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Section .2000 ‑ General Information


Published: 2015

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SECTION .2000 ‑ GENERAL INFORMATION

 

10A NCAC 13D .2001       DEFINITIONS

The following definitions will apply throughout this

Subchapter:

(1)           "Abuse" means the willful infliction of

injury, unreasonable confinement, intimidation or punishment with resulting physical

harm, pain or mental anguish.

(2)           "Accident" means an unplanned or unwanted

event resulting in the injury or wounding, no matter how slight, of a patient

or other individual.

(3)           "Accredited medical record technician"

means a person trained in record maintenance and preservation, and accredited

by the American Health Information Management Association.

(4)           "Adequate" means, when applied to various

services, that the services are at least satisfactory in meeting a referred to

need when measured against contemporary professional standards of practice.

(5)           "Administrator" means a person licensed

by the North Carolina State Board of Examiners for Nursing Home Administrators

in accordance with G.S. 90‑276, Article 20, and who has authority for and

is responsible for the overall operation of a facility.

(6)           "Appropriate" means right, suitable or

proper for the specified use or purpose, suitable or proper, when used as an

adjective.  When used as a transitive verb it means to set aside for some

specified exclusive use.

(7)           "Brain injury long term care" means an

interdisciplinary, intensive maintenance program for patients who have incurred

brain damage caused by external physical trauma and who have completed a

primary course of rehabilitative treatment and have reached a point of no gain

or progress for more than three consecutive months.  Services are provided

through a medically supervised interdisciplinary process and are directed

toward maintaining the individual at the optimal level of physical, cognitive

and behavioral functions.

(8)           "Capacity" means the maximum number of

patient or resident beds for which the facility is licensed to maintain at any

given time.

(9)           "Case manager" means the individual

responsible for the coordination of services, for a given patient, between

disciplines so that the patient may reach optimal rehabilitation through the

judicious use of resources.

(10)         "Combination facility" means a combination

home as defined in G.S. 131E‑101.

(11)         "Comprehensive, inpatient rehabilitation program"

means a program for the treatment of persons with functional limitations or

chronic disabling conditions who have the potential to achieve a significant

improvement in activities of daily living.  A comprehensive, rehabilitation

program utilizes a coordinated and integrated, interdisciplinary approach,

directed by a physician, to assess patient needs and to provide treatment and

evaluation of physical, psychosocial and cognitive deficits.

(12)         "Convalescent care" means care given for

the purpose of assisting the patient or resident to regain health or strength.

(13)         "Department" means the North Carolina

Department of Health and Human Services.

(14)         "Dietitian" means a person who is licensed

according to G.S. 90, Article 25, or is registered by the Commission on

Dietetic Registration (CDR) of the American Dietetic Association (ADA)

according to the standards and qualifications as referenced in the second

edition of the "Accreditation/Approval Manual for Dietetic Education

Program," "The Registration Eligibility Application for

Dietitians" and the "Continuing Professional Education" which

are hereby incorporated by reference, including subsequent amendments and

editions.  Copies of the manual may be purchased from ADA Sales Order Department,

216 W. Jackson Blvd., Chicago, IL 60606-6995 for twenty-one dollars and

ninety-five cents ($21.95), plus three dollars ($3.00) shipping and handling.

(15)         "Director of nursing" means a registered

nurse who has authority and direct responsibility for all nursing services and

nursing care.

(16)         "Discharge" means a patient who physically

relocates to another health care setting or is discharged home or relocated

from a nursing bed to an adult care home bed or from an adult care home bed to

a nursing bed.

(17)         "Drug" means substances:

(a)           recognized in the official United States

Pharmacopoeia, official National Formulary, or any supplement to any of them;

(b)           intended for use in the diagnosis, cure,

mitigation, treatment, or prevention of disease in man or other animals;

(c)           intended to affect the structure or any

function of the body of man or other animals, i.e., substances other than food;

and

(d)           intended for use as a component of any

article specified in Subitems (a), (b), or (c) of this Subparagraph.

(18)         "Existing facility" means a facility

currently licensed or a proposed facility, proposed addition to a licensed

facility or proposed remodeled licensed facility that will be built according

to plans and specifications which have been approved by the Department through the

design development drawings stage prior to the effective date of this Rule.

(19)         "Exit conference" means the conference

held at the end of a survey or investigation between the Department's

representatives and the facility administration representative.

(20)         "Facility" means a nursing facility or

combination facility as defined in this Rule.

(21)         "Finding" (when used in conjunction with

the Nurse Aide program) means a determination by the Department that an

allegation of patient abuse or neglect, or misappropriation of patient property

has been substantiated.

(22)         "HIV Unit" means designated areas

dedicated to patients or residents known to have Human Immunodeficiency Virus

disease.

(23)         "Incident" means any happening, event or

occurrence which is unplanned, unusual or unwanted and has actually caused harm

to a patient or has the potential for harm.

(24)         "Inpatient rehabilitation facility or

unit" means a free‑standing facility or a unit (unit pertains to

contiguous dedicated beds and spaces) within an existing licensed health

service facility approved in accordance with G.S. 131E, Article 9 to establish

inpatient, rehabilitation beds and to provide a comprehensive, inpatient

rehabilitation program.

(25)         "Interdisciplinary" means an integrated

process involving a representative from appropriate disciplines of the health

care team.

(26)         "Licensed" means holding a current and

valid license as required under the General Statutes of North Carolina.

(27)         "Licensed practical nurse" means a nurse

who is licensed as a practical nurse under G.S. 90, Article 9A.

(28)         "Licensee" means the person, firm,

partnership, association, corporation or organization to whom a license to

operate the facility has been issued.  The licensee is the legal entity which

is responsible for the operation of the business.

(29)         "Medical consultations" means

consultations which the rehabilitation physician, the attending physician or

other authorized persons determine are necessary to meet the acute medical

needs of the patient and do not include routine medical needs.

(30)         "Medication" means drug as defined in Item

(17) of this Rule.

(31)         "Medication error rate" means a

discrepancy between what was ordered and what is actually administered.  It is

the number of errors observed divided by the opportunities for error times 100.

(32)         "Misappropriation of property" means the

deliberate misplacement, exploitation, or wrongful, temporary or permanent use

of a patient's belongings or money without the patient's consent.

(33)         "Neglect" means a failure to provide goods

and services necessary to avoid physical harm, mental anguish or mental

illness.

(34)         "New facility" means a proposed facility,

a proposed addition to an existing facility or a proposed remodeled portion of

an existing facility that is constructed according to plans and specifications

approved by the Department subsequent to the effective date of this Rule.  If

determined by the Department that more than half of an existing facility is

remodeled, the entire existing facility shall be considered a new facility.

(35)         "Nurse Aide" means a person who is listed

on the N.C. Nurse Aide Registry and is in compliance with 42 CFR Part 483 which

is incorporated by reference, including subsequent amendments.  Copies of the

Code of Federal Regulations may be purchased from the Superintendent of

Documents, U.S. Government Printing Office, P.O. Box 371954, Pittsburgh, PA 15202-7954 for thirty eight dollars ($38.00) and may be purchased with a credit card by

a direct telephone call to the G.P.O. at (202) 512-1800.

(36)         "Nurse aide trainee" means a person who

has not completed an approved nurse aide training course and competency

evaluation and is demonstrating knowledge, while performing tasks for which

they have been found proficient by an instructor.  These tasks shall be

performed under the direct supervision of a registered nurse.  The term does

not apply to volunteers.

(37)         "Nursing facility" means a nursing home as

defined in G.S. 131E‑101.

(38)         "Nurse‑in‑charge" means the

licensed nurse to whom duties for a specified number of patients and staff for

a specified period of time have been delegated, such as for Unit A on the 7‑3

or 3‑11 shift.

(39)         "Occupational therapist" means a person

licensed in the State of North Carolina as an occupational therapist in

accordance with the provisions of G.S. 90, Article 18D.

(40)         "Occupational therapist assistant" means a

person licensed in the State of North Carolina as an occupational therapist

assistant in accordance with the provisions of G.S. 90, Article 18D.

(41)         "On‑duty personnel" means personnel

who are responsive to patient needs and physically present in the facility

performing assigned duties.

(42)         "Patient" means any person admitted for

nursing care.

(43)         "Pharmaceutical care" means the provision

of drug therapy and other pharmaceutical care services to achieve intended

medication outcomes and minimize negative effects of drug therapy.

(44)         "Pharmacist" means a person who is

licensed to practice pharmacy in North Carolina.

(45)         "Physician" means a person licensed under

G.S. 90, Article 1 to practice medicine in North Carolina.

(46)         "Proposal" means a Negative Action

Proposal containing information that may ultimately be classified as

violations.

(47)         "Provisional License" means an amended

license recognizing significantly less than full compliance with the licensure

rules.

(48)         "Psychologist" means a person licensed as

a practicing psychologist in accordance with G.S. 90, Article 18A.

(49)         "Physiatrist" means a licensed physician

who has completed a physical medicine and rehabilitation residency training

program approved by the Accreditation Council of Graduate Medical Education or

the American Osteopathic Association.

(50)         "Physical therapist" means a person

licensed in the State of North Carolina as a physical therapist in accordance

with the provisions of G.S. 90, Article 18B.

(51)         "Physical therapist assistant" means a

person licensed in the State of North Carolina as a physical therapist

assistant in accordance with the provisions of G.S. 90‑270.24, Article

18B.

(52)         "Recreational therapist" means a person

certified by the State of North Carolina Therapeutic Recreational Certification

Board.

(53)         "Registered Nurse" means a nurse who is

licensed as a registered nurse under G.S. 90, Article 9A.

(54)         "Registered Records Administrator" means a

person who is registered by the American Health Information Management

Association.

(55)         "Rehabilitation nurse" means a registered

nurse licensed in North Carolina, with training, either academic or on‑

the‑job, in physical rehabilitation nursing and at least one year

experience in physical rehabilitation nursing.

(56)         "Rehabilitation aide" means an unlicensed

assistant who works under the supervision of a registered nurse, licensed

physical therapist or occupational therapist in accordance with the appropriate

occupational licensure laws governing his or her supervisor and consistent with

staffing requirements as set forth in Rule .3027 of this Subchapter.  Any

rehabilitation aide, who works in a nursing department and is under the

supervision of a registered nurse, shall be listed on the North Carolina Nurse

Aide Registry and have received additional staff training as listed in Rule

.3028 of this Subchapter.

(57)         "Rehabilitation physician" means a

physiatrist or a physician who is qualified, based on education, training and

experience, regardless of specialty, to provide medical care to rehabilitation

patients.

(58)         "Remodeling" means alterations,

renovations, rehabilitation work, repairs to structural systems, and

replacement of building systems at a nursing facility.

(59)         "Resident" means any person admitted for

care to an adult care home part of a combination facility as defined in G.S.

131E‑101.

(60)         "Respite care" means services provided for

persons admitted to a nursing facility on a temporary basis, not to exceed 30

days.

(61)         "Significant medication error" means an

error which causes the patient discomfort or jeopardizes the health and safety

of the patient.  Factors to consider when determining significance of error

include the patient's condition, the drug category (need titration of blood

levels, etc.) and frequency of the error.

(62)         "Single unit or unit dose package" means

each dose of medication is individually packaged in a properly sealed and

properly labeled container in accordance with the U.S. Pharmacopeia and

professional standards.

(63)         "Sitter" means an employee or volunteer

who provides companionship and social interaction to a particular patient,

usually on a private duty basis.

(64)         "Social worker" means a person who meets

the qualifications set forth in Rule .2802 of this Subchapter.

(65)         "Speech and language pathologist" means a

person licensed in the State of North Carolina as a speech and language

pathologist in accordance with the provisions of G.S. 90, Article 22.

(66)         "Supervisor‑in‑charge" (adult

care home) means any employee to whom supervisory duties for the adult care

home portion of a combination home have been delegated by either the

administrator or director of nursing.

(67)         "Surveyor" means an authorized

representative of the Department who inspects nursing facilities and

combination facilities to determine compliance with rules as set forth in G.S.

131E‑117 and applicable state and federal laws, rules and regulations.

(68)         "Unit dose system" means a drug

distribution system in which each dose of medication is contained in, and

administered from, single unit or unit dose packages.

(69)         "Ventilator dependence" is defined as

physiological dependency by a patient on the use of a ventilator for more than

eight hours a day.

(70)         "Violation" means a finding which directly

relates to a patient's or resident's health, safety or welfare, or which

creates a substantial risk that death or serious physical harm will occur.  It

is determined to be an infraction of the regulations, standards and

requirements set forth in G.S. 131E ‑117 and 131D‑21 or applicable

state and federal laws, rules and regulations.

 

History Note:        Authority G.S. 131E‑104;

RRC objection due to lack of statutory authority Eff.

July 13, 1995;

Eff. January 1, 1996.