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.
