(1) Abuse. The willful infliction of injury,
unreasonable confinement, intimidation or punishment with resulting physical
harm, pain or mental anguish.
Activities of Daily Living (ADL's). Those personal functional activities which
indicate an individual's independence in eating, dressing, personal hygiene,
bathing, toileting, and moving from one place to another.
(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) Aged. A person who is
fifty-five (55) years of age or older.
(6) Agent. An individual designated in an
advance directive for health care to make a health care decision for the
individual granting the power.
Ambulatory resident. A resident who is physically and mentally capable under
emergency conditions of finding a way to safety without physical assistance
from another person. An ambulatory resident may use a cane, wheelchair or other
supportive device and may require verbal prompting.
(8) 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 resident
to make health care decisions while having the capacity to do so. A resident
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 resident shall have the burden of
proving lack of capacity.
Cardiopulmonary Resuscitation (CPR). The administering of any means or device
to restore or support cardiopulmonary function in a resident, 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 resident where cardiac or
respiratory arrest has occurred or is believed to be imminent.
(11) Commissioner. The Commissioner of the
Tennessee Department of Health or his or her authorized
The Tennessee Department of Health.
(13) 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 designation or if the designated physician is not reasonably
available, a physician who undertakes such responsibility.
(14) Do-Not-Resuscitate Order (DNR). A
written order, other than a POST, not to resuscitate a patient in cardiac or
respiratory arrest in accordance with accepted medical practices.
(15) Emancipated 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.
(16) 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
Capability. The ability to either evacuate the building or move to a point of
(19) Guardian. A judicially
appointed guardian of conservator having authority to make a health care
(20) 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. §
(22) Health care decision. Consent, refusal
or consent or withdrawal of consent to health care.
Health Care Decision-maker. In the case
of a resident who lacks capacity, the resident's health care decision-maker is
one of the following: the resident's health care agent as specified in an
advance directive, the resident's court-appointed guardian or conservator with
healthcare decision-making authority, the resident's surrogate as determined
pursuant to Rule
or T.C.A. §
the designated physician pursuant to these Rules or in the case of a minor
child, the person having custody or legal guardianship.
(24) Health Care Institution. A health care
institution as defined in T.C.A. §
(25) Health Care Provider A person who si
licensed, certified or otherwise authorized or permitted by the laws of this
state to administer health care in the ordinary course of business or practice
of a profession.
(26) 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 facility.
(27) Home for the Aged. A home represented
and held out to the general public as a home which accepts primarily aged
persons for relatively permanent, domiciliary care with primarily being defined
as 51% or more of the population of the home for the aged. It provides room,
board and personal services to four (4) or more nonrelated persons. The term
home includes any building or part thereof which provides services as defined
in these rules.
(28) Home for the
Aged Resident. A person who is ambulatory and who requires permanent,
domiciliary care but who will be transferred to a licensed hospital, licensed
nursing home or licensed assisted care living facility when health care
services are needed which must be provided in such other facilities.
(29) Incompetent. A resident who has been
adjudicated incompetent by a court of competent jurisdiction and has not been
restored to legal capacity.
Individual instruction. An individual's direction concerning a health care
decision for the individual.
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 disease.
(31) Licensee. The person or entity to whom
the license is issued. The licensee is held responsible for compliance with all
rules and regulations.
Threatening Or Serious Injury. Injury requiring the patient to undergo
significant additional diagnostic or treatment measures.
(33) Medically Inappropriate Treatment
Resuscitation efforts that cannot be expected either to restore cardiac or
respiratory function to the resident or other medical or surgical treatments to
achieve the expressed goals of the informed resident. In the case of the
incompetent resident, the resident's representative expresses the goals of the
(34) N.F.P.A. The National
Fire Protection Association.
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.
(36) 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
(37) Person. An
individual, corporation, estate, trust, partnership, association, joint
venture, government, governmental subdivision, agency or instrumentality, or
any other legal or commercial entity.
(38) Personal Services. Those services that
are rendered to residents who need supervision or assistance in activities of
daily living. Personal services must include protective care of the resident,
responsibility for the safety of the resident when in the facility, daily
awareness of the resident's whereabouts and the ability and readiness to
intervene if crises arise. Personal services do not include nursing or medical
(39) Personally Informing. A
communication by any effective means from the resident directly to a health
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.
(42) 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
(43) Qualified Emergency Medical
Service Personnel. Includes, but shall not be limited to, emergency services
personnel providers, or entities acting within the usual course of their
professions, and other emergency responders.
(44) 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 resident's health care needs. Such availability
shall include, but not limited to, availability by telephone.
(45) Responsible Attendant. The person
designated by the licensee who remains awake to provide personal services to
the residents. In the absence of the licensee, the responsible attendant is
responsible for ensuring the home complies with all rules and
(46) Secured Unit. A
facility or distinct part of a facility where the residents are intentionally
denied egress by any means.
Shall or Must. Compliance is mandatory.
(48) 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 States.
(49) Supervising Heath Care Provider. The
designated physician or, if there is no designated physician ot the designated
physician is not reasonably available, the health care provider who has
undertaken primary responsibility for an individual's health care.
(50) Surrogate. An individual, other that a
resident's agent or guardian, authorized to make a health care decision for the
(51) Treating Health Care
Provider. A health care provider who at the time is directly or indirectly
involved in providing health care to the resident.