| (97) Palliative Plan of Care--Appropriate medical and
nursing care for residents with advanced and progressive diseases
for whom the focus of care is controlling pain and symptoms while
maintaining optimum quality of life.
(98) Patient care-related electrical appliance--An
electrical appliance that is intended to be used for diagnostic, therapeutic,
or monitoring purposes in a patient care area, as defined in Standard
99 of the National Fire Protection Association.
(99) Person--An individual, firm, partnership, corporation,
association, joint stock company, limited partnership, limited liability
company, or any other legal entity, including a legal successor of
those entities.
(100) Person-centered care--To focus on the resident
as the locus of control, and to support the resident in making choices
and having control over the resident's daily life.
(101) Pharmacist--An individual, licensed by the Texas
State Board of Pharmacy to practice pharmacy, who prepares and dispenses
medications prescribed by a practitioner.
(102) Physical restraint--Any manual method, or physical
or mechanical device, material or equipment attached, or adjacent
to the resident's body, that the individual cannot remove easily which
restricts freedom of movement or normal access to one's body. The
term includes a restraint hold.
(103) Physician--A doctor of medicine or osteopathy
currently licensed by the Texas Medical Board to practice medicine.
(104) Physician assistant (PA)--An individual who is
licensed as a physician assistant under Texas Occupations Code, Chapter
204.
(105) Podiatrist--A practitioner whose profession encompasses
the care and treatment of feet who is licensed to practice podiatry
by the Texas State Board of Podiatric Medical Examiners.
(106) Poison--Any substance that federal or state regulations
require the manufacturer to label as a poison and is to be used externally
by the consumer from the original manufacturer's container. Drugs
to be taken internally that contain the manufacturer's poison label,
but are dispensed by a pharmacist only by or on the prescription
order of a practitioner, are not considered a poison, unless regulations
specifically require poison labeling by the pharmacist.
(107) Practitioner--A physician, podiatrist, dentist,
or an advanced practice registered nurse or physician assistant to
whom a physician has delegated authority to sign a prescription order,
when relating to pharmacy services.
(108) Private and unimpeded access--Access to enter
a facility, or communicate with a resident outside of the hearing
or view of others, without interference or obstruction from facility
employees, volunteers, or contractors.
(109) PRN (pro re nata)--As needed.
(110) Provider--The individual or legal business entity
that is contractually responsible for providing Medicaid services
under an agreement with HHSC.
(111) Qualified mental health professional - community
services--Has the meaning given in 25 TAC §412.303 (relating
to Definitions).
(112) Qualified surveyor--An employee of HHSC who has
completed state and federal training on the survey process and passed
a federal standardized exam.
(113) Quality assessment and assurance committee--A
group of health care professionals in a facility who develop and implement
appropriate action to identify and rectify substandard care and deficient
facility practice.
(114) Quality-of-care monitor--A registered nurse,
pharmacist, or dietitian employed by HHSC who is trained and experienced
in long-term care facility regulation, standards of practice in long-term
care, and evaluation of resident care, and functions independently
of HHSC Regulatory Services Division.
(115) Quality measure report--A report that provides
information derived from an MDS that provides a numeric value to quality
indicators. This data is available to the public as part of the Nursing
Home Quality Initiative (NHQI), and is intended to provide objective
measures for consumers to make informed decisions about the quality
of care in a nursing facility.
(116) RAI--Resident Assessment Instrument. An assessment
tool used to conduct comprehensive, accurate, standardized, and reproducible
assessments of each resident's functional capacity as specified by
the Secretary of the U. S. Department of Health and Human Services.
At a minimum, this instrument must consist of the MDS core elements
as specified by CMS; utilization guidelines; and Care Area Assessment
process.
(117) Recipient--Any individual residing in a Medicaid
certified facility or a Medicaid certified distinct part of a facility
whose daily vendor rate is paid by Medicaid.
(118) Rehabilitative services--Rehabilitative therapies
and devices provided to help a person regain, maintain, or prevent
deterioration of a skill or function that has been acquired but then
lost or impaired due to illness, injury, or disabling condition. The
term includes physical and occupational therapy, speech-language
pathology, and psychiatric rehabilitation services.
(119) Representative payee--A person designated by
the Social Security Administration to receive and disburse benefits,
act in the best interest of the beneficiary, and ensure that benefits
will be used according to the beneficiary's needs.
(120) Resident--Any individual residing in a nursing
facility.
(121) Resident group--A group or council of residents
who meet regularly.
(122) Resident representative--
(A) Any of the following:
(i) an individual chosen by the resident to act on
behalf of the resident in order to support the resident in decision-making;
access medical, social, or other personal information of the resident;
manage financial matters; or receive notifications;
(ii) a person authorized by state or federal law (including
agents under power of attorney, representative payees, and other fiduciaries)
to act on behalf of the resident in order to support the resident
in decision-making; access medical, social, or other personal information
of the resident; manage financial matters; or receive notifications;
(iii) legal representative, as used in Section 712
of the Older Americans Act; or
(iv) the court-appointed guardian of a resident.
(B) This definition is not intended to expand the scope
of authority of any resident representative beyond that authority
specifically authorized by the resident, state or federal law, or
a court of competent jurisdiction.
(123) Responsible party--An individual authorized by
the resident to act for him as an official delegate or agent. Responsible
party is usually a family member or relative, but may be a legal guardian
or other individual. Authorization may be in writing or may be given
orally.
(124) Restraint--A chemical or physical restraint.
(125) Restraint hold--
(A) A manual method, except for physical guidance or
prompting of brief duration, used to restrict:
(i) free movement or normal functioning of all or
a portion of a resident's body; or
(ii) normal access by a resident to a portion of the
resident's body.
(B) Physical guidance or prompting of brief duration
becomes a restraint if the resident resists the guidance or prompting.
(126) RN--Registered nurse. An individual currently
licensed by the Texas Board of Nursing as a registered nurse.
(127) RN assessment coordinator--A registered nurse
who signs and certifies a comprehensive assessment of a resident's
needs, using the RAI, including the MDS, as specified by HHSC.
(128) RUG--Resource Utilization Group. A categorization
method, consisting of 34 categories based on the MDS, that is used
to determine a recipient's service and care requirements and to determine
the daily rate HHSC pays a nursing facility for services provided
to the recipient.
(129) Secretary--Secretary of the U.S. Department of
Health and Human Services.
(130) Services required on a regular basis--Services
which are provided at fixed or recurring intervals and are needed
so frequently that it would be impractical to provide the services
in a home or family setting. Services required on a regular basis
include continuous or periodic nursing observation, assessment, and
intervention in all areas of resident care.
(131) SNF--A skilled nursing facility or distinct part
of a facility that participates in the Medicare program. SNF requirements
apply when a certified facility is billing Medicare for a resident's
per diem rate.
(132) Social Security Administration--Federal agency
for administration of social security benefits. Local social security
administration offices take applications for Medicare, assist beneficiaries
file claims, and provide information about the Medicare program.
Cont'd... |
