###### Editorial Note on Part 51

#### Editorial Note:

Nomenclature changes to part 51 appear at 74 FR 19432, Apr. 29, 2009.

#### § 51.2 Definitions.

For the purposes of this part:

*Activities of daily living (ADLs)* means the functions or tasks for self-care usually performed in the normal course of a day, *i.e.,* mobility, bathing, dressing, grooming, toileting, transferring, and eating.

*Adult day health care* means a therapeutic outpatient care program that includes one or more of the following services, based on patient care needs: Medical services, rehabilitation, therapeutic activities, socialization, and nutrition. Services are provided in a congregate setting.

*Clinical nurse specialist* means a licensed professional nurse with a master's degree in nursing and a major in a clinical nursing specialty from an academic program accredited by the National League for Nursing.

*Director* means the Director of the VA medical center of jurisdiction, unless the reference is specifically to another type of director.

*Domiciliary care* means the furnishing of a home to a veteran, including the furnishing of shelter, food, and other comforts of home, and necessary medical services as defined in this part. For purposes of the definition of “domiciliary care,” *necessary medical services* means the medical services subpart E of this part requires the State home to provide.

*Eligible veteran* means a veteran whose care in a State home may serve as a basis for per diem payments to the State. The requirements that an eligible veteran must meet are set forth in §§ 51.50 (nursing home care), 51.51 (domiciliary care), and 51.52 (adult day health care).

*Licensed medical practitioner* means a nurse practitioner, physician, physician assistant, or primary care physician.

*Nurse practitioner* means a licensed professional nurse who is currently licensed to practice in a State; who meets that State's requirements governing the qualifications of nurse practitioners; and who is currently certified as an adult, family, or gerontological nurse practitioner by a nationally recognized body that provides such certification for nurse practitioners, such as the American Nurses Credentialing Center or the American Academy of Nurse Practitioners.

*Nursing home care* means the accommodation of convalescents or other persons who are not acutely ill and not in need of hospital care, but who require nursing care and related medical services, if such nursing care and medical services are prescribed by, or are performed under the general direction of, persons duly licensed to provide such care. The term includes services furnished in skilled nursing care facilities, in intermediate care facilities, and in combined facilities. It does not include domiciliary care.

*Participant* means an individual receiving adult day health care.

*Physician* means a doctor of medicine or osteopathy legally authorized to practice medicine or surgery in the State.

*Physician assistant* means a person who meets the applicable State requirements for a physician assistant, is currently certified by the National Commission on Certification of Physician Assistants as a physician assistant, and has an individualized written scope of practice that determines the authorization to write medical orders, to prescribe medications, and to accomplish other clinical tasks under appropriate physician supervision.

*Primary care physician* means a designated generalist physician responsible for providing, directing, and coordinating health care that is indicated for the residents or participants.

*Program of care* means any or all of the three levels of care for which VA may pay per diem under this part.

*Resident* means an individual receiving nursing home or domiciliary care.

*State* means each of the several States, the District of Columbia, the Virgin Islands, the Commonwealth of Puerto Rico, Guam, the Commonwealth of the Northern Mariana Islands, and American Samoa.

*State home* means a home recognized and, to the extent required by this part, certified pursuant to this part that a State established primarily for veterans disabled by age, disease, or otherwise, who by reason of such disability are incapable of earning a living. A State home must provide at least one program of care (*i.e.,* domiciliary care, nursing home care, or adult day health care).

*VA* means the U.S. Department of Veterans Affairs.

*Veteran* means a veteran under 38 U.S.C. 101.