New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-P - Former Division of Public Health Services
Chapter He-P 800 - RESIDENTIAL CARE AND HEALTH FACILITY RULES
Part He-P 807 - RULES FOR RESIDENTIAL TREATMENT AND REHABILITATION FACILITIES
Section He-P 807.03 - Definitions

(a) "Abuse" means any one of the following:

(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) "Administrator" means the individual appointed by the licensee to be responsible for all aspects of the daily operation of the licensed premise;

(f) "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;

(g) "Advance directive" 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" shall include 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;

(h) "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, or captive or affiliated insurance companies;

(i) "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 137-J:35;

(j) "Applicant" means an individual, agency, partnership, corporation, government entity, association, or other legal entity seeking a license to operate a RTRF pursuant to RSA 151;

(k) "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 807, or other federal or state requirements;

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

(m) "Care plan" means a documented guide developed by the licensee, in consultation with the licensed practitioner, personnel, the client, and/or the client's guardian, agent or personal representative, if any, as a result of the assessment process for the provision of care and services. This term also includes "treatment plan";

(n) "Change of ownership" means a change in the controlling interest of an established RTRF to a successor business entity;

(o) "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;

(p) "Client" means any person admitted to or in any way receiving care, services or both from a RTRF licensed in accordance with RSA 151 and He-P 807;

(q) "Client record" means documents maintained for each client, which includes all documentation required by RSA 151 and He-P 807, and all documentation compiled relative to the client as required by other federal or state laws;

(r) "Commissioner" means the commissioner of the New Hampshire department of health and human services or his or her designee;

(s) "Comprehensive evaluation" means a multi-disciplinary assessment of level of function by healthcare professionals licensed or certified in the field of rehabilitation;

(t) "Contracted employee" means a temporary employee working under the direct supervision of the RTRF but employed by an outside agency;

(u) "Core services" means those minimal services to be provided to any client by the licensee that shall be included in the basic rate;

(v) "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 effects 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;

(w) "Days" means calendar days unless otherwise specified in the rule;

(x) "Department" means the New Hampshire department of health and human services;

(y) "Direct care" means hands-on care and services to a client, including but not limited to medical, nursing, psychological, or rehabilitative treatments;

(z) "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;

(ba) "Orders" means a document, produced verbally, electronically, or in writing, by a licensed practitioner for medications, treatments, recommendations, or 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;

(bb) "Owner" means a person or organization who has controlling interest in the RTRF;

(bc) "Patient rights" means the privileges and responsibilities possessed by each client provided by RSA 151:21. This term includes "resident rights";

(bd) "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;

(be) "Personal representative" means a person, other than the licensee of an employee of or a person having a direct or indirect ownership interest in, a 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 in RSA 151:19, V;

(bf) "Personnel" means individual(s) employed by the facility, volunteer(s), or independent contractor(s), who provide direct care or services to a client;

(bg) "Physical restraint" means the use of any hands-on or other physically applied techniques to physically limit the client's freedom of movement, such as forced escorts, holding, prone restraints, or other containment techniques;

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

(bi) "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;

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

(bk) "Pro re nata (PRN) medication" means medication taken as circumstances may require in accordance with a licensed practitioner's orders;

(bl) "Protective care" means the provision of client monitoring services, including but not limited to:

(bm) "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;

(bn) "Qualified personnel" means facility staff that have been trained to adequately perform certain assigned tasks, such as housekeeping staff trained in infection control or kitchen staff trained in food safety protocols;

(bo) "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;

(bp) "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;

(bq) "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;

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

(bs) "Residential treatment and rehabilitation facility" (RTRF) means a place, excluding hospitals as defined in RSA 151-C:2, which provides residential care, treatment and comprehensive specialized services relating to the individual's medical, physical, psychosocial, vocational, or educational needs;

(bt) "Self administration of medication without assistance" means an act whereby the client takes his or her own medication(s) without the assistance of another person;

(bu) "Self administration with supervision" means an act whereby the client takes his or her own medication(s) after being prompted by personnel, but without requiring physical assistance from others;

(bv) "Self- directed medication administration" means an act whereby a client, who has a physical limitation that prohibits him or her from self-administration of medication without assistance, directs personnel to physically assist in the medication process, which does not include assisting with infusions, injections, or filling insulin syringes;

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

(bx) "Significant change" means a change in cognitive or physical capabilities that decreases a client's ability to care for himself beyond an episodic event;

(by) "Therapeutic diet" means a diet ordered by a licensed practitioner or other licensed professional with prescriptive authority as part of the treatment for disease or clinical conditions, or to increase or decrease specific nutrients in the food consumed by the client;

(bz) "Unexplained absence" means an incident involving a client leaving the premises of the RTRF without the knowledge of the RTRF personnel; and

(ca) "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.