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.