• DEFINITIONS: For the purposes of these regulations, the following definitions apply:

Abuse means any knowing, intentional or negligent act or omission on the part of a person which results in physical, sexual, verbal, or mental abuse, unreasonable confinement, cruel punishment, exploitation, or denial of essential care, treatment, and services to a resident.

Activities of daily living. (See definition of Care.)

Adjoining means located to allow access without having to enter a general corridor area used or observed by other facility occupants.

Administrator means the operating officer of an assisted-living facility and includes a person with a title such as administrator, chief executive officer, manager, superintendent, director, or other similar designation.

Apartment means portion of a building that contains living and sleeping areas, storage room(s), separate room(s) containing a toilet, lavatory, and bathtub or shower; and a kitchen area with a sink and cooking and refrigeration appliances.

Applicant means the individual, government, corporation, partnership, limited liability company, or other form of business organization who applies for a license.

Assisted-living facility means a facility where shelter, food, and care are provided for remuneration for a period of more than 24 consecutive hours to four or more persons residing at such facility who require or request such services due to age, illness, or physical disability.

This definition does not include a home, apartment or facility where:

  1. Casual care is provided at irregular intervals, or
  2. A competent person residing in such home, apartment or facility provides for or contracts for his or her own personal or professional services if no more than 25% of persons residing in such home, apartment, or facility receive such

 

Authorized representative means:

  1. A person holding a durable power of attorney for health care;
  2. A guardian; or
  3. A person appointed by a court to manage the personal affairs of a resident of an assisted-living facility other than the facility. (See definition of Power of Attorney for Health )

 

Bed capacity means the total number of beds which can be set up in an assisted-living facility for use by residents.

Biological means any virus, therapeutic serum, toxin, antitoxin, or analogous product applicable to the prevention, treatment, or cure of disease or injuries of humans.

Care means the exercise of concern or responsibility for the comfort, welfare, and habilitation of persons, including a minimum amount of supervision and assistance with or the provision of personal care, activities of daily living, health maintenance activities, or other supportive services. For purposes of this chapter:

  1. Activities of daily living means transfer, ambulation, exercise, toileting, eating, self- administration of medication, and similar activities;
  2. Health maintenance activities means noncomplex interventions which can safely be performed according to exact direction, which do not require alteration of the standard procedure, and for which the results and resident responses are predictable; and
  3. Personal care means bathing, hair care, nail care, shaving, dressing, oral care, and similar

 

Chemical restraint means a psychopharmacologic drug that is used for discipline or convenience and is not required to treat medical symptoms.

Complaint means an expression of a concern or dissatisfaction.

Completed application means an application that contains all the information specified in 175 NAC 4-003 and includes all required attachments and documentation and the licensure fee.

Complex nursing interventions means interventions which require nursing judgment to safely alter standard procedures in accordance with the needs of the resident, which require nursing judgment to determine how to proceed from one step to the next, or which require a multidimensional application of the nursing process. Complex nursing interventions does not include a nursing assessment.

Department means the Department of Health and Human Services Regulation and Licensure.

Device means an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including any component, part, or accessory, which is prescribed by a medical practitioner and dispensed by a pharmacist or other person authorized by law to do so.

Direct care staff means staff who provide assistance with activities of daily living, health maintenance activities, and personal care and does not include housekeeping, maintenance, dietary, laundry, administrative or clerical staff if they do not provide any of the above mentioned assistance.

Direction and monitoring means for the purpose of medication administration, the acceptance of responsibility for observing and taking appropriate action regarding any desired effects, side effects, interactions, and contraindications associated with the medication. Direction and monitoring can be done by a:

  1. Competent individual for himself or herself,
  2. Caretaker; or
  3. Licensed health care

 

Director means the Director of Regulation and Licensure.

Drug means substances as defined in Neb. Rev. Stat. § 71-1,142.

Dwelling means a building that contains living and sleeping areas, storage room(s), separate room(s) containing a toilet, lavatory, and bathtub or shower; and a kitchen area with a sink and cooking and refrigeration appliances.

Existing facility means a licensed health care facility or a facility whose construction or remodeling plans were approved by the Department prior to the effective date of 175 NAC 4.

Facility means an assisted-living facility as defined.

Five rights means getting the right drug to the right recipient in the right dosage by the right route at the right time.

Food code means the Nebraska Food Code as defined in Neb. Rev. Stat. § 81-2,244.01 and as published by the Nebraska Department of Agriculture, except for compliance and enforcement provisions.

Foreign when applied to corporations means all those created by authority other than that of the State of Nebraska.

Grievance means a written expression of dissatisfaction which may or may not be the result of an unresolved complaint.

Health care facility means an ambulatory surgical center, an assisted-living facility, a center or group home for the developmentally disabled, a critical access hospital, a general acute hospital, a health clinic, a hospital, an intermediate care facility, an intermediate care facility for the mentally retarded, a long-term care hospital, a mental health center, a nursing facility, a pharmacy, a psychiatric or mental hospital, a public health clinic, a rehabilitation hospital, a skilled nursing facility, or a substance abuse treatment center.

Health care service means an adult day service, a home health agency, a hospice or hospice service, or a respite care service.

Health maintenance activities (see definition of Care).

Licensed health care professional means an individual for whom administration of medication is included in the scope of practice.

Licensee means the individual, government, corporation, partnership, limited liability company, or other form of business organization to whom the license is issued. The licensee has the primary responsibility for the overall operation of the assisted-living facility.

Medical practitioner means any licensed physician, osteopathic physician, dentist, podiatrist, optometrist, chiropractor, physician assistant, certified registered nurse anesthetist, advanced practice registered nurse, or certified nurse midwife.

Medication means any prescription or nonprescription drug intended for treatment or prevention of disease or to affect body function in humans.

Medication administration includes, but is not limited to:

  1. Providing medications for another person according to the five rights;
  2. Recording medication provision; and
  3. Observing, monitoring, reporting, and otherwise taking appropriate actions regarding desired effects, side effects, interactions, and contraindications associated with the medication.

 

Medication aide means an individual who is listed on the medication aide registry operated by the Department as provided for in 172 NAC 95 and 172 NAC 96.

Medication provision means the component of the administration of medication that includes giving or applying a dose of a medication to an individual and includes helping an individual in giving or applying such medication to himself or herself.

Mental abuse means humiliation, harassment, threats of punishment, deprivation, or other actions causing mental anguish.

Misappropriation of money or property means the deliberate misplacement, exploitation, or use of a resident’s belongings or money without the resident’s consent.

NAC means Nebraska Administrative Code.

Neglect means a failure to provide goods or services necessary to avoid physical harm or mental anguish of a resident.

New construction means a facility or a distinct part of a facility in which care and treatment is to be provided and which is enlarged, remodeled or altered in any fashion or is built from the  ground up on or after the effective date of 175 NAC 4.

New facility means a facility or a distinct part of a facility in which care and treatment is to be provided and which is not currently licensed. New facility also includes those facilities, which were previously licensed for care and treatment in another licensure category, and which now intend to seek licensure in a different category.

Personal care (See definition of Care.)

Physical abuse means hitting, slapping, pinching, kicking, or other actions causing injury to the body.

Physical restraint means any manual method or physical or mechanical device, material, or equipment attached or adjacent to the resident’s body that he or she cannot remove easily and that restricts freedom of movement or normal access to his or her own body.

Power of attorney for health care means a power of attorney executed in accordance with Neb. Rev. Stat. §§ 30-3401 to 30-3432 which authorizes a designated attorney in fact to make health care decisions for the principal when the principal is incapable. A person holding the power of attorney for health care can make health care decisions to the extent allowed by the terms of the health care power of attorney.

Premises means a facility, the facility’s grounds and each building or grounds on contiguous property used for administering and operating a facility.

PRN means an administration scheme, in which a medication is not routine, is taken as needed and requires assessment for need and effectiveness.

Qualified inspector means a professional architect or engineer licensed to practice in Nebraska, an official or employee of a local jurisdiction authorized by that jurisdiction to make inspections of particular building equipment or systems, or an individual certified by a nationally recognized organization to make such inspections.

Resident means a person residing and receiving care at an assisted-living facility.

Schematic plans means a diagram of the facility or service which describes the number and location of beds; the location of care and treatment rooms, Life Safety Code construction and occupancy classifications locations, fire compartments, and Fire Marshal approved points of safety.

Sexual abuse means sexual harassment, sexual coercion, or sexual assault. Shelter means to provide lodging for compensation.

Stable or predictable means that a resident’s clinical and behavioral status and nursing care needs are determined to be nonfluctuating and consistent or fluctuating in an expected manner with planned interventions, including an expected deteriorating condition.

Supplement means a product meant to satisfy dietary needs.

Supportive services means those services which support personal care, provision  of medications, activities of daily living and health maintenance activities.

Treatment means a therapy, modality, product, device, or other intervention used to maintain well being or to diagnose, assess, alleviate, or prevent a disability, injury, illness, disease, or other similar condition.

Unlicensed direct care staff means personnel who are not licensed or certified under the Uniform Licensing Law or other state laws governing the practice of health care and whose primary responsibility is to manage, supervise, and/or provide direct care to residents. Unlicensed direct care staff includes nursing assistants, medication aides, and other personnel with this responsibility and with job titles designated by the facility.

Verbal abuse means the use of oral, written or gestured language including disparaging and derogatory terms to residents or within their hearing distance.

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