(1) Abuse. The willful infliction of injury,
unreasonable confinement, intimidation or punishment with resulting physical
harm, pain or mental anguish.
Administrator. An individual appointed by a governing body who is responsible
for the day to day management of the HIV Supportive Living Facility.
(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) Bereavement Counseling. Counseling
services provided to the individual's family and/or significant other both
prior to and after the individual's death.
(7) Bereavement Counselor. An individual who
has at least a bachelor's degree in social work, counseling, psychology,
pastoral care, or specialized training or experience in bereavement theory and
(8) Board. The
Tennessee Board for Licensing Health Care Facilities.
(9) 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.
(10) Cardiopulmonary Resuscitation (CPR). The
administering of any means or device to support cardiopulmonary functions in a
resident, whether by mechanical devices, chest compressions, mouth-to-mouth
resuscitation, cardiac massage, tracheal intubation, manual or mechanical
ventilations 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.
Master Social Worker. A person currently certified as such by the Tennessee
Board of Social Worker Certification and Licensure.
(12) 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
(13) Clinical Note. A
written and dated notation containing a resident assessment, responses to
medications, treatments and services and/or any changes in condition signed by
a health professional who made contact with the resident, family or significant
(14) Commissioner. The
Commissioner of the Tennessee Department of Health or his or her authorized
(15) Competent. A
resident who has capacity.
Core Services. Services consisting of nursing, medical social services,
physician services and counseling services.
(17) Department. The Tennessee Department of
(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) Dietitian. A person currently licensed
as such by the Tennessee Board of Dietitian/Nutritionist Examiners.
(20) 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.
(21) 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.
(22) Emergency 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 emergency.
(23) Guardian. A judicially appointed
guardian or conservator having authority to make a health care decision for an
(24) 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. §
(26) Health Care Decision. Consent, refusal
of consent or withdrawal of consent to health care.
(27) 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
health care decision-making authority, the resident's surrogate as determined
pursuant to Rule 1200-08-28-.13 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. §
(29) 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 or practice
of a profession.
(30) Home Care
Organization. As defined by T.C.A. §
68-11-201 "home care
organizations" provides home health services, home medical equipment services
or hospice services to residents on an outpatient basis in either their regular
or temporary place of residence.
(31) Hospice Services. As defined by T.C.A.
68-11-201, "hospice services"
means a coordinated program of care, under the direction of an identifiable
hospice administrator, providing palliative and supportive medical and other
services to hospice patients and their families in the patient's regular or
temporary place of residence. Hospice services shall be provided twenty-four
(24) hours a day, seven (7) days a week.
(32) 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.
(35) Involuntary Transfer. The movement of a
resident without the consent of the resident, the resident's legal guardian,
next of kin or representative, with required notification to the appropriate
(36) Licensed Clinical
Social Worker. A person currently licensed as such by the Tennessee Board of
Practical Nurse. A person currently licensed as such by the Tennessee Board of
Psychologist. A person currently licensed as such by the Tennessee Board of
Examiners in Psychology.
Licensee. The person or entity to whom the license is issued. The licensee is
held responsible for compliance with all rules and regulations.
(40) Life Threatening Or Serious Injury.
Injury requiring the patient to undergo significant additional diagnostic or
Director. A licensed physician employed by the HIV supportive living facility
to be responsible for medical care in the facility.
(42) 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 resident's health in serious jeopardy,
serious impairment to bodily functions or serious dysfunction of any bodily
organ or part.
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 resident.
Medical Social Services. When provided, shall be given by a certified master
social worker, a licensed clinical social worker, or by a social worker or
social work assistant employed by a home care organization or by contract with
the facility and under the supervision of a certified master social worker or
licensed clinical social worker, and in accordance with the plan of care. The
medical social services provider shall assist the physician and other team
members in understanding the significant social and emotional factors related
to the health problems, participate in the development of the plan of care,
prepare clinical and progress notes, work with the family, utilize appropriate
community resources, participate in discharge planning and inservice programs,
and act as a consultant to other organization personnel.
(45) 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
(46) 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 these rules.
N.F.P.A. The National Fire Protection Association.
(48) Occupational Therapist. A person
currently licensed as such by the Tennessee Board of Occupational and Physical
Occupational Therapy Assistant. A person currently licensed as such by the
Tennessee Board of Occupational and Physical Therapy Examiners.
(50) Palliative. The reduction or abatement
of pain or troubling symptoms by appropriate coordination of all elements of
the health care team to achieve needed relief of distress.
(51) Person. An individual, corporation,
estate, trust, partnership, association, joint venture, government,
governmental subdivision, agency, or instrumentality, or any other legal or
Care Aide. A nursing assistant or a person who can demonstrate through other
education or experience that he or she is qualified to provide assistance with
basic care services, including simple procedures such as feeding, personal
grooming, ambulating, socializing, medication prompting, exercising and other
household services essential to health care.
(53) Personally Informing. A communication by
any effective means from the resident directly to a health care
(54) Pharmacist. A person
currently licensed as such by the Tennessee Board of Pharmacy.
(55) Physical Therapist. A person currently
licensed as such by the Tennessee Board of Occupational and Physical Therapy
(56) Physical Therapist
Assistant. A person currently licensed as such by the Tennessee Board of
Occupational and Physical Therapy Examiners.
(57) 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.
(60) 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
(61) 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
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 be
limited to, availability by telephone.
(63) Registered Nurse. A person currently
licensed as such by the Tennessee Board of Nursing.
(64) Resident. An individual who has been
diagnosed with symptomatic HIV (human immunodeficiency virus) disease, who has
a physician who acts as the primary care provider, and who has voluntarily
requested admission to, and been accepted by a licensed residential
(65) Resident File.
Medical histories, records, reports, clinical notes, summaries, diagnoses,
prognoses, records of treatment and medication ordered and given, entries, and
other written electronics, or graphic data prepared, kept, made or maintained
in the facility that pertains to confinement or services rendered to
Therapist. A person currently licensed as such by the Tennessee Board of
Therapy Technician. A person currently licensed as such by the Tennessee Board
of Respiratory Care.
Care. A short-term period of inpatient care provided to a hospice patient only
when necessary to relieve the family members or other persons caring for the
(69) 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.
(71) Social Worker. An individual who has at
least a bachelor's degree from a school accredited or approved by the Council
on Social Work Education and has one (1) year of social work experience in a
health care setting.
Work Assistant. A person who has a baccalaureate degree in social work,
psychology, sociology, or other field related to social work, and has at least
one (1) year of social work experience in a health care setting. Social work
related fields include bachelor/masters degrees in psychology, sociology, human
services (behavioral sciences, not human resources), masters degree in
counseling fields (psychological guidance and guidance counseling) and degrees
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
(74) Spiritual Counselor.
A person who has met the requirements of a religious organization to serve the
constituency of that organization.
(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 States.
(76) Student. A person currently enrolled in
an accredited course of study that is approved by the appropriate licensing
board or equivalent body.
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 care.
Supervision. Authoritative procedural guidance by a qualified person for the
accomplishment of a function or activity with initial direction and periodic
inspection of the actual act of accomplishing the function or activity.
Periodic supervision must be provided if the person is not a licensed or
certified assistant, unless otherwise provided in accordance with these
(79) Surrogate. An
individual, other than a resident's agent or guardian, authorized to make a
health care decision for the resident.
(80) Terminally ill. An individual with a
medical prognosis that his or her life expectancy is six (6) months or less if
the illness runs its normal course.
(81) Transfer. The movement of a resident at
the direction of a physician or other qualified or certified professionals when
a physician is not readily available, but does not include such movement of a
resident who leaves the facility against medical advice.
(82) Treating Health Care Provider. A health
care provider who at the time is directly or indirectly involved in providing
health care to the resident.
Volunteer. An individual who agrees to provide services to a resident, staff,
significant other and/or family member(s), without monetary compensation, with
appropriate supervision by the facility.