Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 175 - HEALTH CARE FACILITIES AND SERVICES LICENSURE › Chapter 12 - SKILLED NURSING FACILITIES, NURSING FACILITIES, AND INTERMEDIATE CARE FACILITIES › Section 175-12-002 - DEFINITIONS

Current through June 17, 2024
Abuse
means any knowing,
				  intentional, or negligent act or omission on the part of any person which
				  results in physical, sexual, verbal or mental abuse, unreasonable confinement,
				  cruel punishment, exploitation, or denial of essential care, treatment, or
				  services to a resident.
Accident
means an unexpected,
				  unintended event that can cause a resident bodily injury.
Activities of daily living
(See
				  definition of "Care.")
Adjoining
means located to allow
				  access without having to enter a general corridor area used or observed by
				  other facility occupants.
Apartment
means a portion of a
				  building that contains: living and sleeping areas; storage room(s); separate
				  room(s) containing a toilet, lavatory, and bathtub or shower; and a kitchen
				  area with a sink and cooking and refrigeration appliances.
Applicant
means the individual,
				  government, corporation, partnership, limited liability company, or other form
				  of business organization that applies for a license.
Biological
means any virus,
				  therapeutic serum, toxin, antitoxin, or analogous product applicable to the
				  prevention, treatment, or cure of disease or injuries of humans.
Care
means the exercise of concern
				  or responsibility for the comfort, welfare, and habilitation of persons,
				  including a minimum amount of supervision and assistance with or the provision
				  of personal care, activities of daily living, health maintenance activities, or
				  other supportive services. For purposes of this chapter:
1.
Activities of daily living
means
				  transfer, ambulation, exercise, toileting, eating, self-administered
				  medication, and similar activities;
2.
Health maintenance activities
means noncomplex interventions which can safely be performed according to exact
				  directions, which do not require alteration of the standard procedure, and for
				  which the results and resident responses are predictable; and
3.
Personal care
means bathing hair
				  care, nail care, shaving, dressing, oral care, and similar activities.
Chemical restraint
means a
				  psychopharmacologic drug that is used for discipline or convenience and is not
				  required to treat medical symptoms.
Complaint
means any expression of
				  concern or dissatisfaction.
Completed application
means an
				  application that contains all the information specified in 175 NAC
				  12-003 and includes all required
				  attachments, documentation, and the licensure fee.
Department
means the Department of
				  Health and Human Services Regulation and Licensure.
Designee
means a person who is
				  authorized by law or by the resident to act on his or her behalf, for example,
				  a parent of a minor child, a legal guardian, a conservator, or an attorney in
				  fact named in a durable power of attorney for health care.
Device
means an instrument,
				  apparatus, implement, machine, contrivance, implant, in vitro reagent, or other
				  similar or related article, including any component, part, or accessory, which
				  is prescribed by a medical practitioner and dispensed by a pharmacist or other
				  person authorized by law to do so.
Direction and monitoring
means, for
				  the purpose of medication administration, the acceptance of responsibility for
				  observing and taking appropriate action regarding any desired effects, side
				  effects, interactions, and contraindications associated with the medication.
				  Direction and monitoring can be done by a:
1. Competent individual for himself or herself;
2. Caretaker; or
3. Licensed health care professional.
Director
means the Director of
				  Regulation and Licensure.
Dispensing pharmacy
means the
				  pharmacy that provides prescribed medications to residents of the facility or
				  that provides emergency box drugs to an institution pursuant to the Emergency
				  Box Drug Act,
Neb. Rev. Stat.
§§
									71-2410
				  to
				  71-2417.
Drug
means substances as defined in
Neb. Rev. Stat.
§ 71-1,142.
Dwelling
means a building that
				  contains: living and sleeping areas; storage room(s); separate room(s)
				  containing a toilet, lavatory, and bathtub or shower; and a kitchen area with a
				  sink and cooking and refrigeration appliances.
Emergency box drugs
means drugs
				  required to meet the immediate therapeutic needs of residents when the drugs
				  are not available from any other authorized source in time to sufficiently
				  prevent risk of harm to such residents by the delay resulting from obtaining
				  such drugs from such other authorized source.
Existing facility
means a licensed
				  facility or a facility whose construction or remodeling plans were approved by
				  the Department prior to the effective date of 175 NAC 12.
Exploitation
means the taking of
				  property of a resident by means of undue influence, breach of a fiduciary
				  relationship, deception, extortion, or by any unlawful means.
Facility
means a skilled nursing
				  facility, nursing facility, or intermediate care facility as defined.
Five rights
means the right
				  medication to the right resident in the right dosage by the right route at the
				  right time.
Food Code
means the Nebraska Food
				  Code as defined in
Neb. Rev. Stat.
§
									81-2,244.01
				  and as published by the Nebraska Department of Agriculture, except for
				  compliance and enforcement provisions.
Foreign
when applied to
				  corporations means all those created by authority other than that of the State
				  of Nebraska.
Grievance
means any written
				  expression of dissatisfaction which may or may not be the result of an
				  unresolved complaint.
Health care facility
means a(n)
				  ambulatory surgical center, assisted-living facility, center or group home for
				  the developmentally disabled, critical access hospital, general acute hospital,
				  health clinic, hospital, intermediate care facility, intermediate care facility
				  for the mentally retarded, long-term care hospital, mental health center,
				  nursing facility, pharmacy, psychiatric or mental hospital, public health
				  clinic, rehabilitation hospital, skilled nursing facility, or substance abuse
				  treatment center.
Health maintenance activity
(See
				  definition of "Care".)
Incident
means an occurrence likely
				  to have a grave outcome.
Intermediate care facility
means a
				  facility where shelter, food, and nursing care or related services are provided
				  for a period of more than 24 consecutive hours to persons residing at such
				  facility who are ill, injured, or disabled and do not require hospital or
				  skilled nursing facility care.
Licensed health care professional
means an individual for whom medication authorization or administration of
				  medications is included in the scope of practice.
Licensed nurse
means a licensed
				  registered nurse or a licensed practical nurse.
Licensee
means the individual,
				  government, corporation, partnership, limited liability company, or other form
				  of business organization legally responsible for the operation of the facility
				  and to whom the Department has issued a license.
Medical practitioner
means any
				  licensed physician, osteopathic physician, dentist, podiatrist, optometrist,
				  chiropractor, physician assistant, certified registered nurse anesthetist,
				  advanced practice registered nurse, or certified nurse midwife.
Medication
means any prescription
				  or nonprescription drug intended for treatment or prevention of disease or to
				  affect body function in humans.
Medication administration
includes,
				  but is not limited to:
1. Providing medication for another person according to the
				  five rights;
2. Recording medication provision; and
3. Observing, monitoring, reporting, and otherwise taking
				  appropriate actions regarding desired effects, side effects, interactions, and
				  contraindications associated with the medication.
Medication aide
means an individual
				  who is listed on the medication aide registry operated by the Department as
				  provided in 172 NAC 95 and 96.
Medication error
is the
				  preparation, provision or administration of medications which is not in
				  accordance with:
1. Physician orders;
2. Manufacturers specifications regarding the preparation and
				  administration of the drug or biological; or
3. Accepted professional standards and principles that apply
				  to professionals providing services.
Medication error rate
is determined
				  by calculating the percentage of errors. The numerator is the total number of
				  errors that the survey team observes, both significant and nonsignificant. The
				  denominator is called "opportunities for error" and includes all the doses the
				  survey team observed being administered plus the doses ordered but not
				  administered.
Medication provision
means the
				  component of the administration of medication that includes giving or applying
				  a dose of medication to an individual and includes helping an individual in
				  giving or applying such medication to himself or herself.
Medically related social services
means services provided by the facility's staff to assist residents in
				  maintaining or improving their ability to manage their everyday physical,
				  mental, and psychosocial needs.
Mental abuse
means humiliation,
				  harassment, threats of punishment or deprivation, or other action causing
				  mental anguish.
Misappropriation of money or
				  property
means the deliberate misplacement, exploitation, or use
				  of a resident's belongings or money without the resident's consent.
NAC
means Nebraska Administrative
				  Code.
Neglect
means a failure to provide
				  care, treatment, or services necessary to avoid physical harm or mental anguish
				  of a resident.
New construction
means a facility
				  or a distinct part of a facility in which care and treatment is to be provided
				  and which is enlarged, remodeled, or altered in any fashion or is built from
				  the ground up on or after the effective date of 175 NAC 12.
New facility
means a facility or a
				  distinct part of a facility in which care and treatment is to be provided and
				  which is not currently licensed as a health care facility. New facility also
				  includes those facilities, which were previously licensed for care and
				  treatment in another licensure category, that now intend to seek licensure in a
				  different category.
Nursing facility
means a facility
				  where medical care, nursing care, rehabilitation, or related services and
				  associated treatment are provided for a period of more than 24 consecutive
				  hours to persons residing at such facility who are ill, injured, or
				  disabled.
Personal care
(See definition of
				  "Care.")
Physical abuse
means hitting,
				  slapping, pinching, kicking, or other actions causing injury to the
				  body.
Physical restraint
means any manual
				  method or physical or mechanical device, material, or equipment attached or
				  adjacent to the resident's body that he or she cannot remove easily and that
				  restricts freedom of movement or normal access to his or her own body.
Premises
means a facility, the
				  facility's grounds and each building or grounds on contiguous property used for
				  administering and operating a facility.
PRN
means an administration scheme
				  in which a medication is not routine, is taken as needed, and requires
				  assessment for need and effectiveness.
Qualified dietitian
means a
				  Registered Dietitian or a Licensed Medical Nutrition Therapist.
Qualified inspector
means a
				  professional architect or engineer licensed to practice in Nebraska, an
				  official or employee of a local jurisdiction authorized by that jurisdiction to
				  make inspections of particular building equipment or systems, or an individual
				  certified by a nationally recognized organization to make such
				  inspections.
Qualified personnel
means that
				  professional staff are licensed, certified or registered to provide specialized
				  therapy/rehabilitative services in accordance with applicable state
				  laws.
Resident
means a person residing
				  and receiving care and/or treatment as recommended by a medical practitioner at
				  a skilled nursing facility, nursing facility, or intermediate care
				  facility.
Schematic plans
means a diagram of
				  the facility which describes the number and location of beds, the location of
				  care and treatment rooms, Life Safety Code construction and occupancy
				  classifications locations, fire compartments, and Fire Marshal-approved points
				  of safety.
Sexual abuse
means sexual
				  harassment, sexual coercion, or sexual assault.
Significant change
means a major
				  change in the resident's status that is not self-limiting, impacts on more than
				  one area of the resident's health status, and requires interdisciplinary review
				  and/or revision of the care plan.
Significant medication error
means
				  one which jeopardizes a resident's health and safety.
Significant weight loss
is 5% loss
				  of body weight in one month, 7.5 % loss of body weight in three months, or 10%
				  body weight loss in six months.
Skilled nursing facility
means a
				  facility where medical care, skilled nursing care, rehabilitation, or related
				  services and associated treatment are provided for a period of more than 24
				  consecutive hours to persons residing at such facility who are ill, injured, or
				  disabled.
Specialized rehabilitative services
means services provided by qualified personnel such as, but not limited to,
				  physical therapy, speech-language pathology, occupational therapy, and mental
				  health rehabilitative services for mental illness and mental
				  retardation.
Sufficient fluid
means the amount
				  of fluid needed to prevent dehydration (output of fluids far exceeds fluid
				  intake) and maintain health. The amount needed is specific for each resident,
				  and fluctuates as the resident's condition fluctuates.
Therapeutic diet
means a diet
				  ordered by a physician as part of treatment for a disease or clinical
				  condition, to increase, decrease or eliminate certain substances in the diet,
				  or to provide food the resident is able to eat.
Treatment
means a therapy,
				  modality, product, device, or other intervention used to maintain well being or
				  to diagnose, assess, alleviate, or prevent a disability, injury, illness,
				  disease, or other similar condition.
Unlicensed direct care staff
means
				  personnel who are not licensed or certified under the Uniform Licensing Law or
				  other state laws governing the practice of health care and whose primary
				  responsibility is to manage, supervise, and/or provide direct care to
				  residents. Unlicensed direct care staff includes nursing assistants, medication
				  aides, and other personnel with this responsibility and with job titles
				  designated by the facility.
Verbal abuse
means the use of oral,
				  written, or gestured language including disparaging and derogatory terms to
				  residents or within their hearing distance.