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 823 - HOME HOSPICE CARE PROVIDER
Section He-P 823.03 - 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, self-management, and monitoring or supervision 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 an HHCP pursuant to RSA 151.

(h) "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 823, 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:

(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.

(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 New Hampshire department of health and human services or his or her designee.

(n) "Coordinator" means a person from the HHCP who coordinates the care and services necessary to provide optimum health care management for the patient.

(o) "Core services" means those services 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) "Demonstrated competency" means the ability of the employee to demonstrate to an evaluator that he or she is able to complete the required task in a way that reflects the minimum standard including, but not limited to, a certificate of completion of course material or a post test to the training provided.

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

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

(u) "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.

(v) "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. The term includes "do not attempt resuscitation order (DNAR order) ".

(w) "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 hospice services may be temporarily stored.

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

(y) "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, deception, or fraud.

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

(aa) "Home hospice care provider (HHCP) " means an agency which provides hospice services to patients and their families in the patient's residence.

(ab) "Hospice" means a specialized program of care and supportive services, which provides a combination of medical, social and spiritual services to terminally ill patients and their families.

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

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

(af) "Inspection" means the process followed by the department to determine an applicant's or a licensee's compliance with RSA 151 and He-P 823 or to respond to allegations, pursuant to RSA 151:6, of non-compliance with RSA 151 and He-P 823.

(ag) "Investigation" means the process used by the department to respond to allegations of non-compliance with RSA 151 and He-P 823.

(ah) "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 823, and includes the name of the licensee, the name of the business, the physical address, the license 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 and the type(s) of services authorized for which the HHCP is licensed.

(aj) "Licensed practitioner" means a:

(ak) "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 the private residence of a patient receiving services from a HHCP.

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

(am) "Medical director" means a New Hampshire licensed practitioner, licensed in accordance with RSA 329, who is responsible for overseeing the quality of medical care and services within the HHCP.

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

(ao) "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 .

(ap) "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 patient.

(aq) "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.

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

(as) "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.

(at) "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 823.

(au) "Patient record" means the documentation of all care and services, which includes all documentation required by RSA 151, He-P 823, and any other applicable federal and state requirements.

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

(aw) "Personal care" means personal care services that are non-medical, hands-on services provided to a patient including, but not limited to, assistance with activities of daily living such as grooming, toileting, eating, dressing, bathing, getting into or out of a bed or chair, walking, or reminding the patient to take medications.

(ax) "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.

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

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

(ba) "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.

(bb) "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.

(bc) "Point of care devices" means testing involving a system of devices, typically including:

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

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

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

(bg) "Professional management responsibility" means that the professional staff of the HHCP provider continues to provide guidance and services to the patient regardless of the location of the patient.

(bh) "Professional staff" means:

(bi) "Reportable incident" means an occurrence of any of the following while the patient is in the care of HHCP personnel:

(bj) 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 Nur 404.03(b) .

(bk) "Self-administration of medication without assistance" means the patient takes his or her own medication(s) without the assistance of personnel, including prompting.

(bl) "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, with or without assistance, directs personnel to physically assist in the medication process which shall not include assisting with injections or filling insulin syringes.

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

(bn) "Volunteer" means an unpaid person, screened and trained by agency, who provides assistance to patients and families with companionship, household chores, shopping, transportation, et cetera, who does not provide direct care. This term does not include visitors or those persons who provide religious services or entertainment.