New Hampshire Code of Administrative Rules, Part He-P 814, Section He-P 814.03 - Definitions | New Hampshire Code of Administrative Rules

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

(1) "Emotional abuse" means the misuse of power, authority, or both, verbal harassment, or confinement which results or could result in the mental anguish or emotional distress of an individual;

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

(3) "Sexual abuse" means contact or interaction of a sexual nature involving an individual without his or her informed consent.

(b) "Acquired brain disorder" means a disruption in brain functioning that:

(1) Is not congenital or caused by birth trauma;

(2) Presents a severe and life-long disabling condition, which significantly impairs a person's ability to function in society;

(3) Occurs prior to age 60;

(4) Is attributable to one or more of the following reasons:

a. External trauma to the brain as a result of:

1. A motor vehicle incident;

2. A fall;

3. An assault; or

4. Another related traumatic incident or occurrence;

b. Anoxic or hypoxic injury to the brain such as from:

1. Cardiopulmonary arrest;

2. Carbon monoxide poisoning;

3. Airway obstruction;

4. Hemorrhage; or

5. Near drowning;

c. Infectious diseases such as encephalitis and meningitis;

d. Brain tumor;

e. Intracranial surgery;

f. Cerebrovascular disruption such as a stroke;

g. Toxic exposure; and

h. Other neurological disorders such as Huntington's disease or multiple sclerosis which predominantly affect the central nervous system; and

(5) Is manifested by:

a. Significant decline in cognitive functioning and ability;

b. Deterioration in:

1. Personality;

2. Impulse control;

3. Judgment;

4. Modulation of mood; or

5. Awareness of deficits; or

c. Both a. and b. above.

(c) "Activities of daily living (ADL) " means basic daily routine tasks such as:

(1) Walking;

(2) Bathing;

(3) Shaving;

(4) Brushing teeth;

(5) Combing hair;

(6) Dressing;

(7) Food preparation and eating;

(8) Getting into or out of bed;

(9) Laundry;

(10) Cleaning room;

(11) Managing money;

(12) Shopping;

(13) Using public transportation;

(14) Writing letters;

(15) Making telephone calls;

(16) Obtaining and keeping appointments;

(17) Monitoring and supervision of medication;

(18) Recreational and leisure activities; and

(19) Management of incontinence.

(d) "Addition" means an increase in the building area, aggregate floor area, building height, or number of stories of a structure.

(e) "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 an individual for immediate consumption or use by a person authorized by law, including RSA 318-B and RSA 326-B.

(f) "Administrator" means the licensee or person appointed by the licensee to be responsible for all aspects of the daily operation of the licensed premises.

(g) "Admission" means accepted by a licensee for the provision of services to an individual.

(h) "Agent" means an adult to whom authority to make health care decisions is delegated under an activated durable power of attorney for heath care executed in accordance with RSA 137-J.

(i) "Applicant" means an person, agency, partnership, corporation, government entity, association, or other legal entity seeking a license to operate a CR pursuant to RSA 151:2, I(e) .

(j) "Area of non-compliance" means any action, failure to act, or other set of circumstances that causes a licensee to be out of compliance with RSA 151, He-P 814, or other federal and state requirements.

(k) "Building rehabilitation" means any of the following undertaken in an existing building, as defined in this section:

(1) Addition;

(2) Modification;

(3) Reconstruction;

(4) Renovation; and

(5) Repair.

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

(m) "Chemical restraint" means any medication prescribed to control an individual's behavior or emotional state without a supporting diagnosis or for the convenience of personnel.

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

(o) "Community residence (CR) " means a facility of 4 or more individuals that is both certified by the department under RSA 126-A and licensed by the department under RSA 151, and that is operating in accordance with He-M 1001 or He-M 1002. The term includes "home".

(p) "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.

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

(r) "Department" means the New Hampshire department of health and human services at 129 Pleasant Street, Concord, NH 03301.

(s) "Designated Receiving Facility (DRF) " means a facility which receives persons for involuntary admissions under RSA 171-B, designated by the commissioner for one or more purposes, including, but not limited to:

(1) Receiving persons for involuntary admission directly pursuant to a court order; and

(2) Receiving involuntarily admitted persons by transfer with the approval of the commissioner or designee.

(t) "Developmental disability" means "developmental disability" as defined in RSA 171-A:2, V, namely, "a disability:

(1) Which is attributable to an intellectual disability, cerebral palsy, epilepsy, autism, or a specific learning disability, or any other condition of an individual found to be closely related to an intellectual disability as it refers to general intellectual functioning or impairment in adaptive behavior or requires treatment similar to that required for persons with an intellectual disability; and

(2) Which originates before such individual attains age 22, has continued or can be expected to continue indefinitely, and constitutes a severe disability to such individual's ability to function normally in society.

(u) "Direct care" means hands-on care or services provided to an individual, including but not limited to medical, nursing, psychological, or rehabilitative treatments.

(v) "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.

(w) "Elopement" means when an individual who is cognitively, physically, mentally, emotionally, or chemically impaired, or any combination thereof, wanders away, walks away, runs away, escapes, or otherwise leaves a caregiving facility or environment unsupervised, unnoticed, and/or contrary to the hours of supervision specified in his or her service agreement, as described in He-M 401 or He-M 503.

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

(y) "Equipment or fixtures" means any plumbing, heating, electrical, ventilating, air-conditioning, refrigerating, and fire protection equipment, and any elevators, dumbwaiters, escalators, boilers, pressure vessels, or other mechanical facilities or installations related to building services.

(z) "Exploitation" means the illegal use of an individual'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 an individual through the use of undue influence, harassment, duress, deception, or fraud.

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

(ab) "Household member" means the caregiver, all family members, and any other persons age 17 or older, who is not an individual, as defined in (ad) below, who resides at the licensed premises for more than 30 days.

(ac) "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.

(ad) "Individual" means the person who is admitted to the CR for care, services, and training regardless of the length of stay and who is eligible for services due to acquired brain disorder, developmental disability, or mental illness.

(ae) "Individual record" means a separate file maintained for each individual receiving care and services, which includes all documentation required by RSA 151 and He-P 814, and all documentation received relative to the individual as required by other federal and state requirements.

(af) "Infectious waste" means those items specified by Env-Wm 2604.

(ag) "Inspection" means the process followed by the department to determine an applicant's or a licensee's compliance with RSA 151 and He-P 814 or to respond to allegations, pursuant to RSA 151:6, of non-compliance with RSA 151 or He-P 814.

(ah) "License" means the document issued to an applicant or licensee which authorizes operation of a CR in accordance with RSA 151 and He-P 814, and includes the name of the licensee, the name of the business, the physical address, the licensing classification, the effective date, and license number.

(ai) "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, the type(s) of services authorized, and the number of beds for which the CR is licensed.

(aj) "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.

(ak) "Licensed premises" means the building(s), or portion thereof, that comprises the physical location the department has approved for the licensee to conduct operations in accordance with its license.

(al) "Licensee" means any person or legal entity to which a license has been issued pursuant to RSA 151.

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

(an) "Load-bearing element" means any column, girder, beam, joist, truss, rafter, wall, floor, or roof sheathing that supports any vertical load in addition to its own weight, or any lateral load.

(ao) "Mechanical restraint" means locked, secured, or alarmed CRs or units within an CR, or anklets, bracelets, or similar devices that cause a door to automatically lock when approached, thereby preventing an individual from freely exiting the CR or unit within.

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

(aq) "Mental illness" means "mental illness" as defined in RSA 135-C:2, X, namely "a substantial impairment of emotional processes, or of the ability to exercise conscious control of one's actions, or of the ability to perceive reality or to reason, when the impairment is manifested by instances of extremely abnormal behavior or extremely faulty perceptions. It does not include impairment primarily caused by:

(1) Epilepsy;

(2) Mental retardation;

(3) Continuous or noncontinuous periods of intoxication caused by substances such as alcohol or drugs; or

(4) Dependence upon or addiction to any substance such as alcohol or drugs."

(ar) "Modification" means:

(1) The reconfiguration of any space;

(2) The addition, relocation, or elimination of any door or window;

(3) The addition or elimination of load-bearing elements;

(4) The reconfiguration or extension of any system;

(5) The installation of any additional equipment; and

(6) The term does not include repair or replacement of interior finishes.

(as) "Neglect" means an act or omission, which results or could result in the deprivation of essential services or supports necessary to maintain the minimum mental, emotional, or physical health and safety of an individual.

(at) "Notice to correct" means a report issued pursuant to RSA 151:6-a, II, following a life safety inspection when a facility is found to be out of compliance with applicable life safety rules or codes.

(au) "Patient rights" means the privileges and responsibilities possessed by each individual provided by RSA 151:21.

(av) "Personal assistance" means providing or assisting an individual in obtaining one or more of the following services:

(1) Assistance with ADL, such as grooming, toileting, eating, dressing, getting into or out of a bed or chair, walking, or monitoring, supervision, or administration of medication;

(2) Assistance with instrumental activities of daily living such as doing laundry, food preparation, obtaining appointments, or engaging in recreational or leisure activities;

(3) Supportive services such as recreational and leisure activities, transportation, social services, medical, dental, and other health care services, habilitation or rehabilitative services, day care, or other services required to meet an individual's needs; or

(4) Monitoring an individual's activities to provide for the individual's and others' safety and well-being including, general supervision or oversight of the physical and mental well-being of an individual who needs assistance to maintain his or her participation in the facility or who needs assistance to manage his or her personal or financial affairs, regardless of whether a guardian has been appointed for the individual.

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

(ax) "Personnel" means a person 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 individuals.

(ay) "Physical restraint" means the use of hands-on or other physically applied technique to physically limit the individual's freedom of movement, which includes but is not limited to forced escorts, holding, prone restraints, or other containment techniques.

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

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

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

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

(1) Knowledge of individual whereabouts; and

(2) Minimizing the likelihood of accident or injury.

(bd) "Reconstruction" means the reconfiguration of a space:

(1) That affects an exit or a corridor shared by more than one occupant space; or

(2) Such that the building 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.

(be) "Renovation" means the replacement in kind, strengthening, or upgrading of building elements, materials, equipment or fixtures, that does not result in a reconfiguration of the building spaces within.

(bf) "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.

(bg) "Reportable incident" means an occurrence of any of the following while the individual is either in the CR or in the care of CR personnel:

(1) The unanticipated death of the individual;

(2) An injury to an individual that is potentially due to abuse or neglect; or

(3) The elopement or unexplained absence of an individual from the CR.

(bh) "Residential board and care occupancy", as defined in National Fire Protection Association (NFPA) 101 of the fire code, means an occupancy used for lodging and boarding of 4 or more individuals not related by blood or marriage to the owners or operators for the purpose of providing personal care services.

(bi) "Service" means a specific activity performed by the licensee, either directly or indirectly, to benefit or assist an individual.

(bj) "Supervision" means the process by which the individual is guided and assisted in the activities and behaviors necessary to achieve and maintain his or her maximum independence.

(bk) "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.

(bl) "Written and signed orders" means a document, produced electronically or via paper, 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.