Utah Admin. Code R414-501-2 - Definitions
In addition to the definitions in Section R414-1-1, the following definitions apply to Rules R414-501 through R414-503:
(1) "Activities of daily living" are defined
in
42 CFR
483.25(a)(1), and further
includes adaptation to the use of assistive devices and prostheses intended to
provide the greatest degree of independent functioning.
(2) "Categorical determination" means a
determination made pursuant to
42 CFR
483.130 and ATTACHMENT 4.39-A of the State
Plan.
(3) "Code of Federal
Regulations (CFR)" means the most current edition unless otherwise
noted.
(4) "Continued stay review"
means a periodic, supplemental, or interim review of a resident performed by a
Department health care professional either by telephone or on-site
review.
(5) "Discharge planning"
means planning that ensures that the resident has an individualized planned
program of post-discharge continuing care that:
(a) states the medical, functional,
behavioral and social levels necessary for the resident to be discharged to a
less restrictive setting;
(b)
includes the steps needed to move the resident to a less restrictive
setting;
(c) establishes the
feasibility of the resident's achieving the levels necessary for discharge;
and
(d) states the anticipated time
frame for that achievement.
(6) "Health care professional" means a duly
licensed or certified physician, physician assistant, nurse practitioner,
physical therapist, speech therapist, occupational therapist, registered
professional nurse, licensed practical nurse, social worker, or qualified
mental retardation professional.
(7) "Medicaid resident" means a resident who
is a Medicaid recipient.
(8)
"Medicaid admission date" means the date the nursing facility requests Medicaid
reimbursement to begin.
(9) "Mental
retardation" is defined in
42 CFR
483.102(b)(3) and includes
"persons with related conditions" as defined in
42 CFR
435.1009.
(10) "Minimum Data Set (MDS)" means the
standardized, primary screening and assessment tool of health status that forms
the foundation of the comprehensive assessment for all residents in a Medicare
or Medicaid certified long- term care facility.
(11) "Nursing facility" is defined in 42 USC.
1396r(a), and also includes an intermediate care facility for people with
mental retardation as defined in
42 USC
1396 d(d).
(12) "Nursing facility applicant" is an
individual for whom the nursing facility is seeking Medicaid payment.
(13) "Preadmission Screening and Resident
Review (PASRR) Level I Screening" means the preadmission identification
screening described in Section
R414-503-3.
(14) "Preadmission Screening and Resident
Review (PASRR) Level II Evaluation" means the preadmission evaluation and
resident review for serious mental illness or mental retardation described in
Section
R414-503-4.
(15) "Physician Certification" is a written
statement from the Medicaid resident's physician that certifies the individual
requires nursing facility services.
(16) "Resident" means a person residing in a
Medicaid-certified nursing facility.
(17) "Serious mental illness" is defined by
the State Mental Health Authority.
(18) "Significant change" means a major
change in the resident's physical, mental, or psychosocial status that is not
self-limiting, impacts on more than one area of the resident's health status,
and requires interdisciplinary review, revision of the care plan, or may
require a referral to a preadmission screening resident review if a mental
illness or intellectual disability or related condition is suspected or
present.
(19) "Skilled care" means
those services defined in
42
CFR 409.32.
(20) "Specialized rehabilitative services"
means those services provided pursuant to
42 CFR 483.45
and Section
R432-150-23.
(21) "Specialized services" means those
services provided pursuant to
42 CFR
483.120 and ATTACHMENT 4.39 of the State
Plan.
(22) "United States Code
(USC)" means the most current edition unless otherwise noted.
(23) "Working days" means all work days as
defined by the Utah Department of Human Resource Management.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.