Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 381 - REGULATIONS FOR THE LICENSURE OF HOME CARE ORGANIZATIONS › Part I - Definitions and General Information › Section 12VAC5-381-10 - Definitions

Current through Register Vol. 40, No. 24, July 15, 2024
The following words and terms when used in this chapter
					 shall have the following meanings unless the context clearly indicates
					 otherwise:
"Activities of daily living" or "ADLs" means bathing,
					 dressing, toileting, transferring, bowel control, bladder control and
					 eating/feeding. A person's degree of independence in performing these
					 activities is part of determining the appropriate level of care and services. A
					 need for assistance exists when the client is unable to complete an activity
					 due to cognitive impairment, functional disability, physical health problems,
					 or safety. The client's functional level is based on the client's need for
					 assistance most or all of the time to perform personal care tasks in order to
					 live independently.
"Administer" means the direct application of a controlled
					 substance, whether by injection, inhalation, ingestion or any other means, to
					 the body of a client by (i) a practitioner or by his authorized agent and under
					 his direction or (ii) the client at the direction and in the presence of the
					 practitioner as defined in § 54.1-3401 of the Code of Virginia.
"Administrator" means a person designated in writing by
					 the governing body as having the necessary authority for the day-to-day
					 management of the organization. The administrator must be an employee of the
					 organization. The administrator, the director of nursing, or other clinical
					 director may be the same individual if that individual is dually
					 qualified.
"Available at all times during operating hours" means an
					 individual is readily available on the premises or by
					 telecommunications.
"Barrier crimes" means certain offenses, specified in
					 § 32.1-162.9:1 of the Code of Virginia, that automatically bar an
					 individual convicted of those offenses from employment with a home care
					 organization.
"Blanket fidelity bond" means a bond that provides
					 coverage that protects an organization's losses as a result of employee theft
					 or fraud.
"Branch office" means a geographically separate office of
					 the home care organization that performs all or part of the primary functions
					 of the home care organization on a smaller scale.
"Chore services" means assistance with nonroutine, heavy
					 home maintenance for persons unable to perform such tasks. Chore services
					 include minor repair work on furniture and appliances; carrying coal, wood and
					 water; chopping wood; removing snow; yard maintenance; and painting.
"Client record" means the centralized location for
					 documenting information about the client and the care and services provided to
					 the client by the organization. A client record is a continuous and accurate
					 account of care or services, whether hard copy or electronic, provided to a
					 client, including information that has been dated and signed by the individuals
					 who prescribed or delivered the care or service.
"Client's residence" means the place where the individual
					 or client makes his home such as his own apartment or house, a relative's home
					 or an assisted living facility, but does not include a hospital, nursing
					 facility or other extended care facility.
"Commissioner" means the State Health Commissioner.
"Companion services" means assisting persons unable to
					 care for themselves without assistance. Companion services include
					 transportation, meal preparation, shopping, light housekeeping, companionship,
					 and household management.
"Contract services" means services provided through
					 agreement with another agency, organization, or individual on behalf of the
					 organization. The agreement specifies the services or personnel to be provided
					 on behalf of the organization and the fees to provide these services or
					 personnel.
"Criminal record report" means the statement issued by the
					 Central Criminal Record Exchange, Virginia Department of State Police.
"Department" means the Virginia Department of
					 Health.
"Discharge or termination summary" means a final written
					 summary filed in a closed client record of the service delivered, goals
					 achieved and final disposition at the time of client's discharge or termination
					 from service.
"Dispense" means to deliver a drug to an ultimate user by
					 or pursuant to the lawful order of a practitioner, including the prescribing
					 and administering, packaging, labeling or compounding necessary to prepare the
					 substance for that delivery.
"Drop site" means a location that HCO staff use in the
					 performance of daily tasks such as obtaining supplies, using fax and copy
					 machines, charting notes on care or services provided, and storing client
					 records. These locations may also be called charting stations, workstations, or
					 convenience sites.
"Employee" means an individual who has the status of an
					 employee as defined by the U.S. Internal Revenue Service.
"Functional limitations" means the level of a client's
					 need for assistance based on an assessment conducted by the supervising nurse.
					 There are three criteria to assessing functional status: (i) the client's
					 impairment level and need for personal assistance, (ii) the client's lack of
					 capacity, and (iii) how the client usually performed the activity over a period
					 of time. If a person is mentally and physically free of impairment, there is
					 not a safety risk to the individual, or the person chooses not to complete an
					 activity due to personal preference or choice, then that person does not need
					 assistance.
"Governing body" means the individual, group or
					 governmental agency that has legal responsibility and authority over the
					 operation of the home care organization.
"Home attendant" means a nonlicensed individual performing
					 skilled, pharmaceutical and personal care services, under the supervision of
					 the appropriate health professional, to a client in the client's residence.
					 Home attendants are also known as certified nurse aides or CNAs, home care
					 aides, home health aides, or personal care aides.
"Home care organization" or "HCO" means a public or
					 private entity providing an organized program of home health, pharmaceutical or
					 personal care services, according to § 32.1-162.1 of the Code of Virginia
					 in the residence of a client or individual to maintain the client's health and
					 safety in his home. A home care organization does not include any family
					 members, relatives or friends providing caregiving services to persons who need
					 assistance to remain independent and in their own homes.
"Home health agency" means a public or private agency or
					 organization, or part of an agency or organization, that meets the requirements
					 for participation in Medicare under
					 42 CFR
					 440.70(d), by providing
					 skilled nursing services and at least one other therapeutic service, for
					 example, physical, speech, or occupational therapy; medical social services; or
					 home health aide services, and also meets the capitalization requirements under
					 42 CFR
					 489.28.
"Homemaker services" means assistance to persons with the
					 inability to perform one or more instrumental activities of daily living.
					 Homemaker services may also include assistance with bathing areas the client
					 cannot reach, fastening client's clothing, combing hair, brushing dentures,
					 shaving with an electric razor, and providing stabilization to a client while
					 walking. Homemaker services do not include feeding, bed baths, transferring,
					 lifting, putting on braces or other supports, cutting nails or shaving with a
					 blade.
"Infusion therapy" means the procedures or processes that
					 involve the administration of injectable medications to clients via the
					 intravenous, subcutaneous, epidural, or intrathecal routes. Infusion therapy
					 does not include oral, enteral, or topical medications.
"Instrumental activities of daily living" means meal
					 preparation, housekeeping/light housework, shopping for personal items,
					 laundry, or using the telephone. A client's degree of independence in
					 performing these activities is part of determining the appropriate level of
					 care and services.
"Licensed practical nurse" means a person who holds a
					 current license issued by the Virginia Board of Nursing or a current multistate
					 licensure privilege to practice nursing in Virginia as a licensed practical
					 nurse.
"Licensee" means a licensed home care provider.
"Medical plan of care" means a written plan of services,
					 and items needed to treat a client's medical condition, that is prescribed,
					 signed and periodically reviewed by the client's primary care physician.
"Nursing services" means client care services, including,
					 but not limited to, the curative, restorative, or preventive aspects of nursing
					 that are performed or supervised by a registered nurse according to a medical
					 plan of care.
"OLC" means the Office of Licensure and Certification of
					 the Virginia Department of Health.
"Operator" means any individual, partnership, association,
					 trust, corporation, municipality, county, local government agency or any other
					 legal or commercial entity that is responsible for the day-to-day
					 administrative management and operation of the organization.
"Organization" means a home care organization.
"Person" means any individual, partnership, association,
					 trust, corporation, municipality, county, local government agency or any other
					 legal or commercial entity that operates a home care organization.
"Personal care services" means the provision of nonskilled
					 services, including assistance in the activities of daily living, and may
					 include instrumental activities of daily living, related to the needs of the
					 client, who has or is at risk of an illness, injury or disabling condition. A
					 need for assistance exists when the client is unable to complete an activity
					 due to cognitive impairment, functional disability, physical health problems,
					 or safety. The client's functional level is based on the client's need for
					 assistance most or all of the time to perform the tasks of daily living in
					 order to live independently.
"Primary care physician" means a physician licensed in
					 Virginia, according to Chapter 29 (§ 54.1-2900 et seq.) of Title 54.1 of
					 the Code of Virginia, or licensed in an adjacent state and identified by the
					 client as having the primary responsibility in determining the delivery of the
					 client's medical care. The responsibility of physicians contained in this
					 chapter may be implemented by nurse practitioners or physician assistants as
					 assigned by the supervising physician and within the parameters of professional
					 licensing.
"Qualified" means meeting current legal requirements of
					 licensure, registration or certification in Virginia or having appropriate
					 training, including competency testing, and experience commensurate with
					 assigned responsibilities.
"Quality improvement" means ongoing activities designed to
					 objectively and systematically evaluate the quality of client care and
					 services, pursue opportunities to improve client care and services, and resolve
					 identified problems. Quality improvement is an approach to the ongoing study
					 and improvement of the processes of providing health care services to meet the
					 needs of clients and others.
"Registered nurse" means a person who holds a current
					 license issued by the Virginia Board of Nursing or a current multistate
					 licensure privilege to practice nursing in Virginia as a registered
					 nurse.
"Service area" means a clearly delineated geographic area
					 in which the organization arranges for the provision of home care services,
					 personal care services, or pharmaceutical services to be available and readily
					 accessible to persons.
"Skilled services" means the provision of the home health
					 services listed in
					 12VAC5-381-300.
"Supervision" means the ongoing process of monitoring the
					 skills, competencies and performance of the individual supervised and providing
					 regular, documented, face-to-face guidance and instruction.
"Sworn disclosure statement" means a document disclosing
					 an applicant's criminal convictions and pending criminal charges occurring in
					 Virginia or any other state.
"Third-party crime insurance" means insurance coverage
					 that protects an organization's losses as a result of employee theft or
					 fraud.
Statutory Authority: §§ 32.1-12 and
						32.1-162.12 of the Code of Virginia.