Haw. Code R. § 11-94.2-2

Current through November, 2024
Section 11-94.2-2 - Definitions

As used in this chapter:

"Activities professional" or "qualified therapeutic recreational specialist" means:

(1) A qualified professional who has two years of experience in a social or recreational program within the last five years, one of which was full-time in a resident activities program in a health care setting;

(2) An occupational therapist or occupational therapy assistant;

(3) A person who has completed a training course approved by the department; or

(4) A person who is eligible for certification as a therapeutic recreation specialist or as an activities professional by a recognized accrediting body on or after October 1, 1990.

"Advanced directive" means a written or oral declaration made by a competent adult, instructing his or her physician to provide, withhold, or withdraw life-sustaining procedures under certain conditions such as a terminal condition or where the resident has a permanent loss of ability to communicate with others due to irreversible brain injury or coma. (An advanced directive is often referred to as an advanced health care directive or as a living will.)

"Advanced practice registered nurse" or "APRN" means a registered nurse who is licensed pursuant to chapter 457, HRS.

"Bed hold policy" means a written policy that specifies legal readmission rights of a resident who transfers from the facility for a hospitalization or therapeutic leave and a payment schedule to hold the bed during that resident's absence.

"Certified nursing assistant" or "CNA" or "nurse aide" means a person who is currently certified as a nurse aide pursuant to chapter 457A, HRS.

"Comprehensive assessment" means an evaluation completed by the interdisciplinary team to identify a resident's functional capacity, including the resident's strengths, preferences, and needs in the areas including but not limited to activities of daily living (ADLs), cognition, continence, mood, behavior, nutritional status, communication, vision, and psychosocial well-being.

"Controlled drugs" means drugs listed as being subject to high incidences of abuse as defined in chapter 329, HRS.

"Dental services" means an annual inspection of the oral cavity for signs of disease, diagnosis of dental disease, dental radiographs as needed, dental cleaning, fillings (new and repairs), minor dental plate adjustments, smoothing of broken teeth, and limited prosthodontic procedures, e.g., taking impressions for dentures and fitting dentures.

"Dentist" means any person holding a valid license to practice dentistry, pursuant to chapter 448, HRS.

"Department" means the department of health. State of Hawaii.

"Dietary manager" means:

(1) A dietitian who meets the requirements of section 448B-5, HRS;

(2) A graduate of a dietetic technician training program approved by the American Dietetic Association;

(3) An individual certified by the Certifying Board for Dietary Managers of the Dietary Managers Association; or

(4) An individual who has successfully completed an approved course curriculum in any of the following, and has taken annual continuing education credits to keep up with current food service trends and practices, as set forth by the Dietary Managers Association:

(A) State approved course that includes at least ninety or more hours of classroom or correspondence instruction, plus two years of work experience of which at minimum, nineteen months were at the managerial level and the remainder as a nutritionist;

(B) A two- or four-year college degree in food service management and nutrition; or

(C) A United States military training program in food service management with the attainment of a grade of E-5 or its equivalent according to the brand of service.

"Dietitian" means a person who:

(1) Is registered by the Commission on Dietetics Registration; or

(2) Is eligible for such registration.

"Director of health" or "director" means the director of the department of health. State of Hawaii, or the director's designee.

"Discharge" means movement of a resident from a facility to the resident's home or other location in the community, when return to the facility is not expected or planned.

"Disinfect" means to render inactive virtually all recognizable pathogenic microorganisms but not necessarily all microbial forms, e.g., bacterial endospores.

"Drug administration" means the act in which a single dose of a prescribed drug or biological substance is given to a resident by an authorized person in accordance with all existing laws and rules governing those acts.

"Drug dispensing" means the furnishing of drugs pursuant to a prescription in a suitable container, appropriately labeled for subsequent administration to or use by a resident or other individual entitled to receive the drug.

"Emergency dental service" includes dental services to control bleeding, relieve pain, eliminate acute infection, and treatment of injuries to the teeth or supporting structures, and other medically urgent dental services.

"Evacuation capacity designation" means the designation determined by the current county building and fire codes that indicates whether the physical structure of the facility is safe for residents to remain in the building, or whether they must be evacuated from a facility in an emergency or disaster.

"Governing body" means the policy-making group authority that exercises general direction or fiduciary responsibilities over the affairs of a facility and establishes policies concerning its operation and the welfare of the residents the facility serves.

"Infectious waste" or "regulated waste" or "medical waste" or "pathological waste" means any waste that may contain pathogens capable of causing an infectious disease and shall include but is not limited to wastes categorized in section 11-104.1-4.

"Interdisciplinary" means the integration of two or more professional disciplines working together to provide the greatest benefit to the resident.

"Legal guardian" means a person who has the legal authority (and the corresponding duty) to care for the personal or property interests, or both, of another person, referred to as a ward.

"Licensed practical nurse" or "LPN" means a person who is licensed as a practical nurse pursuant to chapter 457, HRS.

"Licensed social worker" or 'social worker" or "LSW" means a person who is licensed to practice social work pursuant to chapter 467E, HRS.

"Nursing facility" means a skilled nursing facility or 'SNF", intermediate care facility or "ICF", or a skilled nursing and intermediate care facility or 'SNF/ICF".

(1) "Intermediate care facility" means a health facility to which a physician has referred individuals who do not need twenty-four hour a day skilled nursing care but who do require the following services for appropriate care;

(A) Twenty-four hours a day assistance with the normal activities of daily living; and

(B) Care provided by licensed nursing and paramedical personnel on a regular, long-term basis.

(2) "Skilled nursing facility" means a health facility that provides skilled nursing and related services to residents who require twenty-four hour a day medical or nursing care, or rehabilitation services, including but not limited to physical therapy, occupational therapy, and speech therapy services.

"Nursing home administrator" means a person licensed pursuant to chapter 457B, HRS.

"Nursing plan of care" means an individualized treatment plan developed at the time of admission, based on the initial nursing assessment of the resident in conjunction with the physician's admission physical examination and initial orders.

"Occupational therapist" means a person licensed pursuant to chapter 457G, HRS.

"Occupational therapy assistant" means a person who is currently certified or eligible for certification by the National Board for Certification in occupational therapy.

"Overall plan of care" means an integrated plan of care that includes the interventions and care or services to be provided by nurses, social workers, rehabilitative therapists, physicians, APRNs, physician assistants, dietitians and other professionals as determined by a comprehensive assessment. The overall plan of care shall have measurable goals and objectives with specific timelines directed to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being. The plan shall also include appropriate discharge planning.

"Performance improvement" or "PI" means the continuous study and improvement of processes with the intent to improve services or outcomes, and prevent or decrease the likelihood of problems, by identifying opportunities for improvement, and testing new approaches to fix underlying causes of persistent or systemic problems or barriers to improvement. PI aims to improve facility processes involved in care delivery and enhanced resident quality of life.

"Pharmacist" means a person who is licensed as a registered pharmacist pursuant to chapter 461, HRS.

"Physical therapist" means a person who is licensed as a physical therapist pursuant to chapter 461J, HRS.

"Physical therapy assistant" means a person who has graduated from a two-year college-level program approved by the Section on Education of the American Physical Therapy Association.

"Physician" means a person who is licensed to practice medicine or osteopathy pursuant to chapter 453, HRS.

"Physician assistant" means a person who is licensed pursuant to chapter 453, HRS.

"Plan of correction" means a plan developed by the facility that includes actions that will be taken to address deficiencies cited or detected by the department pursuant to a survey, inspection, or complaint investigation that shall include preventive measures to ensure compliance with this chapter and chapter 321, HRS, and the timeframe in which these corrections shall take place.

"Quality assurance" or "QA" means the specification of standards for quality of care, service and outcomes, and systems throughout the facility for assuring that care is maintained at acceptable levels in relation to those standards. QA is on-going and both anticipatory and retrospective in its efforts to identify how the facility is performing, including where and why facility performance is at risk or has failed to meet standards.

"Quality assurance and performance improvement" or "QAPI" means the coordinated application of mutually-reinforcing aspects of quality management that takes a systematic, interdisciplinary, comprehensive, and data-driven approach to maintaining and improving safety and quality.

"Registered health information administrator" or "RHIA" means a person who successfully passed a national qualifying examination offered by the American Health Information Management Association and is currently certified by the association as a RHIA.

"Registered health information technician" or "RHIT" means a person who successfully passed a national qualifying examination offered by the American Health Information Management Association and is currently certified by the association as a RHIT.

"Registered nurse" or "RN" means a person who is licensed as a registered nurse pursuant to chapter 457, HRS.

"Rehabilitative plan of care" means a treatment plan based on the attending physician's, physician assistant's, or APRN's orders and assessment of a resident's needs in regard to specialized rehabilitative procedures.

"Reputable and responsible character" means the character of an individual who has not been:

(1) Convicted of a relevant crime as defined in section 321-15.2(a), HRS; or

(2) Confirmed by the State as a perpetrator of adult or child abuse, neglect, financial exploitation, or domestic violence.

"Social work plan of care" means a plan of services based on an assessment completed by the social worker or designee to address social, behavioral, or treatment interventions required to assist the resident to maintain his or her highest practicable physical, mental, or psychosocial wellbeing, with plans for appropriate and timely discharge as practical.

"Social worker designee" means a person who is supervised by a licensed social worker.

"Special diet" or "therapeutic diet" means a diet ordered by a physician or APRN that is prescribed as part of the medical nutrition therapy of a nursing facility resident.

"Speech pathologist" or 'speech therapist" or "audiologist" means a person who is licensed pursuant to chapter 468E, HRS, and:

(1) Is eligible for a certificate of clinical competence granted by the American Speech-Language-Hearing Association in speech therapy, pathology, or audiology; or

(2) Meets the educational requirements for certification and is in the process of accumulating the supervised experience required to take the examination for certification.

"Statement of deficiencies" means a listing of citations given to the facility that describes the extent to which the facility is not compliant with the requirements of this chapter, and that is issued to the facility at the completion of a survey or licensing inspection or complaint investigation.

"Surrogate" means an individual other than the nursing facility's agent or legal guardian who is authorized under chapter 327E, HRS, to make a healthcare decision for the resident.

"Transfer" means the movement of a resident from one facility to another facility for continued care regardless of whether the resident is expected or planned to return to the original facility. It does not refer to movement between beds within the same licensed facility.

"Waiver" means an exemption to a rule.

Haw. Code R. § 11-94.2-2

[Eff 9/16/2022] (Auth: HRS §§ 321-9, 321-11) (Imp: HRS §§ 321-9, 321-11)