Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 11 - Licensing Hospice Care › Section 216-RICR-40-10-11.3 - Definitions (Applies to All Facilities and Programs)

Current through June 14, 2024
A. Wherever used in these rules and
				  regulations the following terms shall be construed as follows:
1. "Attending practitioner" means a
				  physician, as defined in R.I. Gen. Laws Chapter
				  5-37, or a certified nurse
				  practitioner, as defined in R.I. Gen. Laws Chapter
				  5-34, (who may or may not be on the
				  hospice staff) identified by the terminally ill patient/family as having a
				  significant role in the determination and delivery of the patient's medical
				  care. Attending practitioner also means a physician assistant (who may or may
				  not be on the hospice staff), as long as the physician assistant's role is
				  providing medical and surgical services in collaboration with physicians, as
				  set forth in the provisions of R.I. Gen. Laws Chapter
				  5-54.
2. "Bereavement" means the extended period of
				  grief preceding the death and following (usually for one year) the death of a
				  loved one, during which individuals experience, respond, and adjust
				  emotionally, physically, socially, and spiritually to the loss of a loved
				  one.
3. "Branch office" means a
				  fixed and established geographical location from which a licensed hospice
				  program provides services within a portion of the total geographic area served
				  by the licensed central office.
4.
				  "Certified nurse practitioner" means an advanced practice nurse utilizing
				  independent knowledge of physical assessment, diagnosis, and management of
				  health care and illnesses. The practice includes prescriptive privileges.
				  Certified nurse practitioners are members of the health care delivery system
				  practicing in areas including, but not limited to family practice, pediatrics,
				  adult health care, geriatrics, and women's health care in primary, acute,
				  long-term, and critical care settings in health care facilities and the
				  community. Certified nurse practitioners may be recognized as the primary care
				  provider or acute-care provider of record.
5. "Change in operator" means a transfer by
				  the governing body or operator of a hospice program to any other person
				  (excluding delegations of authority to the medical or administrative staff of
				  the facility) of the governing body's authority to:
a. Hire or fire the chief executive officer
				  of the hospice program;
b. Maintain
				  and control the books and records of the hospice program;
c. Dispose of assets and incur liabilities on
				  behalf of the hospice program; or
d. Adopt and enforce policies regarding
				  operation of the hospice program.
e.
				  This definition is not applicable to circumstances wherein the governing body
				  of a hospice program retains the immediate authority and jurisdiction over the
				  activities enumerated in §§
												11.3(A)(6)(a) through
				  (d)   of this Part.
6. "Change in owner" means:
a. In the case of a hospice program that is a
				  partnership, the removal, addition, or substitution of a partner which results
				  in a new partner acquiring a controlling interest in such
				  partnership;
b. In the case of a
				  hospice program that is an unincorporated sole proprietorship, the transfer of
				  the title and property to another person;
c. In the case of a hospice program that is a
				  corporation:
(1) A sale, lease, exchange, or
				  other disposition of all, or substantially all of the property and assets of
				  the corporation; or
(2) A merger of
				  the corporation into another corporation; or
(3) The consolidation of two or more
				  corporations, resulting in the creation of a new corporation; or
(4) In the case of a hospice program that is
				  a business corporation, any transfer of corporate stock that results in a new
				  person acquiring a controlling interest in such corporation; or
(5) In the case of a hospice program that is
				  a non-business corporation, any change in membership that results in a new
				  person acquiring a controlling vote in such corporation.
7. "Collaboration" means the
				  physician assistant shall, as indicated by the patient's condition, the
				  education, competencies, and experience of the physician assistant, and the
				  standards of care, consult with or refer to an appropriate physician or other
				  healthcare professional. The degree of collaboration shall be determined by the
				  practice and includes decisions made by a physician employer, physician group
				  practice, and the credentialing and privileging systems of a licensed hospital,
				  health center, or ambulatory care center. A physician must be accessible at all
				  times for consultation by the physician assistant.
8. "Department" means the Rhode Island
				  Department of Health.
9. "Director"
				  means the Director of the Rhode Island Department of Health.
10. "Disqualifying information" means that
				  information produced by a criminal record check, pertaining to conviction, for
				  the following crimes will result in a letter to the employee and employer
				  disqualifying the applicant from said employment: murder, voluntary
				  manslaughter, involuntary manslaughter, first degree sexual assault, second
				  degree sexual assault, third degree sexual assault, assault on persons sixty
				  (60) years of age or older, child abuse, assault with intent to commit
				  specified felonies (murder, robbery, rape, burglary, or the abominable and
				  detestable crime against nature), felony assault, patient abuse, neglect or
				  mistreatment of patients, burglary, first degree arson, robbery, felony drug
				  offenses, larceny or felony banking law violations.
11. "Equity" means non-debt funds contributed
				  toward the capital costs related to a change in owner or change in operator of
				  a hospice facility which funds are free and clear of any repayment or liens
				  against the assets of the proposed owner and/or licensee and that result in a
				  like reduction in the portion of the capital cost that is required to be
				  financed or mortgaged.
12. "General
				  inpatient care" means hospice care provided to terminally ill patients in an
				  inpatient setting.
13. "Hospice
				  care" (hereinafter referred to as "hospice program") means a program of
				  palliative care that provides for the physical, psychological, social and
				  spiritual needs of a terminally ill patient and his/her family, both in the
				  home and in an inpatient setting.
14. "Hospice inpatient facility" means a
				  health care facility that cares for hospice and palliative care patients
				  requiring short-term, general inpatient, respite care, or routine home care and
				  is operated directly by a hospice program under a license issued by the
				  Department.
15. "Inpatient respite
				  care" means short-term inpatient care provided to terminally ill patients to
				  provide relief to family members or others caring for the patient.
16. "Licensing agency" means the Rhode Island
				  Department of Health.
17.
				  "Medication aide", as used herein, means selected unlicensed personnel who have
				  satisfactorily completed a state-approved course in drug administration who may
				  administer oral or topical drugs (with the exception of Schedule II drugs) in
				  accordance with the requirements of §11.5.8(J) of this Part.
18. "Nurse" means an individual licensed to
				  practice as a professional (registered) (RN) or licensed practical nurse (LPN)
				  in this state under the provisions of R.I. Gen. Laws Chapter
				  5-34.
19. "Nursing assistant" means a nurse's aide,
				  orderly, or home health aide who is a paraprofessional, and who holds a Rhode
				  Island certificate of registration pursuant to the provisions of R.I. Gen. Laws
				  Chapter 23-17.9, and the rules and
				  regulations promulgated thereunder, who is trained to give personal care and
				  related health care and assistance based on his/her level of preparation to
				  individuals who are sick, disabled, dependent, or infirm, and who are patients
				  of or who are receiving services from health care facilities.
20. "Palliative care" means patient and
				  family-centered care that optimizes quality of life by anticipating,
				  preventing, and treating suffering. Palliative care throughout the continuum of
				  illness involves addressing physical, intellectual, emotional, social, and
				  spiritual needs and facilitates patient autonomy, access to information, and
				  choice.
21. "Person" means an
				  individual, trust or estate, partnership, corporation (including associations,
				  joint stock companies), limited liability company, state or political
				  subdivision or instrumentality of a state.
22. "Physician" means any individual licensed
				  to practice medicine in this state under the provisions of R.I. Gen. Laws
				  Chapter 5-37.
23. "Physician assistant" means a person who
				  is qualified by academic and practical training to provide medical and surgical
				  services in collaboration with physicians, as set forth in the provisions of
				  R.I. Gen. Laws Chapter
				  5-54.
24. "Residential area" means a distinct
				  living environment within an inpatient hospice facility that includes no more
				  than sixty (60) beds.
25. "Social
				  worker" means a person licensed under R.I. Gen. Laws Chapter
				  5-38.1 and the Rules and
				  Regulations Pertaining to Licensing Clinical Social Workers and Independent
				  Clinical Social Workers.
26.
				  "Spiritual counselor" means clergy (individual ordained for religious service),
				  pastoral or another similar counselor.
27. "Terminally ill" means that an individual
				  has a medical prognosis of a life expectancy of six months or less if the
				  illness runs its normal course.