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 818 - ADULT DAY PROGRAMS
Section He-P 818.03 - 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 self-management of medications.

(c) "Administer" means "administer" as defined by RSA 318:1.

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

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

(f) "Adult Day Program (ADP) " means a program that provides one or more of the following services, for fewer than 12 hours a day, to participants 18 years of age and older:

(g) "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.

(h) "Applicant" means an individual, agency, partnership, corporation, government entity, association, or other legal entity seeking a license to operate an ADP pursuant to RSA 151:2, I(f) .

(i) "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 818, or other federal or state requirements.

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

(k) "Care plan" means a written guide developed by the licensee, in consultation with personnel, the participant, and the participant's guardian, agent, or personal representative, if any, as a result of the assessment process for the provision of care and services.

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

(m) "Chemical restraint" means any medication prescribed to control a participant's behavior or emotional state without a supporting diagnosis or when used 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) "Core services" means those minimal services to be provided by the licensee that are included in the basic rate.

(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.

(s) "Direct care personnel" means any person providing hands-on care or services to a participant.

(t) "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.

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

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

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

(x) "Household member" means the caregiver, all family members, and any other individuals age 17 or older, who is not a participant, who have resided at the licensed premises for more than 30 days.

(y) "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.

(z) "Infectious waste" means those items specified by Env-Sw 103.28.

(aa) "Inspection" means the process followed by the department to determine an applicant's or a licensee's compliance with RSA 151 and He-P 818, or to respond to allegations of non-compliance with RSA 151 or He-P 818.

(ab) "License" means the document issued by the department to an applicant at the start of operation as an ADP which authorizes operation in accordance with RSA 151 and He-P 818, and includes the name of the licensee, the name of the business, the physical address, the license category, the effective date, and the license number.

(ac) "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 ADP is licensed.

(ad) "Licensed practitioner" means a:

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

(af) "Licensee" means any person or legal entity to which a license has been issued pursuant to RSA 151 and He-P 818.

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

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

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

(aj) "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 a participant.

(ak) "Nursing care" means the provision or oversight of a physical, mental, or emotional condition or diagnosis by a nurse that, if not monitored on a routine basis by a nurse, would or could result in a physical or mental harm to a participant.

(al) "Orders" means written prescriptions, instructions for treatments, special diets, or therapies given by a licensed practitioner, or other professional with prescriptive powers.

(am) "Over-the-counter medications" means non-prescription medications.

(an) "Participant" means any person, over the age of 18, admitted to or in any way receiving care, services, or both, from an ADP licensed in accordance with RSA 151 and He-P 818.

(ao) "Participant record" means a separate file maintained for each person receiving care and services, which includes all documentation required by RSA 151 and He-P 818, and all documentation received relative to the participant as required by other federal and state requirements.

(ap) "Patient rights" means the privileges and responsibilities possessed by each participant provided by RSA 151:21. This term includes "participant rights."

(aq) "Personal assistance" means providing or assisting a participant in carrying out activities of daily living.

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

(as) "Personnel" means individual(s), either paid or volunteer, including independent contractors, who provide direct or indirect care or services or both to a participant.

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

(au) "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 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.

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

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

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

(ay) "Reportable incident" means an occurrence of any of the following while the participant is either in the ADP or in the care of ADP personnel:

(az) "Self administration of medication with assistance" means the participant takes his or her own medication(s) after being prompted by personnel but without requiring physical assistance from others.

(ba) "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.

(bb) "Self-directed medication administration" means a participant, who has a physical limitation that prohibits him or her from self administration of medication, with or without assistance, directs personnel to physically assist in the medication process which shall not include assisting with injections or filling insulin syringes.

(bc) "Senior center" means a community based entity that provides meals, recreational activities, wellness programs, transportation, or other services for seniors but provides no services that require licensure under RSA 151.

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

(be) "Significant change" means a change in a participant's cognitive or physical capabilities that decreases his or her ability to care for himself or herself beyond an episodic event.

(bf) "Unexplained absence" means an incident involving a participant leaving the premises of the ADP without the knowledge of the ADP personnel.