N.H. Code Admin. R. He-E 807.01

Current through Register No. 25, June 20, 2024
Section He-E 807.01 - Definitions
(a) "Centers for medicare and medicaid services (CMS) " means the federal agency which oversees the medicare and medicaid programs administered by each state and territory of the United States.
(b) "Civil money penalty" (CMP) means a monetary penalty that is imposed on a nursing facility that is not in substantial compliance with the conditions of participation in the medicaid program in accordance with 42 CFR 488, Subpart F.
(c) "Deficiency" means the nursing facility's failure to meet the requirements of participation in the medicaid program as specified in 42 CFR 483 Subpart B, in regard to one or more of the nursing facility's residents.
(d) "Harm" means an observable situation which includes the physical, mental or emotional injury to a resident of a nursing facility, or the limitation of a resident's highest practicable physical, mental or emotional well being.
(e) "Immediate family" means husband, wife, natural or adoptive parent, child or sibling, stepparent, stepchild, stepbrother or stepsister, father-in-law, mother-in-law, son-in-law, daughter-in-law, grandparent, or grandchild.
(f) "Immediate jeopardy" means a situation in which the facility's noncompliance with one or more of the requirements of participation in the medicaid program has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident in accordance with 42 CFR 489.3.
(g) "New admission" means a resident of a nursing facility who was not previously admitted to the facility or a former resident of the facility who was transferred or discharged from the facility in accordance with He-E 802.
(h) "Non-compliance" means a situation in which the facility's deficiencies found as a result of a survey, are of such character as to substantially limit the facility's capacity to furnish adequate care or which adversely affect the health and safety of patients residing in the facility.
(i) "Nursing facility (NF) " means an institution, or a distinct part of an institution, which provides skilled nursing care, rehabilitation services or health-related care and services as defined in 42 U.S.C. 1396 r(a) .
(j) "Plan of correction (POC) " means a plan developed by the NF and approved by the survey agency, which describes the actions the facility will take to correct deficiencies and specifies the date by which those deficiencies will be corrected.
(k) "Remedy" means the termination of a NF's provider agreement or an alternative remedy specified in 42 CFR 488.303(d) or (e) that is imposed when a facility is noncompliant with the requirements of the medicaid program.
(l) "State medicaid agency" means the division within the department of health and human services which administers the medicaid program in NFs and has responsibility to enforce remedies on NFs in accordance with 42 CFR 488.400 - 42 CFR 488.456.
(m) "State monitoring" means supervision of a facility by the survey agency for adherence to a POC in accordance with 42 CFR 488.422.
(n) "Substandard quality of care" means that a NF has one or more deficiencies related to the following:
(1) Resident behavior and facility practices pursuant to 42 CFR 483.13;
(2) Quality of life pursuant to 42 CFR 483.15; or
(3) Quality of care pursuant to 42 CFR 483.25.
(o) "Substantial compliance" means a level of compliance with the requirements of participation in medicaid such that any identified deficiencies pose no greater risk to resident health or safety than the potential for causing minimal harm in accordance with 42 CFR 488.30.
(p) "Survey agency" means the division within the department of health and human services which conducts surveys of NFs for compliance with medicaid.
(q) "Temporary management" means the temporary appointment of a substitute facility manager or administrator with the authority to hire, terminate or reassign staff, obligate facility funds, alter facility procedures, and manage the facility to correct deficiencies identified by the survey agency.
(r) "Widespread" means when the conditions causing a deficiency are so pervasive that the deficiency can be found throughout the facility, or represents a systemic failure that has affected, or has the potential to affect, a large portion or all of the residents in the facility.

N.H. Code Admin. R. He-E 807.01

#8177, eff 9-23-04