Ariz. Admin. Code § R9-10-101 - Definitions

In addition to the definitions in A.R.S. §§ 36-401(A) and 36-439, the following definitions apply in this Chapter unless otherwise specified:

1. "Abortion clinic" has the same meaning as in A.R.S. § 36-449.01.

2. "Abuse" means:

a. The same:

i. For an individual 18 years of age or older, as in A.R.S. § 46-451; and

ii. For an individual less than 18 years of age, as in A.R.S. § 8-201;

b. A pattern of ridiculing or demeaning a patient;

c. Making derogatory remarks or verbally harassing a patient; or

d. Threatening to inflict physical harm on a patient.

3. "Accredited" has the same meaning as in A.R.S. § 36-422.

4. "Active malignancy" means a cancer for which:

a. A patient is undergoing treatment, such as through:

i. One or more surgical procedures to remove the cancer;

ii. Chemotherapy, as defined in A.A.C. R9-4-401 ; or

iii. Radiation treatment, as defined in A.A.C. R9-4-401 ;

b. There is no treatment; or

c. A patient is refusing treatment.

5. "Activities of daily living" means ambulating, bathing, toileting, grooming, eating, and getting in or out of a bed or a chair.

6. "Acuity" means a patient's need for medical services, nursing services, or behavioral health services based on the patient's medical condition or behavioral health issue.

7. "Acuity plan" means a method for establishing nursing personnel requirements by unit based on a patient's acuity.

8. "Adjacent" means not intersected by:

a. Property owned, operated, or controlled by a person other than the applicant or licensee; or

b. A public thoroughfare.

9. "Administrative completeness review time-frame" has the same meaning as in A.R.S. § 41-1072.

10. "Administrative office" means a location used by personnel for recordkeeping and record retention but not for providing medical services, nursing services, behavioral health services, or health-related services.

11. "Admission" or "admitted" means, after completion of an individual's screening or registration by a health care institution, the individual begins receiving physical health services or behavioral health services and is accepted as a patient of the health care institution.

12. "Adult" has the same meaning as in A.R.S. § 1-215.

13. "Adult behavioral health therapeutic home" means a residence that provides room and board, assists in acquiring daily living skills, coordinates transportation to scheduled appointments, monitors behaviors, assists in the self-administration of medication, and provides feedback to a case manager related to behavior for an individual 18 years of age or older based on the individual's behavioral health issue and need for behavioral health services and may provide behavioral health services under the clinical oversight of a behavioral health professional.

14. "Adult residential care institution" means a subclass of behavioral health residential facility that only admits residents 18 years of age and older and provides recidivism reduction services.

15. "Adverse reaction" means an unexpected outcome that threatens the health or safety of a patient as a result of a medical service, nursing service, or health-related service provided to the patient.

16. "Affiliated counseling facility" means a counseling facility that shares administrative support with one or more other counseling facilities that operate under the same governing authority.

17. "Affiliated outpatient treatment center" means an outpatient treatment center authorized by the Department to provide behavioral health services that provides administrative support to a counseling facility or counseling facilities that operate under the same governing authority as the outpatient treatment center.

18. "Alternate licensing fee due date" means the last calendar day in a month each year, other than the anniversary date of a facility's health care institution license, by which a licensee is required to pay the applicable fees in R9-10-106.

19. "Ancillary services" means services other than medical services, nursing services, or health-related services provided to a patient.

20. "Anesthesiologist" means a physician granted clinical privileges to administer anesthesia.

21. "Applicant" means a governing authority requesting:

a. Approval of a health care institution's architectural plans and specifications for construction or modification,

b. Approval of a modification,

c. Approval of an alternate licensing fee due date, or

d. A health care institution license.

22. "Application packet" means the information, documents, and fees required by the Department for the:

a. Approval of a health care institution's architectural plans and specifications for construction or modification,

b. Approval of a modification,

c. Approval of an alternate licensing fee due date, or

d. Licensing of a health care institution.

23. "Assessment" means an analysis of a patient's need for physical health services or behavioral health services to determine which services a health care institution will provide to the patient.

24. "Assistance in the self-administration of medication" means restricting a patient's access to the patient's medication and providing support to the patient while the patient takes the medication to ensure that the medication is taken as ordered.

25. "Attending physician" means a physician designated by a patient to participate in or coordinate the medical services provided to the patient.

26. "Authenticate" means to establish authorship of a document or an entry in a medical record by:

a. A written signature;

b. An individual's initials, if the individual's written signature appears on the document or in the medical record;

c. A rubber-stamp signature; or

d. An electronic signature code.

27. "Authorized service" means specific medical services, nursing services, behavioral health services, or health-related services provided by a specific health care institution class or subclass for which the health care institution is required to obtain approval from the Department before providing the medical services, nursing services, or health-related services.

28. "Available" means:

a. For an individual, the ability to be contacted and to provide an immediate response by any means possible;

b. For equipment and supplies, physically retrievable at a health care institution; and

c. For a document, retrievable by a health care institution or accessible according to the applicable time-frames in this Chapter.

29. "Behavioral care"

a. Means limited behavioral health services, provided to a patient whose primary admitting diagnosis is related to the patient's need for physical health services, that include:

i. Assistance with the patient's psychosocial interactions to manage the patient's behavior that can be performed by an individual without a professional license or certificate including:

(1) Direction provided by a behavioral health professional, and

(2) Medication ordered by a medical practitioner or behavioral health professional; or

ii. Behavioral health services provided by a behavioral health professional on an intermittent basis to address the patient's significant psychological or behavioral response to an identifiable stressor or stressors; and

b. Does not include court-ordered behavioral health services.

30. "Behavioral health facility" means a behavioral health inpatient facility, a behavioral health residential facility, a substance abuse transitional facility, a behavioral health specialized transitional facility, an outpatient treatment center that only provides behavioral health services, an adult behavioral health therapeutic home, a behavioral health respite home, or a counseling facility.

31. "Behavioral health inpatient facility" means a health care institution that provides continuous treatment to an individual experiencing a behavioral health issue that causes the individual to:

a. Have a limited or reduced ability to meet the individual's basic physical needs;

b. Suffer harm that significantly impairs the individual's judgment, reason, behavior, or capacity to recognize reality;

c. Be a danger to self;

d. Be a danger to others;

e. Be persistently or acutely disabled, as defined in A.R.S. § 36-501; or

f. Be gravely disabled.

32. "Behavioral health issue" means an individual's condition related to a mental disorder, a personality disorder, substance abuse, or a significant psychological or behavioral response to an identifiable stressor or stressors.

33. "Behavioral health observation/stabilization services" means crisis services provided, in an outpatient setting, to an individual whose behavior or condition indicates that the individual:

a. Requires nursing services,

b. May require medical services, and

c. May be a danger to others or a danger to self.

34. "Behavioral health paraprofessional" means an individual who is not a behavioral health professional who provides the following services to a patient to address the patient's behavioral health issue:

a. Under supervision by a behavioral health professional, services that, if provided in a setting other than a health care institution, would be required to be provided by an individual licensed under A.R.S. Title 32, Chapter 33; or

b. Health-related services.

35. "Behavioral health professional" means:

a. An individual licensed under A.R.S. Title 32, Chapter 33, whose scope of practice allows the individual to:

i. Independently engage in the practice of behavioral health, as defined in A.R.S. § 32-3251; or

ii. Except for a licensed substance abuse technician, engage in the practice of behavioral health, as defined in A.R.S. § 32-3251, under direct supervision as defined in A.A.C. R4-6-101 ;

b. A psychiatrist as defined in A.R.S. § 36-501;

c. A psychologist as defined in A.R.S. § 32-2061;

d. A physician;

e. A behavior analyst as defined in A.R.S. § 32-2091; or

f. A registered nurse practitioner licensed as an adult psychiatric and mental health nurse; or

g. A registered nurse with:

i. A psychiatric-mental health nursing certification, or

ii. One year of experience providing behavioral health services.

36. "Behavioral health residential facility" means a health care institution that provides treatment to an individual experiencing a behavioral health issue that:

a. Limits the individual's ability to be independent, or

b. Causes the individual to require treatment to maintain or enhance independence.

37. "Behavioral health respite home" means a residence where respite care services, which may include assistance in the self-administration of medication, are provided to an individual based on the individual's behavioral health issue and need for behavioral health services.

38. "Behavioral health specialized transitional facility" means a health care institution that provides inpatient behavioral health services and physical health services to an individual determined to be a sexually violent person according to A.R.S. Title 36, Chapter 37.

39. "Behavioral health technician" means an individual who is not a behavioral health professional who provides the following services to a patient to address the patient's behavioral health issue:

a. With clinical oversight by a behavioral health professional, services that, if provided in a setting other than a health care institution, would be required to be provided by an individual licensed under A.R.S. Title 32, Chapter 33; or

b. Health-related services.

40. "Benzodiazepine" means any one of a class of sedative-hypnotic medications, characterized by a chemical structure that includes a benzene ring linked to a seven-membered ring containing two nitrogen atoms, that are commonly used in the treatment of anxiety.

41. "Biohazardous medical waste" has the same meaning as in A.A.C. R18-13-1401.

42. "Calendar day" means each day, not including the day of the act, event, or default from which a designated period of time begins to run, but including the last day of the period unless it is a Saturday, Sunday, statewide furlough day, or legal holiday, in which case the period runs until the end of the next day that is not a Saturday, Sunday, statewide furlough day, or legal holiday.

43. "Case manager" means an individual assigned by an entity other than a health care institution to coordinate the physical health services or behavioral health services provided to a patient at the health care institution.

44. "Certification" means, in this Article, a written statement that an item or a system complies with the applicable requirements incorporated by reference in R9-10-104.01.

45. "Certified health physicist" means an individual recognized by the American Board of Health Physics as complying with the health physics criteria and examination requirements established by the American Board of Health Physics.

46. "Change in ownership" means conveyance of the ability to appoint, elect, or otherwise designate a health care institution's governing authority from an owner of the health care institution to another person.

47. "Chief administrative officer" or "administrator" means an individual designated by a governing authority to implement the governing authority's direction in a health care institution.

48. "Clinical laboratory services" means the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of a disease or impairment of a human being, or for the assessment of the health of a human being, including procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body.

49. "Clinical oversight" means:

a. Monitoring the behavioral health services provided by a behavioral health technician to ensure that the behavioral health technician is providing the behavioral health services according to the health care institution's policies and procedures and, if applicable, a patient's treatment plan;

b. Providing on-going review of a behavioral health technician's skills and knowledge related to the provision of behavioral health services;

c. Providing guidance to improve a behavioral health technician's skills and knowledge related to the provision of behavioral health services; and

d. Recommending training for a behavioral health technician to improve the behavioral health technician's skills and knowledge related to the provision of behavioral health services.

50. "Clinical privileges" means authorization to a medical staff member to provide medical services granted by a governing authority or according to medical staff bylaws.

51. "Collaborating health care institution" means a health care institution licensed to provide outpatient behavioral health services that has a written agreement with an adult behavioral health therapeutic home or a behavioral health respite home to:

a. Coordinate behavioral health services provided to a resident at the adult behavioral health therapeutic home or a recipient at a behavioral health respite home, and

b. Work with the provider to ensure a resident at the adult behavioral health therapeutic home or a recipient at a behavioral health respite home receives behavioral health services according to the resident's treatment plan.

52. "Common area" means licensed space in health care institution that is:

a. Not a resident's bedroom or a residential unit,

b. Not restricted to use by employees or volunteers of the health care institution, and

c. Available for use by visitors and other individuals on the premises.

53. "Communicable disease" has the same meaning as in A.R.S. § 36-661.

54. "Conspicuously posted" means placed:

a. At a location that is visible and accessible; and

b. Unless otherwise specified in the rules, within the area where the public enters the premises of a health care institution.

55. "Consultation" means an evaluation of a patient requested by a medical staff member or personnel member.

56. "Contracted services" means medical services, nursing services, behavioral health services, health-related services, ancillary services, or environmental services provided according to a documented agreement between a health care institution and the person providing the medical services, nursing services, health-related services, ancillary services, or environmental services.

57. "Contractor" has the same meaning as in A.R.S. § 32-1101.

58. "Controlled substance" has the same meaning as in A.R.S. § 36-2501.

59. "Counseling" has the same meaning as "practice of professional counseling" in A.R.S. § 32-3251.

60. "Counseling facility" means a health care institution that only provides counseling, which may include:

a. DUI screening, education, or treatment according to the requirements in 9 A.A.C. 20, Article 1; or

b. Misdemeanor domestic violence offender treatment according to the requirements in 9 A.A.C. 20, Article 2.

61. "Court-ordered evaluation" has the same meaning as "evaluation" in A.R.S. § 36-501.

62. "Court-ordered treatment" means treatment provided according to A.R.S. Title 36, Chapter 5.

63. "Crisis services" means immediate and unscheduled behavioral health services provided to a patient to address an acute behavioral health issue affecting the patient.

64. "Current" means up-to-date, extending to the present time.

65. "Daily living skills" means activities necessary for an individual to live independently and include meal preparation, laundry, house-cleaning, home maintenance, money management, and appropriate social interactions.

66. "Danger to others" has the same meaning as in A.R.S. § 36-501.

67. "Danger to self" has the same meaning as in A.R.S. § 36-501.

68. "Detoxification services" means behavioral health services and medical services provided to an individual to:

a. Treat the individual's signs or symptoms of withdrawal from alcohol or other drugs, and

b. Reduce or eliminate the individual's dependence on alcohol or other drugs.

69. "Diagnostic procedure" means a method or process performed to determine whether an individual has a medical condition or behavioral health issue.

70. "Dialysis" means the process of removing dissolved substances from a patient's body by diffusion from one fluid compartment to another across a semipermeable membrane.

71. "Dialysis services" means medical services, nursing services, and health-related services provided to a patient receiving dialysis.

72. "Dialysis station" means a designated treatment area approved by the Department for use by a patient receiving dialysis or dialysis services.

73. "Dialyzer" means an apparatus containing semi-permeable membranes used as a filter to remove wastes and excess fluid from a patient's blood.

74. "Disaster" means an unexpected occurrence that adversely affects a health care institution's ability to provide services.

75. "Discharge" means a documented termination of services to a patient by a health care institution.

76. "Discharge instructions" means documented information relevant to a patient's medical condition or behavioral health issue provided by a health care institution to the patient or the patient's representative at the time of the patient's discharge.

77. "Discharge planning" means a process of establishing goals and objectives for a patient in preparation for the patient's discharge.

78. "Discharge summary" means a documented brief review of services provided to a patient, current patient status, and reasons for the patient's discharge.

79. "Disinfect" means to clean in order to prevent the growth of or to destroy disease-causing microorganisms.

80. "Documentation" or "documented" means information in written, photographic, electronic, or other permanent form.

81. "Drill" means a response to a planned, simulated event.

82. "Drug" has the same meaning as in A.R.S. § 32-1901.

83. "Electronic" has the same meaning as in A.R.S. § 44-7002.

84. "Electronic signature" has the same meaning as in A.R.S. § 44-7002.

85. "Emergency" means an immediate threat to the life or health of a patient.

86. "Emergency medical services provider" has the same meaning as in A.R.S. § 36-2201.

87. "Emergency services" means unscheduled medical services provided in a designated area to an outpatient in an emergency.

88. "End-of-life" means that a patient has a documented life expectancy of six months or less.

89. "Environmental services" means activities such as housekeeping, laundry, facility maintenance, or equipment maintenance.

90. "Equipment" means, in this Article, an apparatus, a device, a machine, or a unit that is required to comply with the specifications incorporated by reference in R9-10-104.01.

91. "Exploitation" has the same meaning as in A.R.S. § 46-451.

92. "Factory-built building" has the same meaning as in A.R.S. § 41-4001.

93. "Family" or "family member" means an individual's spouse, sibling, child, parent, grandparent, or another individual designated by the individual.

94. "Follow-up instructions" means information relevant to a patient's medical condition or behavioral health issue that is provided to the patient, the patient's representative, or a health care institution.

95. "Food services" means the storage, preparation, serving, and cleaning up of food intended for consumption in a health care institution.

96. "Full-time" means 40 hours or more every consecutive seven calendar days.

97. "Garbage" has the same meaning as in A.A.C. R18-13-302.

98. "General consent" means documentation of an agreement from an individual or the individual's representative to receive physical health services to address the individual's medical condition or behavioral health services to address the individual's behavioral health issues.

99. "General hospital" means a subclass of hospital that provides surgical services and emergency services.

100. "Gravely disabled" has the same meaning as "grave disability" in A.R.S. § 36-501.

101. "Habilitation services" means activities provided to an individual to assist the individual with habilitation, as defined in A.R.S. § 36-551.

101. 102. "Hazard" or "hazardous" means a condition or situation where a patient or other individual may suffer physical injury.

102. 103. "Health care directive" has the same meaning as in A.R.S. § 36-3201.

103. 104. "Hemodialysis" means the process for removing wastes and excess fluids from a patient's blood by passing the blood through a dialyzer.

104. 105. "Home health agency" has the same meaning as in A.R.S. § 36-151.

105. 106. "Home health aide" means an individual employed by a home health agency to provide home health services under the direction of a registered nurse or therapist.

106. 107. "Home health aide services" means those tasks that are provided to a patient by a home health aide under the direction of a registered nurse or therapist.

107. 108. "Home health services" has the same meaning as in A.R.S. § 36-151.

108. 109. "Hospice inpatient facility" means a subclass of hospice that provides hospice services to a patient on a continuous basis with the expectation that the patient will remain on the hospice's premises for 24 hours or more.

109. 110. "Hospital" means a class of health care institution that provides, through an organized medical staff, inpatient beds, medical services, continuous nursing services, and diagnosis or treatment to a patient.

110. 111. "Immediate" means without delay.

111. 112. "Incident" means an unexpected occurrence that harms or has the potential to harm a patient, while the patient is:

a. On the premises of a health care institution, or

b. Not on the premises of a health care institution but directly receiving physical health services or behavioral health services from a personnel member who is providing the physical health services or behavioral health services on behalf of the health care institution.

112. 113. "Infection control" means to identify, prevent, monitor, and minimize infections.

113. 114. "Infectious tuberculosis" has the same meaning as "infectious active tuberculosis" in A.A.C. R9-6-101.

114. 115. "Informed consent" means:

a. Advising a patient of a proposed treatment, surgical procedure, psychotropic medication, opioid, or diagnostic procedure; alternatives to the treatment, surgical procedure, psychotropic medication, opioid, or diagnostic procedure; and associated risks and possible complications; and

b. Obtaining documented authorization for the proposed treatment, surgical procedure, psychotropic medication, opioid, or diagnostic procedure from the patient or the patient's representative.

115. 116. "In-service education" means organized instruction or information that is related to physical health services or behavioral health services and that is provided to a medical staff member, personnel member, employee, or volunteer.

116. 117. "Interdisciplinary team" means a group of individuals consisting of a resident's attending physician, a registered nurse responsible for the resident, and other individuals as determined in the resident's comprehensive assessment or, if applicable, placement evaluation.

117. 118. "Intermediate care facility for individuals with intellectual disabilities" or "ICF/IID" has the same meaning as in A.R.S. § 36-551.

118. 119. "Interval note" means documentation updating a patient's:

a. Medical condition after a medical history and physical examination is performed, or

b. Behavioral health issue after an assessment is performed.

119. 120. "Isolation" means the separation, during the communicable period, of infected individuals from others, to limit the transmission of infectious agents.

120. 121. "Leased facility" means a facility occupied or used during a set time period in exchange for compensation.

121. 122. "License" means:

a. Written approval issued by the Department to a person to operate a class or subclass of health care institution at a specific location; or

b. Written approval issued to an individual to practice a profession in this state.

122. 123. "Licensed occupancy" means the total number of individuals for whom a health care institution is authorized by the Department to provide crisis services in a unit providing behavioral health observation/stabilization services.

123. 124. "Licensee" means an owner approved by the Department to operate a health care institution.

124. 125. "Manage" means to implement policies and procedures established by a governing authority, an administrator, or an individual providing direction to a personnel member.

125. 126. "Medical condition" means the state of a patient's physical or mental health, including the patient's illness, injury, or disease.

126. 127. "Medical director" means a physician who is responsible for the coordination of medical services provided to patients in a health care institution.

127. 128. "Medical history" means an account of a patient's health, including past and present illnesses, diseases, or medical conditions.

128. 129. "Medical practitioner" means a physician, physician assistant, or registered nurse practitioner.

129. 130. "Medical record" has the same meaning as "medical records" in A.R.S. § 12-2291.

130. 131. "Medical staff" means physicians and other individuals licensed pursuant to A.R.S. Title 32 who have clinical privileges at a health care institution.

131. 132. "Medical staff bylaws" means standards, approved by the medical staff and the governing authority, that provide the framework for the organization, responsibilities, and self-governance of the medical staff.

132. 133. "Medical staff member" means an individual who is part of the medical staff of a health care institution.

133. 134. "Medication" means one of the following used to maintain health or to prevent or treat a medical condition or behavioral health issue:

a. Biologicals as defined in A.A.C. R18-13-1401 ,

b. Prescription medication as defined in A.R.S. § 32-1901, or

c. Nonprescription drug as defined in A.R.S. § 32-1901.

134. 135. "Medication administration" means restricting a patient's access to the patient's medication and providing the medication to the patient or applying the medication to the patient's body, as ordered by a medical practitioner.

135. 136. "Medication error" means:

a. The failure to administer an ordered medication;

b. The administration of a medication not ordered; or

c. The administration of a medication:

i. In an incorrect dosage,

ii. More than 60 minutes before or after the ordered time of administration unless ordered to do so, or

iii. By an incorrect route of administration.

136. 137. "Mental disorder" means the same as in A.R.S. § 36-501.

137. 138. "Mobile clinic" means a movable structure that:

a. Is not physically attached to a health care institution's facility;

b. Provides medical services, nursing services, behavioral health services, or health related service to an outpatient under the direction of the health care institution's personnel; and

c. Is not intended to remain in one location indefinitely.

138. 139. "Monitor" or "monitoring" means to check systematically on a specific condition or situation.

139. 140. "Neglect" has the same meaning:

a. For an individual less than 18 years of age, as in A.R.S. § 8-201; and

b. For an individual 18 years of age or older, as in A.R.S. § 46-451.

140. 141. "Nephrologist" means a physician who is board eligible or board certified in nephrology by a professional credentialing board.

141. 142. "Nurse" has the same meaning as "registered nurse" or "practical nurse" as defined in A.R.S. § 32-1601.

143. "Nursing care institution administrator" means an individual licensed according to A.R.S. Title 36, Chapter 4, Article 6.

142. 144. "Nursing personnel" means individuals authorized according to A.R.S. Title 32, Chapter 15 to provide nursing services.

143. 145. "Observation chair" means a physical piece of equipment that:

a. Is located in a designated area where behavioral health observation/stabilization services are provided,

b. Allows an individual to fully recline, and

c. Is used by the individual while receiving crisis services.

144. 146. "Occupational therapist" has the same meaning as in A.R.S. § 32-3401.

145. 147. "Occupational therapy assistant" has the same meaning as in A.R.S. § 32-3401.

146. 148. "Ombudsman" means a resident advocate who performs the duties described in A.R.S. § 46-452.02.

147. 149. "On-call" means a time during which an individual is available and required to come to a health care institution when requested by the health care institution.

148. 150. "Opioid" means a controlled substance, as defined in A.R.S. § 36-2501, that meets the definition of "opiate" in A.R.S. § 362501.

149. 151. "Opioid agonist treatment medication" means a prescription medication that is approved by the U.S. Food and Drug Administration under 21 U.S.C. § 355 for use in the treatment of opioid-related substance use disorder.

150. 152. "Opioid antagonist" means a prescription medication, as defined in A.R.S. § 32-1901, that:

a. Is approved by the U.S. Department of Health and Human Services, Food and Drug Administration; and

b. When administered, reverses, in whole or in part, the pharmacological effects of an opioid in the body.

151. 153. "Opioid treatment" means providing medical services, nursing services, behavioral health services, health-related services, and ancillary services to a patient receiving an opioid agonist treatment medication for opioid-related substance use disorder.

152. 154. "Order" means instructions to provide:

a. Physical health services to a patient from a medical practitioner or as otherwise provided by law; or

b. Behavioral health services to a patient from a behavioral health professional.

153. 155. "Orientation" means the initial instruction and information provided to an individual before the individual starts work or volunteer services in a health care institution.

154. 156. "Outing" means a social or recreational activity that:

a. Occurs away from the premises,

b. Is not part of a behavioral health inpatient facility's or behavioral health residential facility's daily routine, and

c. Lasts longer than four hours.

155. 157. "Outpatient surgical center" means a class of health care institution that has the facility, staffing, and equipment to provide surgery and anesthesia services to a patient whose recovery, in the opinions of the patient's surgeon and, if an anesthesiologist would be providing anesthesia services to the patient, the anesthesiologist, does not require inpatient care in a hospital.

156. 158. "Outpatient treatment center" means a class of health care institution without inpatient beds that provides physical health services or behavioral health services for the diagnosis and treatment of patients.

157. 159. "Overall time-frame" means the same as in A.R.S. § 41-1072.

158. 160. "Owner" means a person who appoints, elects, or designates a health care institution's governing authority.

159. 161. "Pain management clinic" has the same meaning as in A.R.S. § 36-448.01.

160. 162. "Participant" means a patient receiving physical health services or behavioral health services from an adult day health care facility or a substance abuse transitional facility.

161. 163. "Participant's representative" means the same as "patient's representative" for a participant.

162. 164. "Patient" means an individual receiving physical health services or behavioral health services from a health care institution.

163. 165. "Patient's representative" means:

a. A patient's legal guardian;

b. If a patient is less than 18 years of age and not an emancipated minor, the patient's parent;

c. If a patient is 18 years of age or older or an emancipated minor, an individual acting on behalf of the patient with the written consent of the patient or patient's legal guardian; or

d. A surrogate as defined in A.R.S. § 36-3201.

164. 166. "Person" means the same as in A.R.S. § 1-215 and includes a governmental agency.

165. 167. "Personnel member" means, except as defined in specific Articles in this Chapter and excluding a medical staff member, a student, or an intern, an individual providing physical health services or behavioral health services to a patient.

166. 168. "Pest control program" means activities that minimize the presence of insects and vermin in a health care institution to ensure that a patient's health and safety is not at risk.

167. 169. "Pharmacist" has the same meaning as in A.R.S. § 32-1901.

168. 170. "Physical examination" means to observe, test, or inspect an individual's body to evaluate health or determine cause of illness, injury, or disease.

169. 171. "Physical health services" means medical services, nursing services, health-related services, or ancillary services provided to an individual to address the individual's medical condition.

170. 172. "Physical therapist" has the same meaning as in A.R.S. § 32-2001.

171. 173. "Physical therapist assistant" has the same meaning as in A.R.S. § 32-2001.

172. 174. "Physician assistant" has the same meaning as in A.R.S. § 32-2501.

173. 175. "Placement evaluation" means the same as in A.R.S. § 36-551.

174. 176. "Pre-petition screening" has the same meaning as "prepetition screening" in A.R.S. § 36-501.

175. 177. "Premises" means property that is designated by an applicant or licensee and licensed by the Department as part of a health care institution where physical health services or behavioral health services are provided to a patient.

176. 178. "Prescribe" means to issue written or electronic instructions to a pharmacist to deliver to the ultimate user, or another individual on the ultimate user's behalf, a specific dose of a specific medication in a specific quantity and route of administration.

177. 179. "Professional credentialing board" means a non-governmental organization that designates individuals who have met or exceeded established standards for experience and competency in a specific field.

178. 180. "Progress note" means documentation by a medical staff member, nurse, or personnel member of:

a. An observed patient response to a physical health service or behavioral health service provided to the patient,

b. A patient's significant change in condition, or

c. Observed behavior of a patient related to the patient's medical condition or behavioral health issue.

179. 181. "PRN" means pro re nata or given as needed.

180. 182. "Project" means specific construction or modification of a facility stated on an architectural plans and specifications approval application.

181. 183. "Provider" means an individual to whom the Department issues a license to operate an adult behavioral health therapeutic home or a behavioral health respite home in the individual's place of residence.

182. 184. "Provisional license" means the Department's written approval to operate a health care institution issued to an applicant or licensee that is not in substantial compliance with the applicable laws and rules for the health care institution.

183. 185. "Psychotropic medication" means a chemical substance that:

a. Crosses the blood-brain barrier and acts primarily on the central nervous system where it affects brain function, resulting in alterations in perception, mood, consciousness, cognition, and behavior; and

b. Is provided to a patient to address the patient's behavioral health issue.

184. 186. "Quality management program" means ongoing activities designed and implemented by a health care institution to improve the delivery of medical services, nursing services, health-related services, and ancillary services provided by the health care institution.

185. 187. "Recovery care center" has the same meaning as in A.R.S. § 36-448.51.

186. 188. "Referral" means providing an individual with a list of the class or subclass of health care institution or type of health care professional that may be able to provide the behavioral health services or physical health services that the individual may need and may include the name or names of specific health care institutions or health care professionals.

187. 189. "Registered dietitian" means an individual approved to work as a dietitian by the American Dietetic Association's Commission on Dietetic Registration.

188. 190. "Registered nurse" has the same meaning as in A.R.S. § 32-1601.

189. 191. "Registered nurse practitioner" has the same meaning as A.R.S. § 32-1601.

190. 192. "Regular basis" means at recurring, fixed, or uniform intervals.

191. 193. "Rehabilitation services" means medical services provided to a patient to restore or to optimize functional capability.

192. 194. "Research" means the use of a human subject in the systematic study, observation, or evaluation of factors related to the prevention, assessment, treatment, or understanding of a medical condition or behavioral health issue.

193. 195. "Resident" means an individual living in and receiving physical health services or behavioral health services, including rehabilitation services or habilitation services if applicable, from a nursing care institution, an intermediate care facility for individuals with intellectual disabilities, a behavioral health residential facility, an assisted living facility, or an adult behavioral health therapeutic home.

194. 196. "Resident's representative" means the same as "patient's representative" for a resident.

195. 197. "Respiratory care services" has the same meaning as "practice of respiratory care" as defined in A.R.S. § 32-3501.

196. 198. "Respiratory therapist" has the same meaning as in A.R.S. § 32-3501.

197. 199. "Respite capacity" means the total number of children who do not stay overnight for whom an outpatient treatment center or a behavioral health residential facility is authorized by the Department to provide respite services on the premises of the outpatient treatment center or behavioral health residential facility.

198. 200. "Respite services" means respite care services provided to an individual who is receiving behavioral health services.

199. 201. "Restraint" means any physical or chemical method of restricting a patient's freedom of movement, physical activity, or access to the patient's own body.

200. 202. "Risk" means potential for an adverse outcome.

201. 203. "Room" means space contained by a floor, a ceiling, and walls extending from the floor to the ceiling that has at least one door.

202. 204. "Rural general hospital" means a subclass of hospital:

a. Having 50 or fewer inpatient beds,

b. Located more than 20 surface miles from a general hospital or another rural general hospital, and

c. Requesting to be and being licensed as a rural general hospital rather than a general hospital.

203. 205. "Satellite facility" has the same meaning as in A.R.S. § 36-422.

204. 206. "Scope of services" means a list of the behavioral health services or physical health services the governing authority of a health care institution has designated as being available to a patient at the health care institution.

205. 207. "Seclusion" means the involuntary solitary confinement of a patient in a room or an area where the patient is prevented from leaving.

206. 208. "Sedative-hypnotic medication" means any one of several classes of drugs that have sleep-inducing, anti-anxiety, anti-con-vulsant, and muscle-relaxing properties.

207. 209. "Self-administration of medication" means a patient having access to and control of the patient's medication and may include the patient receiving limited support while taking the medication.

208. 210. "Sexual abuse" means the same as in A.R.S. § 13-1404(A).

209. 211. "Sexual assault" means the same as in A.R.S. § 13-1406(A).

210. 212. "Shift" means the beginning and ending time of a continuous work period established by a health care institution's policies and procedures.

211. 213. "Short-acting opioid antagonist" means an opioid antagonist that, when administered, quickly but for a small period of time reverses, in whole or in part, the pharmacological effects of an opioid in the body.

212. 214. "Signature" means:

a. A handwritten or stamped representation of an individual's name or a symbol intended to represent an individual's name, or

b. An electronic signature.

213. 215. "Significant change" means an observable deterioration or improvement in a patient's physical, cognitive, behavioral, or functional condition that may require an alteration to the physical health services or behavioral health services provided to the patient.

214. 216. "Single group license" means a license that includes authorization to operate health care institutions according to A.R.S. § 36-422(F) or (G).

215. 217. "Speech-language pathologist" means an individual licensed according to A.R.S. Title 36, Chapter 17, Article 4 to engage in the practice of speech-language pathology, as defined in A.R.S. § 36-1901.

216. 218. "Special hospital" means a subclass of hospital that:

a. Is licensed to provide hospital services within a specific branch of medicine; or

b. Limits admission according to age, gender, type of disease, or medical condition.

217. 219. "Student" means an individual attending an educational institution and working under supervision in a health care institution through an arrangement between the health care institution and the educational institution.

218. 220. "Substance abuse" means an individual's misuse of alcohol or other drug or chemical that:

a. Alters the individual's behavior or mental functioning;

b. Has the potential to cause the individual to be psychologically or physiologically dependent on alcohol or other drug or chemical; and

c. Impairs, reduces, or destroys the individual's social or economic functioning.

219. 221. "Substance abuse transitional facility" means a class of health care institution that provides behavioral health services to an individual over 18 years of age who is intoxicated or may have a substance abuse problem.

220. 222. "Substance use disorder" means a condition in which the misuse or dependence on alcohol or a drug results in adverse physical, mental, or social effects on an individual.

221. 223. "Substance use risk" means an individual's unique likelihood for addiction, misuse, diversion, or another adverse consequence resulting from the individual being prescribed or receiving treatment with opioids.

222. 224. "Substantial" when used in connection with a modification means:

a. An addition or removal of an authorized service;

b. The addition or removal of a colocator;

c. A change in a health care institution's licensed capacity, licensed occupancy, respite capacity, or the number of dialysis stations;

d. A change in the physical plant, including facilities or equipment, that costs more than $300,000; or

e. A change in the building where a health care institution is located that affects compliance with:

i. Applicable physical plant codes and standards incorporated by reference in R9-10-104.01, or

ii. Physical plant requirements in the specific Article in this Chapter applicable to the health care institution.

223. 225. "Substantive review time-frame" means the same as in A.R.S. § 41-1072.

224. 226. "Supportive services" has the same meaning as in A.R.S. § 36-151.

225. 227. "Surgical procedure" means the excision of or incision in a patient's body for the:

a. Correction of a deformity or defect;

b. Repair of an injury; or

c. Diagnosis, amelioration, or cure of disease.

226. 228. "Swimming pool" has the same meaning as "semipublic swimming pool" in A.A.C. R18-5-201.

227. 229. "System" means interrelated, interacting, or interdependent elements that form a whole.

228. 230. "Tapering" means the gradual reduction in the dosage of a medication administered to a patient, often with the intent of eventually discontinuing the use of the medication for the patient.

229. 231. "Tax ID number" means a numeric identifier that a person uses to report financial information to the United States Internal Revenue Service.

230. 232. "Telemedicine" has the same meaning as in A.R.S. § 36-3601.

231. 233. "Therapeutic diet" means foods or the manner in which food is to be prepared that are ordered for a patient.

232. 234. "Therapist" means an occupational therapist, a physical therapist, a respiratory therapist, or a speech-language pathologist.

233. 235. "Time-out" means providing a patient a voluntary opportunity to regain self-control in a designated area from which the patient is not physically prevented from leaving.

234. 236. "Transfer" means a health care institution discharging a patient and sending the patient to another licensed health care institution as an inpatient or resident without intending that the patient be returned to the sending health care institution.

235. 237. "Transport" means a licensed health care institution:

a. Sending a patient to a receiving licensed health care institution for outpatient services with the intent of the patient returning to the sending licensed health care institution, or

b. Discharging a patient to return to a sending licensed health care institution after the patient received outpatient services from the receiving licensed health care institution.

236. 238. "Treatment" means a procedure or method to cure, improve, or palliate an individual's medical condition or behavioral health issue.

237. 239. "Treatment plan" means a description of the specific physical health services or behavioral health services that a health care institution anticipates providing to a patient.

238. 240. "Unclassified health care institution" means a health care institution not classified or subclassified in statute or in rule.

239. 241. "Vascular access" means the point on a patient's body where blood lines are connected for hemodialysis.

240. 242. "Volunteer" means an individual authorized by a health care institution to work for the health care institution on a regular basis without compensation from the health care institution and does not include a medical staff member who has clinical privileges at the health care institution.

241. 243. "Working day" means a Monday, Tuesday, Wednesday, Thursday, or Friday that is not a state and federal holiday or a statewide furlough day.

Notes

Ariz. Admin. Code § R9-10-101

New Section made by final rulemaking at 8 A.A.R. 3559, effective August 1, 2002 (Supp. 02-3). Amended by exempt rulemaking at 19 A.A.R. 2015, effective October 1, 2013 (Supp. 13-2). Amended by exempt rulemaking at 20 A.A.R. 1409, effective 7/1/2014. Amended by exempt rulemaking at 20 A.A.R. 3535, effective 1/1/2015. Amended by exempt rulemaking at 22 A.A.R. 1035, effective 5/1/2016. Amended by final rulemaking at 24 A.A.R. 3020, effective 1/1/2019. Amended by final rulemaking at 25 A.A.R. 1222, effective 4/25/2019. Amended by final rulemaking at 25 A.A.R. 1583, effective 10/1/2019. Amended by final expedited rulemaking at 25 A.A.R. 3481, effective 11/5/2019. Amended by final exempt rulemaking at 28 A.A.R. 927, effective 4/15/2022.