds on contiguous property used for administering and operating a facility.
PRN means an administration scheme in which a medication is not routine, is taken as needed, and requires assessment for need and effectiveness.
Qualified inspector means a professional architect or engineer licensed to practice in Nebraska, an official or employee of a local jurisdiction authorized by that jurisdiction to make inspections of particular building equipment or systems, or an individual certified by a nationally recognized organization to make the same inspections.
Respite means an interval of rest or relief provided for the caregiver of an individual who is a recipient of hospice services.
Respite care means a person or any legal entity, not otherwise licensed under the Health Care Facility Licensure Act, which provides short term care or related services on an intermittent basis to persons with special needs when the person's regular caregiver is unavailable to provide such care or services and such care or services are not provided at a health care facility licensed under the Act.
Schematic plans means a diagram of the facility which describes the number and locations of beds, the location of care and treatment rooms, Life Safety Code construction and occupancy classifications locations, fire compartments, and Fire Marshall approved points of safety.
Sexual abuse means sexual harassment, sexual coercion, or sexual assault.
Social worker, certified means a person who has received a baccalaureate or master's degree in social work from an approved educational program, and holds a current certificate issued by the Department.
Social work practice means the professional activity of helping individuals, groups, and families or larger systems such as organizations and communities to improve, restore, or enhance their capacities for personal and social functioning and the professional application of social work values, knowledge, principles.
Speech-language pathologist means an individual who is licensed as a Speech Language Pathologist by the Department and who presents himself or herself to the public by any title or description of services incorporating the words speech-language pathologist, speech therapist, speech correctionist, speech clinician, language pathologist, language therapist, language clinician, logpedist, communicologist, aphasiologist, aphasia therapist, voice pathologist, voice therapist, voice clinician, phoniatrist, or any similar title, term, or description of service.
Terminal condition means an incurable and irreversible medical condition caused by injury, disease, or physical illness which, to a reasonable degree of medical certainty, will result in death within six months regardless of the continued application of medical treatment including life-sustaining procedures.
Treatment means a therapy, modality, product, device, or other intervention used to maintain well being or to diagnose, assess, alleviate, or prevent a disability, injury, illness, disease, or other similar condition.
Unlicensed direct care staff means personnel who are not licensed or certified under the Uniform Licensing Law or other state laws governing the practice of health care and whose primary responsibility is to manage, supervise, and/or provide direct care to patients. Unlicensed direct care staff includes home health aides, medication aides, and other personnel with this responsibility and with job titles designated by the hospice. .
Verbal abuse means the use of oral, written, or gestured language including disparaging and derogatory terms to patients or within their hearing distance.
