Hawaii Administrative Rules › Title 11 - DEPARTMENT OF HEALTH › Subtitle 1 - GENERAL DEPARTMENTAL PROVISIONS › Chapter 94.2 - NURSING FACILITIES › Subchapter 1 - GENERAL PROVISIONS › Section 11-94.2-2 - Definitions

Current through June, 2024
As used in this chapter:
"Activities professional" or "qualified therapeutic
					 recreational specialist" means:
(1) A qualified professional who has two years of
					 experience in a social or recreational program within the last five years, one
					 of which was full-time in a resident activities program in a health care
					 setting;
(2) An occupational therapist or occupational therapy
					 assistant;
(3) A person who has completed a training course approved
					 by the department; or
(4) A person who is eligible for certification as a
					 therapeutic recreation specialist or as an activities professional by a
					 recognized accrediting body on or after October 1, 1990.
"Advanced directive" means a written or oral declaration
					 made by a competent adult, instructing his or her physician to provide,
					 withhold, or withdraw life-sustaining procedures under certain conditions such
					 as a terminal condition or where the resident has a permanent loss of ability
					 to communicate with others due to irreversible brain injury or coma. (An
					 advanced directive is often referred to as an advanced health care directive or
					 as a living will.)
"Advanced practice registered nurse" or "APRN" means a
					 registered nurse who is licensed pursuant to chapter
					 457,
					 HRS.
"Bed hold policy" means a written policy that specifies
					 legal readmission rights of a resident who transfers from the facility for a
					 hospitalization or therapeutic leave and a payment schedule to hold the bed
					 during that resident's absence.
"Certified nursing assistant" or "CNA" or "nurse aide"
					 means a person who is currently certified as a nurse aide pursuant to chapter
					 457A, HRS.
"Comprehensive assessment" means an evaluation completed by
					 the interdisciplinary team to identify a resident's functional capacity,
					 including the resident's strengths, preferences, and needs in the areas
					 including but not limited to activities of daily living (ADLs), cognition,
					 continence, mood, behavior, nutritional status, communication, vision, and
					 psychosocial well-being.
"Controlled drugs" means drugs listed as being subject to
					 high incidences of abuse as defined in chapter
					 329, HRS.
"Dental services" means an annual inspection of the oral
					 cavity for signs of disease, diagnosis of dental disease, dental radiographs as
					 needed, dental cleaning, fillings (new and repairs), minor dental plate
					 adjustments, smoothing of broken teeth, and limited prosthodontic procedures,
					 e.g., taking impressions for dentures and fitting dentures.
"Dentist" means any person holding a valid license to
					 practice dentistry, pursuant to chapter
					 448,
					 HRS.
"Department" means the department of health. State of
					 Hawaii.
"Dietary manager" means:
(1) A dietitian who meets the requirements of section
					 448B-5,
					 HRS;
(2) A graduate of a dietetic technician training program
					 approved by the American Dietetic Association;
(3) An individual certified by the Certifying Board for
					 Dietary Managers of the Dietary Managers Association; or
(4) An individual who has successfully completed an
					 approved course curriculum in any of the following, and has taken annual
					 continuing education credits to keep up with current food service trends and
					 practices, as set forth by the Dietary Managers Association:
(A) State approved course that includes at least ninety or
					 more hours of classroom or correspondence instruction, plus two years of work
					 experience of which at minimum, nineteen months were at the managerial level
					 and the remainder as a nutritionist;
(B) A two- or four-year college degree in food service
					 management and nutrition; or
(C) A United States military training program in food
					 service management with the attainment of a grade of E-5 or its equivalent
					 according to the brand of service.
"Dietitian" means a person who:
(1) Is registered by the Commission on Dietetics
					 Registration; or
(2) Is eligible for such registration.
"Director of health" or "director" means the director of
					 the department of health. State of Hawaii, or the director's designee.
"Discharge" means movement of a resident from a facility to
					 the resident's home or other location in the community, when return to the
					 facility is not expected or planned.
"Disinfect" means to render inactive virtually all
					 recognizable pathogenic microorganisms but not necessarily all microbial forms,
					 e.g., bacterial endospores.
"Drug administration" means the act in which a single dose
					 of a prescribed drug or biological substance is given to a resident by an
					 authorized person in accordance with all existing laws and rules governing
					 those acts.
"Drug dispensing" means the furnishing of drugs pursuant to
					 a prescription in a suitable container, appropriately labeled for subsequent
					 administration to or use by a resident or other individual entitled to receive
					 the drug.
"Emergency dental service" includes dental services to
					 control bleeding, relieve pain, eliminate acute infection, and treatment of
					 injuries to the teeth or supporting structures, and other medically urgent
					 dental services.
"Evacuation capacity designation" means the designation
					 determined by the current county building and fire codes that indicates whether
					 the physical structure of the facility is safe for residents to remain in the
					 building, or whether they must be evacuated from a facility in an emergency or
					 disaster.
"Governing body" means the policy-making group authority
					 that exercises general direction or fiduciary responsibilities over the affairs
					 of a facility and establishes policies concerning its operation and the welfare
					 of the residents the facility serves.
"Infectious waste" or "regulated waste" or "medical waste"
					 or "pathological waste" means any waste that may contain pathogens capable of
					 causing an infectious disease and shall include but is not limited to wastes
					 categorized in section
					 11-104.1-4.
"Interdisciplinary" means the integration of two or more
					 professional disciplines working together to provide the greatest benefit to
					 the resident.
"Legal guardian" means a person who has the legal authority
					 (and the corresponding duty) to care for the personal or property interests, or
					 both, of another person, referred to as a ward.
"Licensed practical nurse" or "LPN" means a person who is
					 licensed as a practical nurse pursuant to chapter
					 457,
					 HRS.
"Licensed social worker" or 'social worker" or "LSW" means
					 a person who is licensed to practice social work pursuant to chapter
					 467E, HRS.
"Nursing facility" means a skilled nursing facility or
					 'SNF", intermediate care facility or "ICF", or a skilled nursing and
					 intermediate care facility or 'SNF/ICF".
(1) "Intermediate care facility" means a health facility to
					 which a physician has referred individuals who do not need twenty-four hour a
					 day skilled nursing care but who do require the following services for
					 appropriate care;
(A) Twenty-four hours a day assistance with the normal
					 activities of daily living; and
(B) Care provided by licensed nursing and paramedical
					 personnel on a regular, long-term basis.
(2) "Skilled nursing facility" means a health facility that
					 provides skilled nursing and related services to residents who require
					 twenty-four hour a day medical or nursing care, or rehabilitation services,
					 including but not limited to physical therapy, occupational therapy, and speech
					 therapy services.
"Nursing home administrator" means a person licensed
					 pursuant to chapter
					 457B, HRS.
"Nursing plan of care" means an individualized treatment
					 plan developed at the time of admission, based on the initial nursing
					 assessment of the resident in conjunction with the physician's admission
					 physical examination and initial orders.
"Occupational therapist" means a person licensed pursuant
					 to chapter
					 457G, HRS.
"Occupational therapy assistant" means a person who is
					 currently certified or eligible for certification by the National Board for
					 Certification in occupational therapy.
"Overall plan of care" means an integrated plan of care
					 that includes the interventions and care or services to be provided by nurses,
					 social workers, rehabilitative therapists, physicians, APRNs, physician
					 assistants, dietitians and other professionals as determined by a comprehensive
					 assessment. The overall plan of care shall have measurable goals and objectives
					 with specific timelines directed to attain or maintain the resident's highest
					 practicable physical, mental, and psychosocial well-being. The plan shall also
					 include appropriate discharge planning.
"Performance improvement" or "PI" means the continuous
					 study and improvement of processes with the intent to improve services or
					 outcomes, and prevent or decrease the likelihood of problems, by identifying
					 opportunities for improvement, and testing new approaches to fix underlying
					 causes of persistent or systemic problems or barriers to improvement. PI aims
					 to improve facility processes involved in care delivery and enhanced resident
					 quality of life.
"Pharmacist" means a person who is licensed as a registered
					 pharmacist pursuant to chapter
					 461, HRS.
"Physical therapist" means a person who is licensed as a
					 physical therapist pursuant to chapter
					 461J, HRS.
"Physical therapy assistant" means a person who has
					 graduated from a two-year college-level program approved by the Section on
					 Education of the American Physical Therapy Association.
"Physician" means a person who is licensed to practice
					 medicine or osteopathy pursuant to chapter
					 453, HRS.
"Physician assistant" means a person who is licensed
					 pursuant to chapter
					 453, HRS.
"Plan of correction" means a plan developed by the facility
					 that includes actions that will be taken to address deficiencies cited or
					 detected by the department pursuant to a survey, inspection, or complaint
					 investigation that shall include preventive measures to ensure compliance with
					 this chapter and chapter
					 321, HRS, and the timeframe in which
					 these corrections shall take place.
"Quality assurance" or "QA" means the specification of
					 standards for quality of care, service and outcomes, and systems throughout the
					 facility for assuring that care is maintained at acceptable levels in relation
					 to those standards. QA is on-going and both anticipatory and retrospective in
					 its efforts to identify how the facility is performing, including where and why
					 facility performance is at risk or has failed to meet standards.
"Quality assurance and performance improvement" or "QAPI"
					 means the coordinated application of mutually-reinforcing aspects of quality
					 management that takes a systematic, interdisciplinary, comprehensive, and
					 data-driven approach to maintaining and improving safety and quality.
"Registered health information administrator" or "RHIA"
					 means a person who successfully passed a national qualifying examination
					 offered by the American Health Information Management Association and is
					 currently certified by the association as a RHIA.
"Registered health information technician" or "RHIT" means
					 a person who successfully passed a national qualifying examination offered by
					 the American Health Information Management Association and is currently
					 certified by the association as a RHIT.
"Registered nurse" or "RN" means a person who is licensed
					 as a registered nurse pursuant to chapter
					 457,
					 HRS.
"Rehabilitative plan of care" means a treatment plan based
					 on the attending physician's, physician assistant's, or APRN's orders and
					 assessment of a resident's needs in regard to specialized rehabilitative
					 procedures.
"Reputable and responsible character" means the character
					 of an individual who has not been:
(1) Convicted of a relevant crime as defined in section
					 321-15.2(a),
					 HRS; or
(2) Confirmed by the State as a perpetrator of adult or
					 child abuse, neglect, financial exploitation, or domestic violence.
"Social work plan of care" means a plan of services based
					 on an assessment completed by the social worker or designee to address social,
					 behavioral, or treatment interventions required to assist the resident to
					 maintain his or her highest practicable physical, mental, or psychosocial
					 wellbeing, with plans for appropriate and timely discharge as practical.
"Social worker designee" means a person who is supervised
					 by a licensed social worker.
"Special diet" or "therapeutic diet" means a diet ordered
					 by a physician or APRN that is prescribed as part of the medical nutrition
					 therapy of a nursing facility resident.
"Speech pathologist" or 'speech therapist" or "audiologist"
					 means a person who is licensed pursuant to chapter
					 468E, HRS, and:
(1) Is eligible for a certificate of clinical competence
					 granted by the American Speech-Language-Hearing Association in speech therapy,
					 pathology, or audiology; or
(2) Meets the educational requirements for certification
					 and is in the process of accumulating the supervised experience required to
					 take the examination for certification.
"Statement of deficiencies" means a listing of citations
					 given to the facility that describes the extent to which the facility is not
					 compliant with the requirements of this chapter, and that is issued to the
					 facility at the completion of a survey or licensing inspection or complaint
					 investigation.
"Surrogate" means an individual other than the nursing
					 facility's agent or legal guardian who is authorized under chapter
					 327E, HRS, to make a healthcare
					 decision for the resident.
"Transfer" means the movement of a resident from one
					 facility to another facility for continued care regardless of whether the
					 resident is expected or planned to return to the original facility. It does not
					 refer to movement between beds within the same licensed facility.
"Waiver" means an exemption to a rule.