The following words and terms when used in these
regulations shall have the following meaning unless the context clearly
indicates otherwise.
"Activities of daily living" means bathing, dressing,
toileting, transferring, bowel control, bladder control and
eating/feeding.
"Administer" means the direct application of a controlled
substance, whether by injection, inhalation, ingestion, or any other means, to
the body of a patient by (i) a practitioner or by his authorized agent and
under his supervision or (ii) the patient at the direction and in the presence
of the practitioner as defined in §
54.1-3401 of the Code
of Virginia.
"Administrator" means a person designated, in writing, by
the governing body as having the necessary authority for the day-to-day
management of the hospice program. The administrator must be a member of the
hospice staff. The administrator, director of nursing, or another clinical
director may be the same individual if that individual is dually
qualified.
"Adverse outcome" means the result of drug or health care
therapy that is neither intended nor expected in normal therapeutic use and
that causes significant, sometimes life-threatening conditions or consequences
at some future time. Such potential future adverse outcome may require the
arrangement of appropriate follow-up surveillance and perhaps other departures
from the usual plan of care.
"Attending physician" means a physician licensed in
Virginia, according to Chapter 29 (§
54.1-2900 et seq.) of
Title 54.1 of the Code of Virginia, or licensed in an adjacent state and
identified by the patient as having the primary responsibility in determining
the delivery of the patient's medical care. The responsibilities of physicians
contained in this chapter may be implemented by nurse practitioners or
physician assistants as assigned by the supervising physician and within the
parameters of professional licensing.
"Available at all times during operating hours" means an
individual is available on the premises or by telecommunications.
"Barrier crimes" means certain offenses specified in §
32.1-162.9:1
of the Code of Virginia that automatically bar an individual convicted of those
offenses from employment with a hospice program.
"Bereavement service" means bereavement counseling as
defined in
42
CFR 418.3.
"Cannabidiol oil" means the same as that term is defined in
subsection A of §
54.1-3408.3
of the Code of Virginia.
"Commissioner" means the State Health Commissioner.
"Coordinated program" means a continuum of palliative and
supportive care provided to a terminally ill patient and the patient's family,
24 hours a day, seven days a week.
"Core services" means those services that must be provided
by a hospice program. Such services are: (i) nursing services, (ii) physician
services, (iii) counseling services, and (iv) medical social services.
"Counseling services" means the provision of bereavement
services, dietary services, spiritual and any other counseling services for the
patient and family while the person is enrolled in the program.
"Criminal record report" means the statement issued by the
Central Criminal Records Exchange, Virginia Department of State Police.
"Designated support person" means a person who is
knowledgeable about the needs of a person with a disability and who is
designated, orally or in writing, by the individual with a disability, the
individual's guardian, or the individual's care provider to provide support and
assistance, including physical assistance, emotional support, assistance with
communication or decision-making, or any other assistance necessary as a result
of the person's disability, to the person with a disability at any time during
which health care services are provided.
"Dispense" means to deliver a drug to the ultimate user by
or pursuant to the lawful order of a practitioner, including the prescribing
and administering, packaging, labeling or compounding necessary to prepare the
substance for that delivery as defined in §
54.1-3401 of the Code
of Virginia.
"Employee" means an individual who is appropriately trained
and performs a specific job function for the hospice program on a full-time or
part-time basis with or without financial compensation.
"Governing body" means the individual, group, or
governmental agency that has legal responsibility and authority over the
operation of the hospice program.
"Home attendant" means a nonlicensed individual performing
personal care and environmental services, under the supervision of the
appropriate health professional, to a patient in the patient's residence. Home
attendants are also known as certified nursing assistants or CNAs, home care
aides, home health aides, and personal care aides.
"Hospice" means a hospice as defined in §
32.1-162.1 of the
Code of Virginia.
"Hospice facility" means an institution, place, or building
as defined in §
32.1-162.1 of the
Code of Virginia.
"Inpatient" means the provision of services, such as food,
laundry, housekeeping, and staff to provide health or health-related services,
including respite and symptom management, to hospice patients, whether in a
hospital, nursing facility, or hospice facility.
"Interdisciplinary group" means the group responsible for
assessing the health care and special needs of the patient and the patient's
family. Providers of special services, such as mental health, pharmacy, and any
other appropriate associated health services may also be included on the team
as the needs of the patient dictate. The interdisciplinary group is often
referred to as the IDG.
"Licensee" means a licensed hospice program
provider.
"Medical director" means a physician currently licensed in
Virginia, according to Chapter 29 (§
54.1-2900 et seq.) of
Title 54.1 of the Code of Virginia, and responsible for the medical direction
of the hospice program.
"Medical record" means a continuous and accurate documented
account of services provided to a patient, including the prescription and
delivery of the treatment or care.
"Medication error" means one or more violations of the five
principles of medication administration: the correct drug to the right patient
at the prescribed time in the prescribed dose via the prescribed route.
"Nursing services" means the patient care performed or
supervised by a registered nurse according to a plan of care.
"OLC" means the Office of Licensure and Certification of
the Virginia Department of Health.
"Operator" means any individual, partnership, association,
trust, corporation, municipality, county, local government agency, or any other
legal or commercial entity responsible for the day-to-day administrative
management and operation of the hospice.
"Palliative care" means treatment directed at controlling
pain, relieving other symptoms, and focusing on the special needs of the
patient and family as they experience the stress of the dying process.
Palliative care means treatment to enhance comfort and improve the quality of a
patient's life during the last phase of his life.
"Patient" means a hospice patient as defined in §
32.1-162.1 of the
Code of Virginia.
"Patient's family" means a hospice patient's family as
defined in §
32.1-162.1 of the
Code of Virginia.
"Patient's residence" means the place where the individual
or patient makes his home.
"Person" means any individual, partnership, association,
trust, corporation, municipality, county, local government agency, or any other
legal or commercial entity that operates a hospice.
"Plan of care" means a written plan of services developed
by the interdisciplinary group to maximize patient comfort by symptom control
to meet the physical, psychosocial, spiritual, and other special needs that are
experienced during the final stages of illness, during dying, and
bereavement.
"Primary caregiver" means an individual that, through
mutual agreement with the patient and the hospice program, assumes
responsibility for the patient's care.
"Progress note" means a documented statement contained in a
patient's medical record, dated and signed by the person delivering the care,
treatment, or service, describing the treatment or services delivered and the
effect of the care, treatment, or services on the patient.
"Quality improvement" means ongoing activities designed to
objectively and systematically evaluate the quality of care and services,
pursue opportunities to improve care and services, and resolve identified
problems. Quality improvement is an approach to the ongoing study and
improvement of the processes of providing services to meet the needs of
patients and their families.
"Separate and distinct entrance" means an entrance to the
hospice facility other than the formal public entrance used by patients and
family members.
"Staff" means an employee who receives financial
compensation.
"Supervision" means the ongoing process of monitoring the
skills, competencies, and performance of the individual supervised and
providing regular face-to-face guidance and instruction.
"Terminally ill" means a medical prognosis that life
expectancy is six months or less if the illness runs its usual course.
"THC-A oil" means the same as that term is defined in
subsection A of §
54.1-3408.3
of the Code of Virginia.
"Volunteer" means an employee who receives no financial
compensation.
