South Carolina Code of Regulations
Chapter 61 - DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
Subchapter 61-103 - Residential Treatment Facilities for Children and Adolescents
Sec2 61-103.100 - DEFINITIONS AND LICENSE REQUIREMENTS
Section 61-103.100.101 - Definitions

Universal Citation: SC Code Regs 61-103.100.101

Current through Register Vol. 48, No. 9, September 27, 2024

For the purpose of these standards, the following definitions shall apply:

A. Abuse. Physical abuse or psychological abuse.

1. Physical Abuse. The act of intentionally inflicting or allowing to be inflicted physical injury on a resident by an act or failure to act. Physical abuse includes, but is not limited to, slapping, hitting, kicking, biting, choking, pinching, actual or attempted sexual battery, use of medication outside the standards of reasonable medical practice for the purpose of controlling behavior, and unreasonable confinement. Physical abuse also includes the use of a restrictive or physically intrusive procedure to control behavior for the purpose of punishment except that a therapeutic procedure prescribed by a licensed physician or other legally authorized healthcare professional or that is part of a written care plan by a physician or other legally authorized healthcare professional is not considered physical abuse. Physical abuse does not include altercations or acts of assault between residents.

2. Psychological Abuse. Deliberately subjecting a resident to threats or harassment or other forms of intimidating behavior causing fear, humiliation, degradation, agitation, confusion, or other forms of serious emotional distress.

B. Administrator. The individual designated by the governing body or licensee who is in charge of and responsible for the administration of the facility.

C. Airborne Infection Isolation (AII). A room designed to maintain Airborne Infection Isolation (AII), formerly called a negative pressure isolation room. An Airborne Infection Isolation (AII) room is a single-occupancy resident-care room used to isolate persons with suspected or confirmed infectious tuberculosis (TB) disease. Environmental factors are controlled in Airborne Infection Isolation (AII) rooms to minimize the transmission of infectious agents that are usually spread from person-to-person by droplet nuclei associated with coughing or aerosolization of contaminated fluids. Airborne Infection Isolation (AII) rooms may provide negative pressure in the room (so that air flows under the door gap into the room), an air flow rate of six to twelve (6 to 12) air changes per hour (ACH), and direct exhaust of air from the room to the outside of the building or recirculation of air through a high efficiency particulate air (HEPA) filter.

D. Annual. A time period that required an activity to be performed at least every twelve (12) months.

E. Assessment. A procedure for determining the nature and extent of the problem(s) and needs of a resident or prospective resident to ascertain if the facility can adequately address those problems, meet those needs, and to secure information for use in the development of the treatment plan. Included in the process is an evaluation of the physical, psychiatric, psychological, developmental, social, nursing, educational, vocational, recreational, and legal status and/or needs of a resident or prospective resident. Consideration of each resident's needs, strengths, and weaknesses shall be included in the assessment.

F. Authorized Healthcare Provider. An individual authorized by law and currently licensed in South Carolina to provide specific treatments, care, or services to residents, such as an advanced practice registered nurse or physician assistant.

G. Blood Assay for Mycobacterium tuberculosis (BAMT). A general term to refer to in vitro diagnostic tests that assess for the presence of tuberculosis (TB) infection with M. tuberculosis. This term includes, but is not limited to, IFN-y release assays (IGRA).

H. Child, Adolescent, or Young Adult. An individual who is at least one (1) year of age but under twenty-one (21) years of age.

I. Consultation. A visit by Department representative(s) who will provide information to the licensee with the goal of facilitating compliance with these regulations.

J. Contact Investigation. Procedures that occur when a case of infectious TB is identified, including finding persons (contacts) exposed to the case, testing and evaluation of contacts to identify Latent TB Infection (LTBI) or TB disease, and treatment of these persons, as indicated.

K. Controlled Substance. A medication or other substance included in Schedule I, II, III, IV, or V of the Federal Controlled Substances Act and the South Carolina Controlled Substances Act.

L. Department. The South Carolina Department of Health and Environmental Control (DHEC).

M. Designee. A staff member designated by the administrator to act on his or her behalf.

N. Dietitian. A person who is registered by or meets the requirements of the American Dietetic Association and has at least one (1) year of experience in clinical nutrition.

O. Direct Care Staff Member. The individual(s) who provide assistance to residents.

P. Discharge. The point at which residence in a facility is terminated and the facility no longer maintains active responsibility for the care of the resident.

Q. Dispensing Medication. The transfer or possession of one (1) or more doses of a medication or device by a licensed pharmacist or individual as permitted by law, to the ultimate consumer or his or her agent pursuant to a lawful order of a practitioner in a suitable container appropriately labeled for subsequent administration to, or use by a resident.

R. Exploitation.

1) Causing or requiring a resident to engage in an activity or labor that is improper, unlawful, or against the reasonable and rational wishes of a resident. Exploitation does not include requiring a resident to participate in an activity or labor that is a part of a written care plan or prescribed or authorized by the resident's attending physician;

2) an improper, unlawful, or unauthorized use of the funds, assets, property, power of attorney, guardianship, or conservatorship of a resident by an individual for the profit or advantage of that individual or another individual; or

3) causing a resident to purchase goods or services for the profit or advantage of the seller or another individual through undue influence, harassment, duress, force, coercion, or swindling by overreaching, cheating, or defrauding the resident through cunning arts or devices that delude the resident and cause him or her to lose money or other property.

S. Facility. A Residential Treatment Facility for Children and Adolescents licensed by the Department.

T. Health Assessment. An evaluation of the health status of a staff member by a physician, other authorized healthcare provider, or registered nurse, pursuant to written standing orders and/or protocol approved by a physician's signature. The standing orders or protocol shall be reviewed annually by the physician, with a copy maintained at the facility.

U. Incident. An unusual unexpected adverse event resulting in harm, injury, or death of staff or residents, accidents, such as medication errors, adverse medication reactions, or elopement of a resident.

V. Individual Treatment Plan (ITP). A documented regimen of appropriate care and/or services or written action plan prepared by the facility for each resident based on the resident's assessment, needs and preferences and which is to be implemented for the benefit of the resident.

W. Inspection. Specific scrutiny of a facility or prospective facility by a Department representative(s) for the purpose of determining compliance with this regulation. Inspections include, but are not limited to, plan reviews, construction inspections, and licensing inspections.

X. Investigation. A visit by a Department representative(s) to a licensed or unlicensed entity for the purpose of determining the validity of allegations received by the Department relating to this regulation.

Y. Latent TB Infection (LTBI). Infection with M. tuberculosis. Persons with Latent TB Infection carry the organism that causes TB but do not have TB disease, are asymptomatic, and are noninfectious. Such persons usually have a positive reaction to the tuberculin skin test and/or positive BAMT.

Z. Legend Drug.

1. A drug when, under federal law, is required, prior to being dispensed or delivered, to be labeled with any of the following statements:
a. "Caution: Federal law prohibits dispensing without prescription";

b. "Rx only"; or

2. A drug which is required by any applicable federal or state law to be dispensed pursuant only to a prescription drug order or is restricted to use by practitioners only;

3. Any drug products considered to be a public health threat, after notice and public hearing as designated by the South Carolina Board of Pharmacy; or

4. Any prescribed compounded prescription drug within the meaning of the Pharmacy Act.

AA. License. The authorization to operate a facility as defined in this regulation and as evidence by a current certificate issued by the Department to a facility.

BB. Licensed Nurse. A person to whom the South Carolina Board of Nursing has issued a license as a registered nurse or licensed practical nurse or an individual licensed as a registered nurse or licensed practical nurse who resides in another state that has been granted multistate licensing privileges by the South Carolina Board of Nursing may practice nursing in any facility or activity licensed by the Department subject to the provisions and conditions as indicated in the Nurse Licensure Compact Act.

CC. Licensee. The individual, corporation, organization, or public entity that has been issued a license to provide care, treatment, and services at a facility and with whom rests the ultimate responsibility for compliance with this regulation.

DD. Local Transportation. The maximum travel distance the facility shall undertake, as addressed by the resident written agreement, to secure or provide healthcare for the resident. Local transportation shall be based on a reasonable assessment of the proximity of customary healthcare resources in the region, such as the nearest hospitals, physicians, or other healthcare providers, and appropriate consideration of resident preferences.

EE. Medication. A substance that has therapeutic effects, including, but not limited to, legend, nonlegend, herbal products, over-the-counter, nonprescription, vitamins, and nutritional supplements.

FF. Neglect. The failure or omission of a staff member to provide the care, goods, or services necessary to maintain the health or safety of a resident including, but not limited to, food, clothing, medicine, shelter, supervision, and medical services. Failure to provide adequate supervision resulting in harm to residents, including altercations or acts of assault between residents, may constitute neglect. Neglect may be repeated conduct or a single incident that has produced or could result in physical or psychological harm or substantial risk of death. Noncompliance with regulatory standards alone does not constitute neglect.

GG. Nonlegend Drug. A drug which may be sold without a prescription and which is labeled for use by the consumer in accordance with the requirements of the laws of this state and the federal government.

HH. Physical Examination. An examination of a resident by a physician or other authorized healthcare provider which addresses those issues identified in Section 1100 of this regulation.

II. Physician. An individual currently licensed to practice medicine by the South Carolina Board of Medical Examiners.

JJ. Physician Assistant. An individual currently licensed as such by the South Carolina Board of Medical Examiners.

KK. Quarterly. A time period that requires an activity to be performed at least four (4) times a year within intervals ranging from eighty-one to ninety-nine (81 to 99) days.

LL. Repeat Violation. The recurrence of a violation cited under the same section of the regulation within a thirty-six (36) month period. The time period determinant of repeat violation status is applicable in instances when there are ownership changes.

MM. Resident. Any individual who has been admitted for treatment in a residential treatment facility.

NN. Resident Room. An area enclosed by four (4) ceiling high walls that can house one (1) or more residents of the facility.

OO. Residential Treatment Facility for Children and Adolescents. A facility operated for the assessment, diagnosis, treatment, and care of two (2) or more children and/or adolescents in need of mental health treatment which provides:

1. An education program, including a program for students with disabilities, that meets all applicable federal and state requirements, as defined by the South Carolina Department of Education (SCDE). The education program may be provided at the facility, if appropriate space is available to provide a free appropriate public education in the least restrictive environment, or an alternate location;

2. Recreational facilities with an organized youth development program; and

3. Residential treatment for a child or adolescent in need of mental health treatment.

PP. Responsible Party. A person who is authorized by law to make decisions on behalf of a resident, to include, but not be limited to, a court-appointed guardian (or legal guardian as referred to in the Resident's Bill of Rights) or conservator, or healthcare or other durable power of attorney.

QQ. Restraint. Any means by which movement of a resident is inhibited, for example, physical, mechanical, or chemical. In addition, devices shall be considered a restraint if a resident is unable to easily release from the device.

RR. Revocation of License. An action by the Department to cancel or annul a facility license by recalling, withdrawing, or rescinding its authority to operate.

SS. Risk Assessment. An initial and ongoing evaluation of the risk for transmission of M. tuberculosis in a particular healthcare setting. To perform a risk assessment, the following factors shall be considered: the community rate of TB, number of TB residents encountered in the setting, and the speed with which residents with TB disease are suspected, isolated, and evaluated. The TB risk assessment determines the types of administrative and environmental controls and respiratory protection needed for a setting.

TT. Sponsor. The public agency or individual involved in one (1) or more of the following: protective custody authorized by law, placement, providing ongoing services, or assisting in providing services to a resident(s) consistent with the wishes of the resident or responsible party or specific administrative or court order.

UU. Staff Member. An adult, to include the administrator, who is a compensated employee or contract employee of the facility on either a full- or part-time basis.

VV. Suspension of License. An action by the Department requiring a facility to cease operations for a period of time or to require a facility to cease admitting residents, until such time as the Department rescinds that restriction.

WW. Volunteer. An adult who performs tasks at the facility at the direction of the administrator without compensation.

Disclaimer: These regulations may not be the most recent version. South Carolina may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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