(1) Abuse. The willful infliction of injury,
unreasonable confinement, intimidation or punishment with resulting physical
harm, pain or mental anguish.
Administrator. The individual designated by the licensee or the governing body
to be the person responsible for the day to day supervision and operation of
the PCCC and may be either the licensee or the nursing director.
(3) Adult. An individual who has capacity and
is at least 18 years of age.
Advance Directive. An individual instruction or a written statement relating to
the subsequent provision of health care for the individual, including, but not
limited to, a living will or a durable power of attorney for health
(5) Agent. An individual
designated in an advance directive for health care to make a health care
decision for the individual granting the power.
(6) Board. The Tennessee Board for Licensing
Health Care Facilities.
Capacity. An individual's ability to understand the significant benefits,
risks, and alternatives to proposed health care and to make and communicate a
health care decision. These regulations do not affect the right of a patient to
make health care decisions while having the capacity to do so. A patient shall
be presumed to have capacity to make a health care decision, to give or revoke
an advance directive, and to designate or disqualify a surrogate. Any person
who challenges the capacity of a patient shall have the burden of proving lack
Resuscitation (CPR). The administering of any means or device to restore or
support cardiopulmonary function in a child, whether by mechanical devices,
chest compressions, mouth-to-mouth resuscitation, cardiac massage, tracheal
intubation, manual or mechanical ventilators or respirations, defibrillation,
the administration of drugs and/or chemical agents intended to restore cardiac
and/or respiratory functions in a child where cardiac or respiratory arrest has
occurred or is believed to be imminent.
(9) Certified Master Social Worker. A person
currently certified as such by the Tennessee Board of Social Worker
Certification and Licensure.
Certified Nurse Practitioner. A person who is licensed as a registered nurse
and has further been issued a certificate of fitness to prescribe and/or issue
drugs by the Tennessee Board of Nursing.
(11) Certified Respiratory Technician. A
person currently licensed as such by the Tennessee Board of Respiratory
(12) Child or Children. A
person or persons under 18 years of age.
(13) Child Care. The provision of
supervision, protection, and meeting, at a minimum, the basic needs of a child
for three (3) or more hours a day, but less than twenty-four (24) hours a
(14) Clinical Fellow. A Speech
Language Pathologist who is in the process of obtaining his or her paid
professional experience, as defined by a Communications Disorders and Sciences
Board-approved accreditation agency, before being qualified for
(15) Commissioner. The
Commissioner of the Tennessee Department of Health or his or her authorized
(16) Dentist. A
person currently licensed as such by the Tennessee Board of
(17) Department. The
Tennessee Department of Health.
(18) Designated Physician. A physician
designated by an individual or the individual's agent, guardian, or surrogate,
to have primary responsibility for the individual's health care or, in the
absence of a designation or if the designated physician is not reasonably
available, a physician who undertakes such responsibility.
(19) Developmentally Appropriate. As defined
by the National Association for the Education of Young Children,
developmentally appropriate practice is the use of child development knowledge
to identify the range of appropriate behaviors, activities and materials for a
specific age group. This knowledge is used in conjunction with understanding
about an individual child's growth patterns, strengths, interests, and
experiences to design the most appropriate learning environment.
Developmentally appropriate curriculum provides for all areas of a child's
development: physical, emotional, social, and cognitive through an integrated
(20) Dietitian. A person
currently licensed as such by the Tennessee Board of Dietitian/Nutritionist
Order (DNR). A written order, other than a POST, not to resuscitate a patient
in cardiac or respiratory arrest in accordance with accepted medical
Signature. The authentication of a health record document or documentation in
an electronic form achieved through electronic entry of an exclusively
assigned, unique identification code entered by the author of the
Minor. Any minor who is or has been married or has by court order or otherwise
been freed from the care, custody and control of the minor's parents.
(24) Emergency. Any situation or condition
which presents an imminent danger of death or serious physical or mental harm
Responder. A paid or volunteer firefighter, law enforcement officer, or other
public safety official or volunteer acting within the scope of his or her
proper function under law or rendering emergency care at the scene of an
Assessment. An evaluation of the child's abilities and needs related to self
care, communication skills, social skills, motor skills, pre-academic areas,
play with toys/objects, growth and development appropriate for age.
(27) Group. A specific number of children
comprising an age range, assigned to specific staff in an assigned space, which
is divided from the space of other groups by a recognizable barrier to define
limits and to reduce distractions.
(28) Guardian. A judicially appointed
guardian or conservator having authority to make a health care decision for an
(29) Hazardous Waste.
Materials whose handling, use, storage, and disposal are governed by local,
state, or federal regulations.
Health Care. Any care, treatment, service or procedure to maintain, diagnose,
treat, or otherwise affect an individual's physical or mental condition, and
includes medical care as defined in T.C.A. §
(31) Health Care Decision. Consent, refusal
of consent or withdrawal of consent to health care.
(32) Health Care Decision-maker. In the case
of an individual who lacks capacity, the individual's health care
decision-maker is one of the following: the individual's health care agent as
specified in an advance directive, the individual's court-appointed guardian or
conservator with health care decision-making authority, the individual's
surrogate as determined pursuant to Rule 1200-08-02-.12 or T.C.A. §
33-3-220, the designated physician
pursuant to these Rules or in the case of a minor child, the person having
custody or legal guardianship.
Health Care Institution. A health care institution as defined in T.C.A. §
(34) Health Care Provider. A person who is
licensed, certified or otherwise authorized or permitted by the laws of this
state to administer health care in the ordinary course of business of practice
of a profession.
(35) High School
Diploma. As used in the context of staff qualifications, refers to a document
recognizing graduation from a legally approved institution, public or private,
based on the issuing state's required number of academic credits, including
passing a GED test. As used in this Chapter, a certificate or statement of
attendance or similar document, or correspondence or video courses, do not
qualify as a high school diploma.
(36) Holding Out to the Public. Advertising
or soliciting the public through the use of personal, telephone, mail or other
forms of communication to provide information about services provided by the
instruction. An individual's direction concerning a health care decision for
(38) Infant. A
child who is six (6) weeks through fifteen (15) months of age.
(39) Infectious Waste. Solid or liquid wastes
which contain pathogens with sufficient virulence and quantity such that
exposure to the waste by a susceptible host could result in an infectious
(40) Licensee. The person
or entity to whom the license is issued. The licensee is held responsible for
compliance with all rules and regulations.
(41) Licensed Clinical Social Worker. A
person currently licensed as such by the Tennessee Board of Social
(42) Licensed Practical
Nurse. A person currently licensed as such by Tennessee Board of
(43) Medical Emergency. A
medical condition manifesting itself by acute symptoms of sufficient severity
(including severe pain) such that the absence of immediate medical attention
could reasonably be expected to result in placing the child's health in serious
jeopardy, serious impairment to bodily functions or serious dysfunction of any
bodily organ or part, which includes labor when delivery is imminent, when
there is inadequate time to effect safe transfer to a hospital prior to
delivery, or when a transfer may pose a threat to the health and safety of the
child or the unborn child.
Medical Record. Medical histories, records, reports, summaries, diagnoses,
prognoses, records of treatment and medication ordered and given, entries,
x-rays, radiology interpretations, and other written electronics, or graphic
data prepared, kept, made or maintained in a facility that pertains to
confinement or services rendered to patients admitted or receiving
(45) Medically Inappropriate
Treatment. Resuscitation efforts that cannot be expected either to restore
cardiac or respiratory function to the patient or other medical or surgical
treatments to achieve the expressed goals of the informed patient. In the case
of the incompetent patient, the patient's representative expresses the goals of
Practitioner. A certified nurse practitioner or a licensed physician
(47) Misappropriation of
Patient/Resident Property. The deliberate misplacement, exploitation or
wrongful, temporary or permanent use of an individual's belongings or money
without the individual's consent.
(48) Neglect. The failure to provide goods
and services necessary to avoid physical harm, mental anguish or mental
illness; however, the withholding of authorization for or provision of medical
care to any terminally ill person who has executed an irrevocable living will
in accordance with the Tennessee Right to Natural Death Law, or other
applicable state law, if the provision of such medical care would conflict with
the terms of the living will, shall not be deemed "neglect" for purposes of
(49) N.F.P.A. The
National Fire Protection Association.
(50) Nursing Director. A licensed registered
nurse providing continuous supervision of PCCC services and managing the
operations of the facility.
Occupational Therapist. A person currently licensed as such by the Tennessee
Board of Occupational and Physical Therapy Examiners.
(52) Occupational Therapy Assistant. A person
currently licensed as such by the Tennessee Board of Occupational and Physical
Optometrist. A person currently licensed as such by the Tennessee Board of
(54) Parent. A
biological, legal or adoptive parent, guardian, or a legal or physical
custodian who has primary responsibility for a child.
(55) Person. An individual, corporation,
estate, trust, partnership, association, joint venture, government,
governmental subdivision, agency, or instrumentality, or any other legal or
Informing. A communication by any effective means from the patient directly to
a health care provider.
Pharmacist. A person currently licensed as such by the Tennessee Board of
(58) Physical Therapist.
A person currently licensed as such by the Tennessee Board of Occupational and
Physical Therapy Examiners.
Physical Therapy Assistant. A person currently licensed as such by the
Tennessee Board of Occupational and Physical Therapy Examiners.
(60) Physician. An individual authorized to
practice medicine or osteopathy under Tennessee Code Annotated, Title 63,
Chapters 6 or 9.
Assistant. A person who has graduated from a physician assistant educational
program accredited by the Accreditation Review Commission on Education for the
Physician Assistant, has passed the Physician Assistant National Certifying
Examination, and is currently licensed in Tennessee as a physician assistant
under title 63, chapter 19.
Physician Orders for Scope of Treatment or POST. Written orders that:
(a) Are on a form approved by the Board for
Licensing Health Care Facilities;
(b) Apply regardless of the treatment setting
and that are signed as required herein by the patient's physician, physician
assistant, nurse practitioner, or clinical nurse specialist; and
Specify whether, in the event the patient suffers cardiac or respiratory
arrest, cardiopulmonary resuscitation should or should not be
2. Specify other medical
interventions that are to be provided or withheld; or
3. Specify both 1 and 2.
(63) Plan of Care. The
comprehensive plan for implementation of medical, nursing, psychosocial,
developmental, and educational therapies to be provided upon admission and
shall include necessary equipment to meet the child's need, and the plan will
be revised to include recommended changes in the therapeutic plans. The
disposition to be followed in the event of emergency situations will be
specified in the Plan of Care.
Podiatrist. A person currently licensed as such by the Tennessee Board of
Registration in Podiatry.
Power of Attorney for Health Care. The designation of an agent to make health
care decisions for the individual granting the power under T.C.A. Title 34,
Chapter 6, Part 2.
Child Care Center (PCCC). A nonresidential child care, health care/child care
center providing physician prescribed services and appropriate developmental
services for six (6) or more children who are medically and/or technology
dependent and require continuous nursing intervention. Child care for purposes
of this section means the provision of supervision, protection, and meeting the
basic needs of children, who are not related to the primary caregivers, for
three (3) or more hours a day, but less than twenty-four (24) hours a day. As
part of the continuum of care for medically dependent children, the center
provides a triad of medically necessary services: skilled nursing care,
developmental programming, and parental training. Prescribed child care (PCCC)
provides a less restrictive alternative to hospitalization and reduces the
isolation often experienced by the homebound, medically dependent child and
family. The purpose of prescribed childcare is health care, but does not
exclude other services.
Psychologist. A person currently licensed as such by the Tennessee Board of
Examiners in Psychology.
Qualified Emergency Medical Service Personnel. Includes, but shall not be
limited to, emergency medical technicians, paramedics, or other emergency
services personnel, providers, or entities acting within the usual course of
their professions, and other emergency responders.
(69) Reasonably Available. Readily able to be
contacted without undue effort and willing and able to act in a timely manner
considering the urgency of the child's health care needs. Such availability
shall include, but not be limited to, availability by telephone.
(70) Registered Nurse. A person currently
licensed as such by the Tennessee Board of Nursing.
(71) Registered Respiratory Therapist. A
person currently licensed as such by the Tennessee Board of Respiratory
(72) Shall or Must.
Compliance is mandatory.
Social Worker. A person who has at least a bachelor's degree in Social Work or
related field, and preferably, two (2) years medical social work or other
community based work experience.
(74) Speech Language Pathologist. As defined
in T.C.A. §
63-17-103, a person currently
licensed as such by the Tennessee Board of Communications Disorders and
(75) State. A state of
the United States, the District of Columbia, the Commonwealth of Puerto Rico,
or a territory or insular possession subject to the jurisdiction of the United
(76) Supervising Health
Care Provider. The designated physician or, if there is no designated physician
or the designated physician is not reasonably available, the health care
provider who has undertaken primary responsibility for an individual's health
(77) Surrogate. An
individual, other than a patient's agent or guardian, authorized to make a
health care decision for the patient.
(78) Toddler. A child who is sixteen (16)
months through thirty (30) months of age.
(79) Treating Health Care Provider. A health
care provider who at the time is directly or indirectly involved in providing
health care to the child.