North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-05.2 - Nursing Facility Enforcement Action › Section 75-02-05.2-01 - Definitions

Current through Supplement No. 393, July, 2024
1. "Certification of compliance" means a facility is in at
				  least substantial compliance and is eligible to participate in medicaid as a
				  nursing facility.
2. "Certification of noncompliance" means a facility is not
				  in substantial compliance and is not eligible to participate in medicaid as a
				  nursing facility.
3. "Deficiency" means the occurrence of a violation recorded
				  by the survey agency, including a violation found during a standard survey,
				  during an extended survey, or in response to a complaint, investigation, visit,
				  or otherwise. A deficiency may include a violation that occurred at a time
				  prior to the date of the survey or visit, even if the violation no longer
				  exists at the time of the survey or visit.
4. "Department" means the department of human services.
5. "Enforcement action" means the process of imposing one or
				  more remedies available under this chapter.
6."Facility" means an institution or a distinct part of an
				  institution which:
a. Is primarily engaged in providing:
(1) Nursing care and related services for residents who
				  require medical or nursing care;
(2) Rehabilitation services for the rehabilitation of
				  injured, disabled, or sick persons; or
(3) On a regular basis, health-related care and services to
				  individuals who because of mental or physical conditions require care and
				  services above the level of basic care that can be made available only through
				  an institutional facility;
b. Is required to have in effect a transfer agreement,
				  meeting the requirements of 42 U.S.C. 1396 x(1), with one or
				  more hospitals having agreements in effect under
				  42 U.S.C.
				  1395 cc;
c. Is required to meet the requirements for a nursing
				  facility described in 42
				  U.S.C. 1396 r(b), (c), and (d); and
d. Is not primarily engaged in providing care and treatment
				  of mental diseases.
7. "Medicaid agency" means the department of human services.
8. "New admission" means a resident is admitted to a facility
				  on or after the effective date of a denial of payment remedy and, if previously
				  admitted, has been discharged before the effective date of a denial of payment.
				  A resident admitted before the effective date of the denial of payment and
				  taking temporary leave is not considered a new admission.
9. "Noncompliance" means any deficiency that causes a
				  facility not to be in substantial compliance.
10. "Regional office" means the health care financing
				  administration's regional office responsible for program administration in
				  North Dakota.
11. "Repeated noncompliance" means a facility has received
				  three consecutive findings of substandard quality of care on three consecutive
				  standard surveys. The consecutive findings need not be based on the exact tag
				  number of a deficiency.
12. "Secretary" means the secretary of the United States
				  department of health and human services.
13. "Substandard quality of care" means a facility has one or
				  more deficiencies related to participation requirements for resident behavior
				  and facility practices, quality of life, or quality of care that constitute
				  immediate jeopardy to resident health or safety; a pattern of or widespread
				  actual harm that is not immediate jeopardy; or a widespread potential for more
				  than minimum harm, but less than immediate jeopardy, with no actual harm.
14. "Substantial compliance" means compliance with the
				  participation requirements and includes any identified deficiencies posing no
				  greater risk to resident health or safety than the potential for causing
				  minimal harm.
15. "Survey agency" means the state department of health.
General Authority: NDCC
					 50-24.1-04
Law Implemented:
					 42 USC
					 1396
					 r(h)