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 809 - HOME HEALTH CARE PROVIDERS
Section He-P 809.03 - Definitions

Universal Citation: NH Admin Rules He-P 809.03

Current through Register No. 12, March 21, 2024

(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 a patient;

(2) "Physical abuse" means the misuse of physical force which results or could result in physical injury to a patient; and

(3) "Sexual abuse" means contact or interaction of a sexual nature involving a patient with or 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 self-management of medications.

(c) "Administer" means "administer" as defined by RSA 318:1, I, namely "an act whereby a single dose of a drug is instilled into the body of, applied to the body of, or otherwise given to a person for immediate consumption or use."

(d) "Administrator" means the licensee, or an individual appointed by the licensee, who is responsible for all aspects of the daily operations of the HHCP.

(e) "Admission" means accepted by a licensee for the provision of services to a patient.

(f) "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.

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

(h) "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 809, or other federal or state requirements.

(i) "Assessment" means an evaluation of the patient to determine the care and services that are needed.

(j) "Branch office" means a location physically separate from the primary location of the HHCP and that:

(1) Provides oversight for employees who provide direct care services to patients in their residential setting; and

(2) Is under the administration and supervision of the primary location of the HHCP.

(k) "Care plan" means a written guide developed by the licensee, or its personnel, in consultation with the patient, guardian, agent, or personal representative, if any, as a result of the assessment process for the provision of care and services as required by He-P 809.15(o) -(q) .

(l) "Change of ownership" means a change in the controlling interest of an established HHCP to a successor business entity.

(m) "Commissioner" means the commissioner of the department of health and human services or his or her designee.

(n) "Community health services" means services that are provided in community settings, including but not limited to foot clinics, flu shot clinics, educational programs and nutrition services.

(o) "Critical incident stress management (CISM) " means an adaptive, short-term psychological helping-process that focuses solely on an immediate and identifiable problem. Its purpose is to enable people to return to their daily routine more quickly and with less likelihood of experiencing post-traumatic stress disorder.

(p) "Days" means calendar days unless otherwise specified in the rule.

(q) "Department" means the New Hampshire department of health and human services.

(r) "Direct care" means hands-on care and services provided to a patient, including but not limited to medical, nursing, psychological, or rehabilitative treatments.

(s) "Directed plan of correction" means a plan developed and written by the department that specifies the necessary actions the licensee shall take to correct identified areas of non-compliance.

(t) "Do not resuscitate order (DNR order) " means an order that, in the event of an actual or imminent cardiac or respiratory arrest, chest compression and ventricular defibrillation will not be performed, the patient will not be intubated or manually ventilated, and there will be no administration of resuscitation drugs. This term includes "do not attempt resuscitation order (DNAR order) ".

(u) "Drop site" means a location, which does not meet the definition of a branch office, where materials, equipment, and supplies used in the provision of services may be temporarily stored.

(v) "Emergency plan" means a document outlining the responsibilities of personnel in an emergency.

(w) "Exploitation" means the illegal use of a patient'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 patient through the use of undue influence, harassment, duress, or fraud.

(x) "Guardian" means a person appointed in accordance with RSA 464-A to make informed decisions relative to the patient's health care and other personal needs.

(y) "Home health care provider (HHCP) " means any organization or business entity, whether public or private, whether operated for profit or not, which is engaged in arranging or providing, directly or through contract arrangement, one or more of the following services:

(1) Nursing services;

(2) Home health aide services; or

(3) Other therapeutic and related services, which can include, but are not limited to;
a. Physical and occupational therapy;

b. Speech pathology;

c. Nutritional services;

d. Medical social services;

e. Personal care services; and

f. Homemaker services which may be of a preventative, therapeutic, rehabilitative, health guidance, or supportive nature to persons in their places of residence.

(z) "Homemaker services" means services that are of a supportive nature that do not routinely require hands-on contact with a patient other than to maintain the patient's safety. Such services may include, but are not limited to, laundry, housecleaning, cooking, transporting to and from medical or other appointments, shopping, companion services, and medication reminders.

(aa) "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.

(ab) "Infectious waste" means those items specified by Env-Sw 904.

(ac) "In-service" means an educational program, which is designed to increase the knowledge, skills, and overall effectiveness of personnel.

(ad) "Inspection" means the process followed by the department to determine an applicant's or a licensee's compliance with RSA 151 and He-P 809 or to respond to allegations, pursuant to RSA 151:6, of non-compliance with RSA 151 and He-P 809.

(ag) "Investigation" means the process used by the department to respond to allegations of non-compliance with RSA 151 and He-P 809.
(ae) "License" means the document issued by the department to an applicant at the start of operation as an HHCP which authorizes operation in accordance with RSA 151 and He-P 809, and includes the name of the licensee, the name of the business, the physical address, the license classification, the effective date, and license number.

(af) "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 and the type(s) of services authorized for which the HHCP is licensed.

(ag) "Licensed practitioner" means a:
(1) Medical doctor;

(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 state licensing board.

(ah) "Licensed premises" means the building(s) that comprises the physical location the department has approved for the licensee to conduct operations in accordance with its license. This term includes branch offices. This term does not include drop sites or the private residence of a patient receiving services from a HHCP.

(ai) "Licensing classification" means the specific category of services authorized by a license.

(aj) "Medication" means a substance available with or without a prescription, which is used as a curative or remedial substance.

(ak) "Neglect" means an act or omission that results, or could result, in the deprivation of essential services or supports necessary to maintain the mental, emotional, or physical health and safety of a patient.

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

(am) "Owner" means any person, corporation, association, or any other legal entity, whether organized for profit or not, holding or claiming ownership of, or title to, a license.

(an) "Patient" means any person admitted to or in any way receiving care, services, or both from a HHCP licensed in accordance with RSA 151 and He-P 809. Patient includes patient as used in RSA 151:20 and RSA 151:21.

(ao) "Patient record" means the documentation of all care and services, which includes all documentation required by RSA 151 and He-P 809 and any other applicable federal or state requirements.

(ap) "Patient rights" means the privileges and responsibilities possessed by each patient provided by RSA 151:21-b.

(aq) "Personal care service provider" means a person who provides non-medical hands-on assistance to a patient, to help with activities of daily living such as grooming, toileting, eating, dressing, bathing, getting into or out of a bed or chair, walking, assisting with topical medications, or reminding a patient to take medications.

(ar) "Personal representative" means a person designated in accordance with RSA 151:19, V, to assist the patient for a specific, limited purpose or for the general purpose of assisting the patient in the exercise of any rights.

(as) "Personnel" means an individual who is employed by the facility, who is a volunteer, or who is an independent contractor who provides direct care or personal care services to patients.

(at) "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 inspection conducted pursuant to RSA 151:6-a or during the course of a complaint investigation conducted pursuant to RSA 151:6.

(au) "Point of care testing (POCT) " means laboratory testing performed using either manual methods or hand held instruments at or near the site of patient care.

(av) "Point of care devices" means testing involving a system of devices, typically including:
(1) A lancing or finger stick device to get the blood sample;

(2) A test strip to apply the blood sample; or

(3) A meter or monitor to calculate and show the results including:
a. Blood glucose meters, also called "glucometers";

b. Prothrombin time (PT) and iternational normalized ratio (INR) anticoagulation meters; or

c. Cholesterol meter.

(aw) "Primary location" means the principal site for the HHCP where the business office and administrative staff are located.

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

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

(az) "Professional staff" means:
(1) Physicians;

(2) Physician assistants;

(3) Advanced practice registered nurses;

(4) Registered nurses;

(5) Registered physical therapists;

(6) Speech therapists;

(7) Licensed practical nurses;

(8) Licensed respiratory therapists;

(9) Occupational therapists;

(10) Medical social workers; and

(11) Dietitians.

(ba) "Reportable incident" means an occurrence of any of the following while the patient is in the care of HHCP personnel:
(1) The unanticipated death of the patient; or

(2) An injury to a patient that is potentially due to abuse or neglect.

(bb) "Self-administration of medication with assistance" means an act whereby the patient takes his or her own medication after being prompted by personnel but without requiring physical assistance from others beyond placing the container within reach, opening the medication container, reading the medication label to the patient, and utilizing hand over hand technique pursuant to Nurs 404.03(b) .

(bc) "Self-administration of medication without assistance" means the participant is able to take his or her own medication(s) without the assistance of personnel, including prompting.

(bd) "Self-directed medication administration" means an act whereby a patient, 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.

(be) "Significant change" means a visible or observable change in functional, cognitive, or daily activity ability of the patient.

(bf) "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.

#4073, eff 6-26-86, EXPIRED: 6-26-92

New. #5630, eff 5-26-93; amd by #6240, HB 32, eff 5-3-96, EXPIRED 12-31-98; ss by #7006, INTERIM, eff 5-26-99, EXPIRED: 9-23-99

New. #9466, eff 5-2-09

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