Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 175 - HEALTH CARE FACILITIES AND SERVICES LICENSURE › Chapter 4 - ASSISTED LIVING FACILITIES › Section 175-4-002 - DEFINITIONS

Current through June 17, 2024
For the purposes of these regulations, the following
				  definitions apply:
Abuse
means any knowing,
				  intentional or negligent act or omission on the part of a person which results
				  in physical, sexual, verbal, or mental abuse, unreasonable confinement, cruel
				  punishment, exploitation, or denial of essential care, treatment, and services
				  to a resident.
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.
Administrator
means the operating
				  officer of an assisted-living facility and includes a person with a title such
				  as administrator, chief executive officer, manager, superintendent, director,
				  or other similar designation.
Apartment
means 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 who applies for a license.
Assisted-living facility
means a
				  facility where shelter, food, and care are provided for remuneration for a
				  period of more than 24 consecutive hours to four or more persons residing at
				  such facility who require or request such services due to age, illness, or
				  physical disability.
This definition does not include a home, apartment or
				  facility where:
1. Casual care is provided at irregular intervals, or
2. A competent person residing in such home, apartment or
				  facility provides for or contracts for his or her own personal or professional
				  services if no more than 25% of persons residing in such home, apartment, or
				  facility receive such services.
Authorized representative
means:
1. A person holding a durable power of attorney for health
				  care;
2. A guardian; or
3. A person appointed by a court to manage the personal
				  affairs of a resident of an assisted-living facility other than the facility.
				  (See definition of Power of Attorney for Health Care.)
Bed capacity
means the total number
				  of beds which can be set up in an assisted-living facility for use by
				  residents.
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-administration of
				  medication, and similar activities;
2.
Health maintenance activities
means noncomplex interventions which can safely be performed according to exact
				  direction, 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 an expression of a
				  concern or dissatisfaction.
Completed application
means an
				  application that contains all the information specified in 175 NAC
				  4-003 and includes all required
				  attachments and documentation and the licensure fee.
Complex nursing interventions
means
				  interventions which require nursing judgment to safely alter standard
				  procedures in accordance with the needs of the resident, which require nursing
				  judgment to determine how to proceed from one step to the next, or which
				  require a multidimensional application of the nursing process. Complex nursing
				  interventions does not include a nursing assessment.
Department
means the Department of
				  Health and Human Services Regulation and Licensure.
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.
Direct care staff
means staff who
				  provide assistance with activities of daily living, health maintenance
				  activities, and personal care and does not include housekeeping, maintenance,
				  dietary, laundry, administrative or clerical staff if they do not provide any
				  of the above mentioned assistance.
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.
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.
Existing facility
means a licensed
				  health care facility or a facility whose construction or remodeling plans were
				  approved by the Department prior to the effective date of 175 NAC 4.
Facility
means an assisted-living
				  facility as defined.
Five rights
means getting the right
				  drug to the right recipient 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 a written
				  expression of dissatisfaction which may or may not be the result of an
				  unresolved complaint.
Health care facility
means an
				  ambulatory surgical center, an assisted-living facility, a center or group home
				  for the developmentally disabled, a critical access hospital, a general acute
				  hospital, a health clinic, a hospital, an intermediate care facility, an
				  intermediate care facility for the mentally retarded, a long-term care
				  hospital, a mental health center, a nursing facility, a pharmacy, a psychiatric
				  or mental hospital, a public health clinic, a rehabilitation hospital, a
				  skilled nursing facility, or a substance abuse treatment center.
Health care service
means an adult
				  day service, a home health agency, a hospice or hospice service, or a respite
				  care service.
Health maintenance activities
(see
				  definition of Care).
Licensed health care professional
means an individual for whom administration of medication is included in the
				  scope of practice.
Licensee
means the individual,
				  government, corporation, partnership, limited liability company, or other form
				  of business organization to whom the license is issued. The licensee has the
				  primary responsibility for the overall operation of the assisted-living
				  facility.
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 medications 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 for in 172 NAC 95 and 172 NAC 96.
Medication provision
means the
				  component of the administration of medication that includes giving or applying
				  a dose of a medication to an individual and includes helping an individual in
				  giving or applying such medication to himself or herself.
Mental abuse
means humiliation,
				  harassment, threats of punishment, deprivation, or other actions 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
				  goods 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 4.
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. New facility also includes those facilities,
				  which were previously licensed for care and treatment in another licensure
				  category, and which now intend to seek licensure in a different
				  category.
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.
Power of attorney for health care
means a power of attorney executed in accordance with
Neb. Rev.
				  Stat.
§§
									30-3401 to
				  30-3432
				  which authorizes a designated attorney in fact to make health care decisions
				  for the principal when the principal is incapable. A person holding the power
				  of attorney for health care can make health care decisions to the extent
				  allowed by the terms of the health care power of attorney.
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 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.
Resident
means a person residing
				  and receiving care at an assisted-living facility.
Schematic plans
means a diagram of
				  the facility or service 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.
Shelter
means to provide lodging
				  for compensation.
Stable or predictable
means that a
				  resident's clinical and behavioral status and nursing care needs are determined
				  to be nonfluctuating and consistent or fluctuating in an expected manner with
				  planned interventions, including an expected deteriorating condition.
Supplement
means a product meant to
				  satisfy dietary needs.
Supportive services
means those
				  services which support personal care, provision of medications, activities of
				  daily living and health maintenance activities.
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.