Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 255 - HOSPITAL REPORT CARD CODE › Section 255.100 - Definitions

Current through Register Vol. 48, No. 28, July 12, 2024
"Act" means the Hospital Report Card Act.
"Actual nurse staffing assignment roster" means the
				nurse-patient assignment on each unit that reflects direct nursing services
				provided within a 24-hour time period to each patient, excluding any
				information that might identify a particular patient or nurse.
"Acute care" means the treatment of a condition or disease for
				a short period of time in which a patient is treated for a brief but severe
				episode of illness with the goal of discharging the patient.
"Appropriately trained" means has completed the orientation
				course for the job title as specified by the employing hospital.
"Artificial life support" means a system that uses medical
				technology to aid, support, or replace a vital function of the body that has
				been seriously damaged.
"Assigned" means that the registered professional nurse,
				licensed practical nurse, or other nursing personnel have responsibility for
				the provision of care to a particular patient within their scope of
				practice.
"Assistive nursing personnel" means personnel assigned
				responsibility for the provision of nursing care to a particular patient within
				their scope of practice, other than registered professional nurses or licensed
				practical nurses.
"Average daily census" means the average number of
				inpatients receiving service on any given 24-hour period beginning at midnight
				in each clinical service area of the hospital.
(Section 10 of the Act)
				Average daily census shall be calculated as the sum of inpatients every day at
				midnight for the quarter, divided by the number of days in the quarter.
"Average daily hours worked" means the total number of direct
				care nursing hours paid in the quarter per clinical service area, divided by
				the total number of calendar days in the quarter, to obtain the average number
				of worked hours per calendar day.
"Behavioral health" means the clinical service areas in which
				inpatients are receiving care and treatment for mental illnesses, substance
				abuse disorders or dependence, co-occurring mental illness and substance abuse
				disorders, or organic brain disorders, such as Alzheimer's Disease or senile
				dementia with psychotic or depressive symptoms. For the purposes of this Part,
				behavioral health clinical service areas do not include the following areas and
				their subcategories: critical care; maternal-child; medical-surgical;
				pediatrics; perioperative; and telemetry.
"Clinical service area" means a grouping of clinical
				services by a generic class of various types or levels of support functions,
				equipment, care, or treatment provided to inpatients.
Hospitals
				may have, but are not required to have, behavioral health, critical care,
				maternal-child care, medical-surgical, pediatrics, perioperative services, and
				telemetry.
(Section 10 of the Act) These services shall be measured in
				patient day units. "Perioperative" clinical service areas are defined in the
				definition of "perioperative" in this Part.
"Critical care" means the clinical service areas organized,
				operated, and maintained to provide for monitoring and caring for patients with
				severe or potentially severe physiologic instability requiring technical
				support and often requiring artificial life support.
"Critical care service area" means adult and pediatric critical
				care patient populations, but does not include intensive care newborn nursery
				services. For the purposes of this Part, critical care clinical service areas
				do not include the following areas and their subcategories: behavioral health;
				maternal-child; medical-surgical; pediatrics; perioperative; and
				telemetry.
"Current nursing staff schedules" means the prospective
				staffing schedules for each patient care unit, excluding any information that
				might identify a particular nurse, made in advance of a designated time frame,
				e.g., weekly, monthly or quarterly.
"Department" means the Department of Public
				Health
. (Section 10 of the Act)
"Direct-care nurse" and "direct-care nursing staff"
				include any registered nurse, licensed practical nurse, or assistive nursing
				personnel with direct responsibility to oversee or carry out medical regimens
				or nursing care for one or more patients
. (Section 10 of the
				Act)
"Direct patient care responsibilities" means the activities of
				direct care nurses and direct care assistive nursing personnel who are assigned
				to a patient or patients.
"Direct supervision" means a situation in which an individual
				is responsible for directing the actions of another individual in the facility
				and is physically close enough to be readily available, if needed, by the
				supervised individual. "Direct supervision" shall be conducted by a registered
				professional nurse.
"Employee" means any full-time or part-time direct care nursing
				staff employee who works a regularly scheduled number of hours in a defined pay
				period. Not included are direct care nursing staff who work on an as-needed
				basis and are not guaranteed work hours, including, but not limited to, casual,
				per diem, and registry personnel.
"Full-time equivalent" means hospital-employed licensed nursing
				hours budgeted to work in a seven-day time period divided by 37.5, or in a
				14-day time period divided by 75, or annually divided by 1950.
"Indirect patient care responsibilities" means the activities
				of nurses, such as nurse managers, charge nurses, clinical nurse specialists
				and other ancillary licensed nursing personnel, when they are not assigned to
				direct patient care activities.
"Hospital" means a health care facility licensed under
				the Hospital Licensing Act
. (Section 10 of the Act)
"Hospital Quality Alliance" means the public-private
				collaboration that collects and reports hospital quality performance
				information and makes it available to consumers through Centers for Medicare
				and Medicaid Services (CMMS) information channels.
"Inpatient" means a person admitted for at least one overnight
				stay to health facilities, usually hospitals, that provide board and room, for
				the purpose of observation, care, diagnosis or treatment.
"Intensive Care Unit" or "ICU" means a hospital facility for
				provision of intensive nursing and medical care of critically ill patients,
				characterized by high quality and quantity of continuous nursing and medical
				supervision and by use of sophisticated monitoring and resuscitative equipment.
				An ICU may be organized for the care of specific patient groups, e.g., neonatal
				or newborn ICU, neurological ICU, or pulmonary ICU.
"Licensed nursing hours per inpatient day" means, for the
				quarter, the total number of productive hours worked by licensed nursing
				personnel with direct care responsibilities, divided by the total inpatient
				days.
"Licensed practical nurse" or "LPN" means a person meeting the
				requirements for licensure by the Department of Financial and Professional
				Regulation as a licensed practical nurse pursuant to the Nurse Practice
				Act.
"Maternal-child" means the clinical service areas that are
				designed, equipped, organized and operated in accordance with the requirements
				of the Hospital Licensing Act relating to the medical-surgical care of a
				patient prior to and during the act of giving birth to either a living child or
				a dead fetus and the continuing care of both patient and newborn infant. For
				the purposes of this Part, intensive care newborn nursery services are included
				in maternal-child clinical service areas. Maternal-child clinical service areas
				do not include the following clinical service areas and their subcategories:
				behavioral health; critical care; medical-surgical; pediatrics; perioperative;
				and telemetry.
"Medical-surgical" means the clinical service areas in which
				patients who require less care than that which is available in intensive care
				units or telemetry units have available 24-hour inpatient general medical
				services, post-surgical services, or both general medical and post-surgical
				services. These units may include mixed patient populations of diverse
				diagnoses and diverse age groups. For the purposes of this Part,
				medical-surgical clinical service areas do not include the following areas and
				their subcategories: behavioral health; critical care; maternal-child;
				pediatrics; perioperative; and telemetry.
"Nursing care" means care that falls within the scope
				of practice set forth in the Nurse Practice Act or is otherwise encompassed
				within recognized professional standards of nursing practice, including
				assessment, nursing diagnosis, planning, intervention, evaluation, and patient
				advocacy.
(Section 10 of the Act)
"Nursing hours per inpatient day" means, for the quarter, the
				total number of productive hours worked by registered nurses, licensed
				practical nurses, and assistive nursing personnel, in each case, with direct
				patient care responsibilities, divided by the total inpatient days.
"Observation care" means those services furnished by a hospital
				on the hospital's premises, including use of a bed and at least periodic
				monitoring by a hospital's nursing or other staff, that are reasonable and
				necessary to evaluate an outpatient's condition or determine the need for a
				possible admission to the hospital as an inpatient. In general, the duration of
				observation care services does not exceed 24 to 48 hours, depending on the
				hospital, physician and health plan.
"Pediatrics" means the clinical service areas in acute care
				hospitals that are designed, equipped, organized and operated to render
				non-intensive care to the 0-17 age population performed at the direction of a
				physician on behalf of the patient by physicians, dentists, nurses, and other
				professional and technical personnel. For the purposes of this Part, pediatric
				clinical service areas in acute care hospitals do not include the following
				areas and their subcategories: behavioral health; critical care;
				maternal-child; medical-surgical; perioperative; and telemetry. Pediatric
				hospitals may incorporate any or all of these clinical service areas in
				fulfilling their role of specialty treatment facilities for the medical care of
				infants, children, and adolescents. Pediatric hospitals shall consider all care
				provided as pediatric without regard for where in the facility the service was
				rendered. For patients in specialty pediatric hospitals, age requirements are
				extended to include those patients who, due to condition, care and treatment
				requirements, continue to be considered pediatric. Clinical service area
				comparisons for pediatric hospitals shall follow the guidelines of national
				pediatric organizations. An adult or specialty hospital operating a pediatric
				hospital within the larger hospital shall report using its National Provider
				Identifier and taxonomy codes to allow differentiation of nursing hours and
				more meaningful comparisons.
"Perioperative" means the clinical service areas that are
				designed, equipped, organized and operated to provide care for inpatients
				during the preoperative, intraoperative and immediate postoperative periods of
				a hospital stay. For the purposes of this Part, perioperative clinical service
				areas do not include the following areas and their subcategories: behavioral
				health; critical care; maternal-child; medical-surgical; pediatrics; and
				telemetry.
"Productive hours" means the actual work hours, exclusive of
				vacation, holidays, sick leave and any other absences, with the following
				inclusions and exclusions.
Agency, per diem and registry RNs with direct patient care
				responsibility shall be included in the number of productive hours for the
				mandated reports.
The number of productive hours for mandated reports shall not
				include nurse managers, charge nurses who are not assigned direct patient care
				responsibilities, or any other licensed nursing personnel who do not have a
				direct care patient assignment.
The number of productive hours for mandated reports shall not
				include licensed nurses who are participating in orientation.
"Registered professional nurse" or "RN" means a person meeting
				the requirements for licensure by the Department of Financial and Professional
				Regulation as a registered professional nurse pursuant to the provisions of the
				Nurse Practice Act.
"Separated" means any licensed nursing employee who is
				permanently removed for any reason, including voluntary, involuntary or
				employee transfer, from the payroll allotted for a clinical service
				area.
"Staffing levels" means the numerical nurse to patient
				ratio by licensed nurse classification within a nursing department or
				unit.
(Section 10 of the Act)
"Telemetry unit" means a unit organized, operated and
				maintained to provide care for and continuous cardiac monitoring of patients in
				a stable condition, having or suspected of having a cardiac condition or a
				disease requiring the electronic monitoring, recording, retrieval, and display
				of cardiac electrical signals. "Telemetry unit" does not include fetal
				monitoring or fetal surveillance. For the purposes of this Part, telemetry
				clinical service areas do not include the following areas and their
				subcategories: behavioral health; critical care; maternal-child;
				medical-surgical; pediatrics; and perioperative care.
"Technical support" means specialized equipment and/or
				personnel providing for invasive monitoring, telemetry, or mechanical
				ventilation, for the immediate amelioration or remediation of severe
				pathology.
"Unit" means a functional division or area of a
				hospital in which nursing care is provided.
(Section 10 of the
				Act)