Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart C - Long-Term Care Facilities › Chapter 201 - APPLICABILITY, DEFINITIONS, OWNERSHIP AND GENERAL OPERATION OF LONG-TERM CARE NURSING FACILITIES › GENERAL PROVISIONS › Section 201.3 - Definitions

Current through Register Vol. 54, No. 28, July 13, 2024
The following words and terms, when used in this subpart,
						have the following meanings, unless the context clearly indicates otherwise:
Abuse
-As defined in
						42 CFR
						483.5 (relating to definitions).
Act
-The Health Care Facilities Act
						(35
						P.S. §§
												448.101-448.904b).
Administration of medication
-The giving
						of a dose of medication to a resident as a result of an order of a practitioner
						licensed by the Commonwealth to prescribe medications.
Administrator
-As defined in
						42 CFR
						483.70(d)(2) (relating to
						administration). The administrator shall be currently licensed and registered
						by the Department of State under the Nursing Home Administrators License Act
						(63
						P.S. §§
												1101-1114.2).
Authorized person to administer
						medications
-Persons qualified to administer medications in facilities
						are as follows:
(i) Physicians and
					 dentists who are currently licensed by the Bureau of Professional and
					 Occupational Affairs, Department of State.
(ii) Registered nurses who are currently
					 licensed by the Bureau of Professional and Occupational Affairs, Department of
					 State.
(iii) Practical nurses who
					 have successfully passed the State Board of Nursing examination.
(iv) Practical nurses licensed by waiver in
					 this Commonwealth who have successfully passed the United States Public Health
					 Service Proficiency Examination.
(v) Practical nurses licensed by waiver in
					 this Commonwealth who have successfully passed a medication course approved by
					 the State Board of Nursing.
(vi)
					 Student nurses of approved nursing programs who are functioning under the
					 direct supervision of a member of the school faculty who is present in the
					 facility.
(vii) Recent graduates of
					 approved nursing programs who possess valid temporary practice permits and who
					 are functioning under the direct supervision of a professional nurse who is
					 present in the facility. The permits shall expire if the holders of the permits
					 fail the licensing examinations.
(viii) Physician assistants and registered nurse practitioners who
					 are certified by the Bureau of Professional and Occupational Affairs.
Basement
-A story or floor level below
						the main or street floor. If, due to grade differences, there are two levels
						qualifying as a street floor, a basement is a floor below the lower of the two
						street floors.
CRNP-certified registered nurse
						practitioner
-A registered nurse licensed in this Commonwealth who is
						certified by the State Board of Nursing and the State Board of Medicine as a
						CRNP, under The Professional Nursing Law (63 P.S. §§
												211-225) and the Medical Practice Act of 1985
						(63
						P.S. §§
												422.1422.45).
Charge nurse
-A person designated by the
						facility who is experienced in nursing service administration and supervision
						and in areas such as rehabilitative or geriatric nursing or who acquires the
						preparation through formal staff development programs and who is licensed by
						the Commonwealth as one of the following:
(i) An RN.
(ii) An RN
					 licensed by another state as an RN and who has applied for endorsement from the
					 State Board of Nursing and has received written notice that the application has
					 been received by the State Board of Nursing. This subparagraph applies for 1
					 year, or until Commonwealth licensure is completed, whichever period is
					 shorter.
(iii)
					 [Reserved].
(iv) An LPN designated
					 by the facility as a charge nurse on the night tour of duty in a facility with
					 a census of 59 or less in accordance with §
											211.12 (relating to nursing
					 services).
Clinical laboratory
-As defined in
						42 U.S.C.A. §
												263a(a).
Construction, alteration or
						renovation
-The erection, building, remodeling, modernization,
						improvement, extension or expansion of a facility, or the conversion of a
						building or portion thereof to a facility. The term does not include
						part-for-part replacement or regular facility maintenance.
Controlled substance
-A drug, substance
						or immediate precursor included in Schedules I-V of the Controlled Substance,
						Drug, Device and Cosmetic Act (35 P.S. §§
												780-101-780-144).
Corridor
-A passageway, hallway or other
						common avenue used by residents and personnel to travel between buildings or
						sections of the same building to reach a common exit or service area. The
						service area includes, but is not limited to, living room, kitchen, bathroom,
						therapy rooms and storage areas not immediately adjoining the resident's
						sleeping quarters.
Department
-The Department of Health of
						the Commonwealth.
Director of nursing services
-An RN
						designated by a facility under
						42 CFR
						483.35(b)(2) (relating to
						nursing services) and has 1 year of experience or education in nursing service
						administration and supervision, as well as additional education or experience
						in areas such as rehabilitative or geriatric nursing, and participates annually
						in continuing nursing education.
Discharge
-The movement of a resident
						from a bed in one certified facility to a bed in another certified facility or
						other location in the community, when return to the original facility is not
						expected.
Elopement
-When a resident leaves the
						premises or a safe area without authorization.
Exit or exitway
-A means of egress which
						is lighted and has three components: an exit access (corridor leading to the
						exit), an exit (a door) and an exit discharge (door to the street or public
						way).
Exploitation
-As defined in
						42 CFR
						483.5.
Facility
-A licensed long-term care
						nursing facility as defined in Chapter 8 of the act (35 P.S. §§
												448.801-448.821).
Full-time
-A minimum of a 35-hour work
						week.
Full compliance
-Means total
						compliance.
Health care practitioner
-As defined in
						section 103 of the act (35 P.S. §
												448.103).
Interdisciplinary team
-As defined in
						42 CFR
						483.21(b)(2)(ii) (relating
						to comprehensive person-centered care planning).
Intimidation
-As defined in section 3 of
						the Older Adults Protective Services Act (35 P.S. §
												10225.103).
Involuntary seclusion
-Separation of a
						resident from other residents or from the resident's room or confinement with
						or without roommates against the resident's will, or the will of the resident's
						representative, excluding emergency or short term monitored separation from
						other residents for a limited period of time as a therapeutic intervention to
						reduce agitation until professional staff can develop a plan of care to meet
						the resident's needs.
LPN-licensed practical nurse
-A practical
						nurse licensed to practice under the Practical Nurse Law (63 P.S. §§
												651-667.8) and the regulations of the State
						Board of Nursing in 49 Pa. Code Chapter 21, Subchapter B (relating to practical
						nurses).
Licensee
-The individual, partnership,
						association or corporate entity including a public agency or religious or
						fraternal or philanthropic organization authorized to operate a licensed
						facility.
Long-term care ombudsman
-An individual
						at the State or local level who is responsible for carrying out the duties and
						functions under section 3058g of the State Long-Term Care Ombudsman Program
						(42 U.S.C.A. §
												3058g).
Medication
-A substance meeting one of
						the following qualifications:
(i) Is
					 recognized in the official United States pharmacopeia, or official National
					 formulary or a supplement to either of them.
(ii) Is intended for use in the diagnosis, cure, mitigation,
					 treatment or prevention of disease in man or other animals.
(iii) Is other than food and intended to
					 affect the structure or a function of the human body or other animal
					 body.
(iv) Is intended for use as a
					 component of an article specified in subparagraphs (i), (ii) or (iii), but not
					 including devices or their components, parts or accessories.
Medication administration
-An act in
						which a single dose of a prescribed medication or biological is given to a
						resident by an authorized person in accordance with statutes and regulations
						governing the act. The complete act of administration entails removing an
						individual dose from a previously dispensed, properly labeled container,
						verifying it with the physician's orders, giving the individual dose to the
						proper resident and promptly recording the time and dose given.
Medication dispensing
-An act by a
						practitioner or a person who is licensed in this Commonwealth to dispense
						medications under the Pharmacy Act (63 P.S. §§
												390-1-390-13) entailing the interpretation of
						an order for a medication or biological and, under that order, the proper
						selecting, measuring, labeling, packaging and issuance of the medication or
						biological for a resident or for a service unit of the facility.
Mental abuse
-Includes humiliation,
						harassment, threats of punishment or deprivation.
Misappropriation of resident
						property
-As defined in
						42 CFR
						483.5.
Mistreatment
-As defined in
						42 CFR
						483.5.
NFPA
-National Fire Protection
						Association.
Neglect
-As defined in
						42 CFR
						483.5.
Non-prescription medication
-An
						over-the-counter medication legally purchased without a prescription.
Nurse aide
-An individual, as defined in
						42 CFR
						483.5, providing nursing or nursing-related
						services to residents in a facility who:
(i) Does not have a license to practice
					 professional or practical nursing in this Commonwealth.
(ii) Does not volunteer services for no
					 pay.
(iii) Has met the requisite
					 training and competency evaluation requirements as defined in
					 42 CFR
					 483.35 (relating to nursing
					 services).
(iv) Appears on the
					 Commonwealth's Nurse Aide Registry.
(v) Has no substantiated findings of abuse, neglect or
					 misappropriation of resident property recorded in the Nurse Aide
					 Registry.
Nursing care
-A planned program to meet
						the physical and emotional needs of the resident. The term includes procedures
						that require nursing skills and techniques applied by properly trained
						personnel.
Nursing service personnel
-Registered
						nurses, licensed practical nurses and nurse aides.
Person
-As defined in section 103 of the
						act.
Pharmacist
-A person licensed by the
						State Board of Pharmacy to engage in the practice of pharmacy.
Pharmacy
-A place properly licensed by
						the State Board of Pharmacy where the practice of pharmacy is conducted.
Physical abuse
-Includes hitting,
						slapping, pinching and kicking. The term also includes controlling behavior
						through corporal punishment.
Physician assistant
-An individual
						certified as a physician assistant by the State Board of Medicine under the
						Medical Practice Act of 1985, or by the State Board of Osteopathic Medical
						Examiners under the Osteopathic Medical Practice Act (63 P.S.
						§§
												271.1-271.18).
Practitioner
-A health care practitioner
						as defined in section 103 of the act.
Prescription
-A written or verbal order
						for medications issued by a health care practitioner in the course of
						professional practice.
Qualified dietician
-As defined in
						42 CFR
						483.60(a)(1) (relating to
						food and nutrition services).
Qualified social worker
-As defined in
						42 CFR
						483.70(p).
Qualified therapeutic recreation
						specialist
-As defined in
						42 CFR
						483.24(c) (relating to
						quality of life).
RN-registered nurse
-An individual
						licensed to practice professional nursing under The Professional Nursing Law
						and the regulations of the State Board of Nursing in 49 Pa. Code Chapter 21,
						Subchapter A (relating to registered nurses).
Resident
-A person who is admitted to a
						licensed long-term care nursing facility for observation, treatment or care for
						illness, disease, injury or other disability.
Resident representative
-As defined in
						42 CFR
						483.5.
Restraint
-A restraint can be physical
						or chemical.
(i) A physical restraint
					 includes any manual method, physical or mechanical device, equipment or
					 material that is attached or adjacent to the resident's body, cannot be removed
					 easily by the resident, and restricts the resident's freedom of movement or
					 normal access to the resident's body.
(ii) A chemical restraint includes any
					 medication that is used for discipline or convenience and not required to treat
					 medical symptoms.
Serious bodily injury
-As defined in
						section 3 of the Older Adults Protective Services Act.
Serious physical injury
-As defined in
						section 3 of the Older Adults Protective Services Act.
Sexual abuse
-Non-consensual contact of
						any type with a resident, including sexual harassment, sexual coercion or
						sexual assault.
Substantial compliance
-
(i) cited deficiencies are, individually and
					 in combined effect, of a minor nature such that neither the deficiencies nor
					 efforts toward their correction will interfere with or adversely affect normal
					 facility operations or adversely affect any resident's health or safety;
					 and
(ii) the facility has
					 implemented a plan of correction approved by the Department.
Transfer
-The movement of a resident
						from a bed in one certified facility to a bed in another certified facility
						when the resident expects to return to the original facility.
Verbal abuse
-Use of oral, written or
						gestured language that willfully includes disparaging and derogatory terms to
						residents or their families, or within their hearing distance, regardless of
						their age, ability to comprehend or disability. Examples of verbal abuse
						include:
(i) Threats of
					 harm.
(ii) Saying things to
					 frighten a resident, such as telling a resident that the resident will never be
					 able to see the resident's family again.
The provisions of this §
													201.3 amended under section 803 of
						  the Health Care Facilities Act (35 P. S. §
														448.803); and section 2102(g) of The
						  Administrative Code of 1929 (71 P. S. §
														532(g)).
This section cited in 28 Pa. Code §
													211.9 (relating to pharmacy
						  services).