N.M. Code R. § 7.1.23.7

Current through Register Vol. 35, No. 11, June 11, 2024

Section 7.1.23.7 - DEFINITIONS

In addition to the definitions in the Health Information System Act, Section 24-14A-1 et seq. NMSA 1978, the following terms have the following meaning for purposes of this rule:

A. Amount of payment of award means the total dollar amount paid during the reporting period to or on behalf of a participant in a program designated by this rule.

B. Behavioral health or psychiatric beds (as specified by the facility) means the licensed bed capacity, as specified by the state health facility licensing authority, for hospital beds reserved for acute, residential or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted on the basis of an authorized health professional's orders and approved nursing care plans. Long-term care may include intensive supervision to persons with chronic mental illnesses, mental disorders, or other chronic or severe mental disabilities.

C. Current license expiration date means the date on which the current license issued by the state health facility licensing authority expires.

D. Current license issuance date means the date on which the current license was issued by the state health facility licensing authority.

E. Current license number means the number assigned and listed on the licensed document of each health facility licensed by the state health facility licensing authority.

F. Date first licensed in New Mexico means the date that the health care professional was initially licensed to practice in the stated profession at their current professional level in New Mexico.

G. Date of birth means the date of birth of a licensed health care professional or a participant in a state administered program to improve the distribution of health professionals.

H. Date of graduation means the month and the year that the health care professional graduated from the health professional educational institution.

I. Dental care means preventive, restorative and/or emergency services provided by a dental health care professional.

J. Director means the director of the New Mexico health policy commission.

K. Dually certified beds means beds certified by the federal health care finance administration (HCFA) for reimbursement under both medicaid and medicare programs.

L. Emergency care means provision of emergency services, either on site or through stabilization and transport on a regular basis, to meet life, limb or function-threatening conditions.

M. Facility ID means the identification number assigned for internal control to a health facility licensed by the state health facility licensing authority.

N. Facility type means the type of a facility licensed by the state health facility licensing authority or a federal agency, including inpatient, community health or public health, laboratory, etc., as designated by the state health facility licensing authority.

O. Family planning services means provision of contraceptive/birth control and/or infertility treatment, including counseling and education by health professionals.

P. Full time equivalent means the average portion of the amount of time considered normal for working during a week. In general, this means the average number of hours worked weekly by an individual divided by forty; however, the value should not exceed one, regardless of average hours worked.

Q. Gender means the sex of the licensed health care professional.

R. Geographic access data system (GADS) means the data system developed pursuant to the Health Information Systems Act, Section 24-14A-1 et seq. NMSA 1978, to provide data and information to assist the commission, the legislature and other agencies and organizations in planning, formulating policy, administering programs and allocating resources to improve geographic access to health services.

S. Geographic access data system (GADS) data sources means state health professional and facility licensing agencies and boards; licensed outpatient medical facilities; and state entities administering programs to improve the distribution of health professionals.

T. Gynecological services means the provision of diagnostic and treatment services relating to the female reproductive system, including annual pelvic exams and pap smears, follow-up and outpatient treatment of abnormal findings, and diagnosis and treatment of sexually transmitted diseases, but not including family planning services.

U. Health care means any care, treatment, service or procedure to maintain, diagnose or otherwise affect an individual's physical or mental condition.

V. Health care professional means any individual licensed, certified or otherwise authorized or permitted by law to provide health care in the practice of a profession.

W. License employment classification means the employment status of a person licensed by the New Mexico state board of nursing, classified as either:

(1) employed full-time;

(2) employed part-time;

(3) unemployed.

X. License number means the number assigned to a health care professional by a state health care professional licensing board or authority.

Y. License status means the type of health care professional license issued classified as:

(1) active;

(2) inactive

Z. Mailing address means the mailing address, including the street address or post office box number, city, state and zip code of a health facility licensed by the state health facility licensing authority.

AA. Medicaid Title XIX number means the number assigned by medicaid to the health care facility.

BB. Medicare provider certification number means the number assigned by medicare to the health care facility.

CC. Mental health services means a range of services provided by a licensed mental health care professional for the diagnosis and/or treatment of patients with behavioral, emotional or psycho-social disorders.

DD. Name of administering entity means the full name, including the applicable department, board or commission and any applicable divisional or sub-divisional descriptors, of a state agency charged with the day-to-day administration of a program designated by this rule.

EE. Name of administrator means the first name, last name and middle initial of the current administrator of a health facility licensed by the state health facility licensing authority.

FF. Name of health care professional means the first and last names and the middle initial of the health care professional.

GG. Name of hospital or facility means the name listed on the license document of each health facility licensed by the state health facility licensing authority.

HH. Name of program means the full name established by statute or customarily used in budget documents, audits and/or required reports to identify a program designated by this rule.

II. Non-public data means data submitted to the commission by a GADS data source pursuant to this rule that:

(1) has not otherwise been determined by the data source to be public data, or is not considered to be public data in accordance with the Public Records Act, Section 14-3-1 et seq. NMSA 1978 and the Open Meetings Act, Section 10-15-1 et seq. NMSA 1978; and

(2) has been determined by the commission, in consultation with the GADS data source, to be of a confidential or restricted nature.

JJ. Number of dental hygienists means the number of licensed full-time equivalent (FTE) dental hygienists practicing at the facility.

KK. Number of dentists means the number of licensed full-time equivalent (FTE) dentists practicing at the facility.

LL. Number of nurse practitioners means the number of licensed full-time equivalent (FTE) nurse practitioners practicing at the facility.

MM. Number of other advanced practice nurses means the number of full-time equivalent (FTE) nurses with advanced or specialized training, including clinical nurse specialists (CNS) and certified nurse mid-wives (CNM), practicing at the facility.

NN. Number of other nursing staff means the number of other licensed full-time equivalent (FTE) nursing staff, not otherwise reported, including licensed practical nurses (LPN) and certified nursing assistants (CNA) practicing at the facility.

OO. Number of other professional health personnel means the total number of other full-time equivalent (FTE) certified or licensed health professionals, not otherwise reported, providing health care at the facility, including pharmacists, dental assistants, occupational and physical therapists, podiatrists and optometrists. Not included are administrative support personnel, such as receptionists or medical record technicians.

PP. Number of physicians means the number of licensed full time equivalent (FTE) physicians, both allopathic and osteopathic, practicing at the facility.

QQ. Number of physicians' assistants means the number of licensed full-time equivalent (FTE) physicians' assistants practicing at the facility.

RR. Number of registered nurses means the number of licensed full-time equivalent (FTE) registered nurses practicing at the facility.

SS. Nursing facility capacity means the licensed bed capacity, as specified by the state health facility licensing authority, to provide care to patients with a variety of physical conditions or functional disabilities that do not require the care provided by a hospital or a skilled nursing facility, but do need supervision and support services.

TT. Obstetrical care means the provision of the full continuum of services related to pregnancy, delivery and postpartum care, including prenatal care, antepartum fetal assessment, labor and delivery professional care and postpartum care.

UU. Owner(s) of facility means the name of the owner(s) listed on the current license of a health facility licensed by the state health facility licensing.

VV. Pharmaceuticals means on-site dispensing of prescription medication and other pharmaceutical products.

WW. Physical location means the street address, city, county and zip code of the physical location of a health care facility licensed by the state licensing authority.

XX. Physical location of recipient means the primary business location designated by street address, city, county and zip code of an individual or an entity that has received a payment, an award, or service during the reporting period from a program designated by this rule. For licensed health professionals this is the physical location of their primary practice site. For other individuals, such as students, this is the official address recognized by the program designated by this rule.

YY. Practice/business address(es) means the full address, city, county, state and zip code of the principal current practice location of each licensed health professional and any additional practice sites listed; or the official address, city, county, state and zip code as recognized by the health professional licensing board or authority.

ZZ. Prenatal care means a range of services including diagnosis, counseling, treatment and follow-up provided to pregnant women up to the onset of labor.

AAA. Primary care services means services that address the first level of basic or general health care for an individual's health needs.

BBB. Professional degree(s) means the health professional degree awarded as a consequence of completion or graduation from a health professional educational institution.

CCC. Professional educational institution means the name and the city, state and county of the health professional educational institution from which the health care professional graduated.

DDD. Public data means data submitted to the commission by a GADS data source pursuant to this rule that:

(1) has otherwise been determined by the data source to be public data, or is considered to be public data in accordance with the Public Records Act, Section 14-3-1 et seq. NMSA 1978 and the Open Meetings Act, Section 10-15-1 et seq. NMSA 1978; or

(2) has been determined by the commission, in consultation with the GADS data source, to be exempt from the access provisions of 7 NMAC 1.20 [now 7.1.20 NMAC].

EEE. Skilled nursing capacity means the licensed bed capacity, as specified by the state health facility licensing authority, to provide non-acute medical and nursing services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

FFF. Specialties means certain branches or sub-divisions of a health professional discipline relating to specific services, as certified in accordance with standards specified by a board, association or agency recognized as competent within each health professional group in which a health professional is specially trained.

GGG. State general fund funding means the total dollar amount appropriated from the state general fund for the reporting period for activities of a program designated by this rule.

HHH. Status of recipient means the status during the reporting period of any person who has a current service obligation incurred in the course of participation in a program designated by this rule, classified as either:

(1) in service;

(2) cash repayment;

(3) default;

(4) deferred - education/training;

(5) deferred - other;

(6) obligation completed;

(7) obligation resolved in other manner

III. Substance abuse services means a range of services to patients with alcoholism, drug dependency, or other substance abuse disorders. May include screening and diagnosis, detoxification, individual and group counseling, self-help support groups, alcohol and drug education, rehabilitation, remedial education and vocational training services and aftercare.

JJJ. Swing bed capacity means the licensed bed capacity, as specified by the state health facility licensing authority, for hospital or other facility beds which may be used for either skilled nursing care or general medical surgical care according to the presenting needs of the patient population.

KKK. Telephone number of facility means the phone number, including the area code, of a health facility licensed by the state health facility licensing authority.

LLL. Total expenditures by eligible health professional discipline means the total dollar amount directly expended during the reporting period by a program designated by this rule, subtotaled by each health profession approved for participation according to the terms and conditions of the program or administering entity.

MMM. Total licensed bed capacity means the total licensed bed capacity for the facility, as specified by the state health facility licensing authority, for hospital or other facility beds.

NNN. Total number of individuals by eligible health professional discipline means the total number of individuals who participated during the reporting period in a program designated by this rule, subtotaled by each health profession approved for participation according to the terms and conditions of the program or administering entity.

OOO. Total program funding means the total dollar amount during the reporting period available for or allocated to activities, including administration, of a program designated by this rule.

PPP. Twenty four-hour coverage means the provision of health care services on a 24-hour basis , 7 days a week, 365 days a year.

QQQ. Unit of service(s) by health profession means a specific quantifiable measure of impact in terms of outcomes and output mutually agreed upon by the commission and a program designated by this rule, subtotaled by each health profession approved for participation according to the terms and conditions of the program or administering entity.

RRR. Urgent care means provision of health care of an urgent or immediate nature on a routine or regular basis.

SSS. Use of payment means the specific purpose for which a payment or award has been made by a program designated by this rule to a local entity, including community based health facilities or political subdivisions, during the reporting period. Payment purposes are classified as either:

(1) continuing health professional education;

(2) housing;

(3) malpractice insurance;

(4) moving expenses;

(5) practice development and/or maintenance;

(6) professional development education;

(7) retention bonus;

(8) salary and benefits;

(9) other incentives to recruit and/or retain a health professional.

TTT. X-ray diagnostic services means technical services provided on-site through the means of radiological equipment and testing procedures for the purpose of identifying presenting or potential diseases or health risk factors. (Does not include services of a physician to order and/or to analyze/interpret results from these procedures.)

N.M. Code R. § 7.1.23.7

1/1/99; Recompiled 10/31/01