Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 391 - REGULATIONS FOR THE LICENSURE OF HOSPICE › Part I - Definitions and General Information › Section 12VAC5-391-10 - Definitions

Current through Register Vol. 40, No. 24, July 15, 2024
The following words and terms when used in these
					 regulations shall have the following meaning unless the context clearly
					 indicates otherwise.
"Activities of daily living" means bathing, dressing,
					 toileting, transferring, bowel control, bladder control and
					 eating/feeding.
"Administer" means the direct application of a controlled
					 substance, whether by injection, inhalation, ingestion, or any other means, to
					 the body of a patient by (i) a practitioner or by his authorized agent and
					 under his supervision or (ii) the patient 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 hospice program. The administrator must be a member of the
					 hospice staff. The administrator, director of nursing, or another clinical
					 director may be the same individual if that individual is dually
					 qualified.
"Adverse outcome" means the result of drug or health care
					 therapy that is neither intended nor expected in normal therapeutic use and
					 that causes significant, sometimes life-threatening conditions or consequences
					 at some future time. Such potential future adverse outcome may require the
					 arrangement of appropriate follow-up surveillance and perhaps other departures
					 from the usual plan of care.
"Attending 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 patient as having the primary responsibility in determining
					 the delivery of the patient's medical care. The responsibilities 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.
"Available at all times during operating hours" means an
					 individual is 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 hospice program.
"Bereavement service" means bereavement counseling as
					 defined in
					 42
					 CFR 418.3.
"Cannabidiol oil" means the same as that term is defined in
					 subsection A of §
										54.1-3408.3
					 of the Code of Virginia.
"Commissioner" means the State Health Commissioner.
"Coordinated program" means a continuum of palliative and
					 supportive care provided to a terminally ill patient and the patient's family,
					 24 hours a day, seven days a week.
"Core services" means those services that must be provided
					 by a hospice program. Such services are: (i) nursing services, (ii) physician
					 services, (iii) counseling services, and (iv) medical social services.
"Counseling services" means the provision of bereavement
					 services, dietary services, spiritual and any other counseling services for the
					 patient and family while the person is enrolled in the program.
"Criminal record report" means the statement issued by the
					 Central Criminal Records Exchange, Virginia Department of State Police.
"Designated support person" means a person who is
					 knowledgeable about the needs of a person with a disability and who is
					 designated, orally or in writing, by the individual with a disability, the
					 individual's guardian, or the individual's care provider to provide support and
					 assistance, including physical assistance, emotional support, assistance with
					 communication or decision-making, or any other assistance necessary as a result
					 of the person's disability, to the person with a disability at any time during
					 which health care services are provided.
"Dispense" means to deliver a drug to the 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 as defined in §
										54.1-3401 of the Code
					 of Virginia.
"Employee" means an individual who is appropriately trained
					 and performs a specific job function for the hospice program on a full-time or
					 part-time basis with or without financial compensation.
"Governing body" means the individual, group, or
					 governmental agency that has legal responsibility and authority over the
					 operation of the hospice program.
"Home attendant" means a nonlicensed individual performing
					 personal care and environmental services, under the supervision of the
					 appropriate health professional, to a patient in the patient's residence. Home
					 attendants are also known as certified nursing assistants or CNAs, home care
					 aides, home health aides, and personal care aides.
"Hospice" means a hospice as defined in §
										32.1-162.1 of the
					 Code of Virginia.
"Hospice facility" means an institution, place, or building
					 as defined in §
										32.1-162.1 of the
					 Code of Virginia.
"Inpatient" means the provision of services, such as food,
					 laundry, housekeeping, and staff to provide health or health-related services,
					 including respite and symptom management, to hospice patients, whether in a
					 hospital, nursing facility, or hospice facility.
"Interdisciplinary group" means the group responsible for
					 assessing the health care and special needs of the patient and the patient's
					 family. Providers of special services, such as mental health, pharmacy, and any
					 other appropriate associated health services may also be included on the team
					 as the needs of the patient dictate. The interdisciplinary group is often
					 referred to as the IDG.
"Licensee" means a licensed hospice program
					 provider.
"Medical director" means a physician currently licensed in
					 Virginia, according to Chapter 29 (§
										54.1-2900 et seq.) of
					 Title 54.1 of the Code of Virginia, and responsible for the medical direction
					 of the hospice program.
"Medical record" means a continuous and accurate documented
					 account of services provided to a patient, including the prescription and
					 delivery of the treatment or care.
"Medication error" means one or more violations of the five
					 principles of medication administration: the correct drug to the right patient
					 at the prescribed time in the prescribed dose via the prescribed route.
"Nursing services" means the patient care performed or
					 supervised by a registered nurse according to a 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 responsible for the day-to-day administrative
					 management and operation of the hospice.
"Palliative care" means treatment directed at controlling
					 pain, relieving other symptoms, and focusing on the special needs of the
					 patient and family as they experience the stress of the dying process.
					 Palliative care means treatment to enhance comfort and improve the quality of a
					 patient's life during the last phase of his life.
"Patient" means a hospice patient as defined in §
										32.1-162.1 of the
					 Code of Virginia.
"Patient's family" means a hospice patient's family as
					 defined in §
										32.1-162.1 of the
					 Code of Virginia.
"Patient's residence" means the place where the individual
					 or patient makes his home.
"Person" means any individual, partnership, association,
					 trust, corporation, municipality, county, local government agency, or any other
					 legal or commercial entity that operates a hospice.
"Plan of care" means a written plan of services developed
					 by the interdisciplinary group to maximize patient comfort by symptom control
					 to meet the physical, psychosocial, spiritual, and other special needs that are
					 experienced during the final stages of illness, during dying, and
					 bereavement.
"Primary caregiver" means an individual that, through
					 mutual agreement with the patient and the hospice program, assumes
					 responsibility for the patient's care.
"Progress note" means a documented statement contained in a
					 patient's medical record, dated and signed by the person delivering the care,
					 treatment, or service, describing the treatment or services delivered and the
					 effect of the care, treatment, or services on the patient.
"Quality improvement" means ongoing activities designed to
					 objectively and systematically evaluate the quality of care and services,
					 pursue opportunities to improve care and services, and resolve identified
					 problems. Quality improvement is an approach to the ongoing study and
					 improvement of the processes of providing services to meet the needs of
					 patients and their families.
"Separate and distinct entrance" means an entrance to the
					 hospice facility other than the formal public entrance used by patients and
					 family members.
"Staff" means an employee who receives financial
					 compensation.
"Supervision" means the ongoing process of monitoring the
					 skills, competencies, and performance of the individual supervised and
					 providing regular face-to-face guidance and instruction.
"Terminally ill" means a medical prognosis that life
					 expectancy is six months or less if the illness runs its usual course.
"THC-A oil" means the same as that term is defined in
					 subsection A of §
										54.1-3408.3
					 of the Code of Virginia.
"Volunteer" means an employee who receives no financial
					 compensation.
Statutory Authority: §§
												32.1-12
						and
						32.1-162.5 of the
						Code of Virginia.