N.M. Admin. Code § 8.370.9.7 - DEFINITIONS
A.
"Abuse" means:
(1) knowingly,
intentionally, and without justifiable cause inflicting physical pain, injury
or mental anguish;
(2) the
intentional deprivation by a caretaker or other person of services necessary to
maintain the mental and physical health of a person;
(3) sexual abuse, including criminal sexual
contact, incest, and criminal sexual penetration; or
(4) verbal abuse, including profane,
threatening, derogatory, or demeaning language, spoken or conveyed with the
intent to cause mental anguish.
B.
"Bureau" means the health
care authority, division of health improvement, health facility licensing and
certification bureau.
C.
"Case manager" means the staff person designated to coordinate and
monitor the individual service plan for persons receiving services.
D.
"Complaint" means any report,
assertion, or allegation of abuse, neglect, or exploitation of, or injuries of
unknown origin to, a consumer made by a reporter to the incident management
system, and includes any reportable incident that a licensed health care
facility is required to report under applicable law.
E.
"CMS" means the centers for
medicare and medicaid services.
F.
"Consumer" means any person who engages the professional services
of a medical or other health professional on an inpatient or outpatient basis,
or person requesting services from a hospital.
G.
"Division" means the health
care authority, division of health improvement.
H.
"Employee" means:
(1) any person whose employment or
contractual service with a licensed health care facility which includes direct
care or routine and unsupervised physical or financial access to any care
recipient serviced by that licensed health care facility; or
(2) any compensated persons such as
employees, contractors and employees of contractors; or guardianship service
providers or case management entities that provide services to people with
developmental disabilities; or administrators or operators of facilities who
are routinely on site.
I.
"Exploitation" means an unjust or improper use of a person's money
or property for another person's profit or advantage, financial or
otherwise.
J.
"Immediate
access" means physical or in person direct and unobstructed access, to
electronic or other access needed by employees, consumers, family members or
legal guardian to the licensed health care facility's incident management
reporting procedures or access to the division's incident report
form.
K.
"Immediate
reporting" means reporting that is done as soon as practicable and no
later than 24 hours from knowledge of the incident.
L.
"Immediate jeopardy" means a
provider's noncompliance with one or more requirements of medicaid or medicare
participation, which causes or is likely to cause, serious injury, harm,
impairment, or death to a consumer.
M.
"Incident" means any known,
alleged or suspected event of abuse, neglect, exploitation, injuries of unknown
origin or other reportable incidents.
N.
"Incident management system"
means the written policies and procedures adopted or developed by the licensed
health facility for reporting abuse, neglect, exploitation, injuries of unknown
origin or other reportable incidents.
O.
"Incident report form" means
the reporting format issued by the division for the reporting of incidents or
complaints.
P.
"ISP"
means a consumer's individual service plan.
Q.
"Licensed health care
facilities" means any organization licensed by the authority for the
following services: adult day care center, assisted living facility, ambulatory
surgical center, diagnostic and treatment center, end stage renal disease
facility, general, acute, special and limited service hospitals, home health
agency, hospice facility, hospital infirmary, intermediate care facility for
the mentally retarded or intellectually and developmentally disabled, limited
diagnostic and treatment center, nursing facility, skilled nursing facility,
rural health clinic.
R.
"Mental anguish" means a relatively high degree of mental pain and
distress that is more than mere disappointment, anger, resentment or
embarrassment, although it may include all of these, and is objectively
manifested by the recipient of care or services by significant behavioral or
emotional changes or physical symptoms.
S.
"Neglect" means the failure
of the caretaker to provide basic needs of a person, such as clothing, food,
shelter, supervision and care for the physical and mental health of that
person. Neglect causes, or is likely to cause, harm to a person.
T.
"Quality assurance" means a
systematic approach to the continuous study and improvement of the efficiency
and efficacy of organizational, administrative and clinical practices in
meeting the needs of persons served as well as achieving the licensed health
care facility's mission, values and goals.
U.
"Quality improvement system"
means the adopted or developed licensed health care facility's policies and
procedures for reviewing and documenting all alleged incidents of abuse,
neglect, exploitation, injuries of unknown origin, or other reportable
incidents for the continuous study and improvement of the efficiency and
efficacy of organizational, administrative and preventative practices in
employee training and reporting.
V.
"Reportable incident" means possible abuse, neglect, exploitation,
injuries of unknown origin and other events including but not limited to falls
which cause injury, unexpected death, elopement, medication error which causes
or is likely to cause harm, failure to follow a doctor's order or an ISP, or
any other incident which may evidence abuse, neglect, or
exploitation.
W.
"Reporter" means any person who or any entity that reports
possible abuse, neglect or exploitation to the division.
X.
"Restraints" means use of a
mechanical device, or chemical restraints imposed, for the purposes of
discipline or convenience, to physically restrict a consumer's freedom of
movement, performance of physical activity, or normal access to his
body.
Y.
"Revocation"
means a type of sanction making a license null and void through its
cancellation.
Z.
"Sanction" means a measure imposed by the authority on a licensed
program, pursuant to these requirements, in response to a finding of
deficiency, with the intent of obtaining increased compliance with these
requirements.
AA.
"Substantiated" means the verification of a complaint based upon a
preponderance of reliable evidence obtained from an appropriate investigation
of a complaint of abuse, neglect, or exploitation.
BB.
"Suspension" means a
temporary cancellation of a license pending an appeal, hearing or correction of
the deficiency. During a suspension the provider's medicare or medicaid
agreement is not in effect.
CC.
"Training curriculum" means the instruction manual or pamphlet
adopted or developed by the licensed health facility containing policies and
procedures for reporting abuse, neglect, misappropriation of consumers'
property or other reportable incidents.
DD.
"Unsubstantiated" means that
the complaint or incident could not be verified based upon a preponderance of
reliable evidence obtained from an appropriate investigation of a complaint of
abuse, neglect, or exploitation.
EE.
"Volunteer" means any person
who works without compensation for a licensed health care facility whose
services includes direct care or routine and unsupervised physical or financial
access to any care recipient serviced by that licensed health care
facility.
Notes
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