Ga. Comp. R. & Regs. R. 350-3-.01 - Definitions
(1) "Complaint Investigation" means a survey or visit to
determine the validity of allegations of resident abuse, neglect or
misappropriation of resident property, or of other noncompliance with
applicable federal and state requirements.
(2) "Deficiency" means a failure of compliance with a Program
Requirement. The fact that a deficiency no longer exists at the time of the
Survey or complaint investigation which identifies it shall not negate its
status as a deficiency for the purpose of imposing a civil monetary penalty or
requesting a Plan of Correction.
(3) "Finding" means a determination, as the result of a survey
or complaint investigation of the facility, that noncompliance with a Program
Requirement could or should have been prevented or has not yet been identified
by the facility, is not being corrected by proper action by the facility, or
cannot be justified by special circumstances unique to the facility or the
resident.
(4) "Initial finding" means the first time that a deficiency or
deficiencies is recorded by a surveyor as the result of a survey or complaint
investigation. Initial findings may be records of deficiencies that occurred
prior to the date of the survey visit even if the deficiencies no longer exist
at the time of the current survey.
(5) "Monitor" means a person or organization placed in a
facility by the Department or the State Survey Agency for the purpose of
overseeing a facility's correction of deficiencies or to ensure orderly closure
of a facility. A monitor shall have practical long-term care experience related
to the aspect(s) for which the facility is being monitored.
(6) "Nursing Facility" means an institution (or a distinct part
of an institution) which
(a) is primarily engaged in providing to residents
1. skilled nursing care and related services for residents who
require medical or nursing care,
2. rehabilitation services for the rehabilitation of injured,
disabled, or sick persons, or
3. on a regular basis, health-related care and services to
individuals who because of their mental or physical condition require care and
services (above the level of room and board) which can be made available to
them only through institutional facilities, and
(b) is not primarily for the care and treatment of mental
diseases; and
(c) is enrolled as a provider in the Georgia Medical Assistance
program.
(7) "Program Requirement" means any requirement contained in
Subsection 1919(b), (c), or (d) of the Social Security Act of 1935, as amended,
including but not limited to the provisions implemented by the Omnibus Budget
Reconciliation Act of 1987, P.L. 100-203.
(8) "Repeat deficiency" is a deficiency related to resident
care which recurs within eighteen (18) months of its citing in an Initial
Finding, and which is found at a follow-up visit, complaint investigation,
subsequent survey, or otherwise.
(9) "Repeated noncompliance" means a finding of substandard
quality of care on three (3) consecutive annual surveys.
(10) "Resurvey" means a follow-up visit to determine whether
the deficiencies found in a survey or complaint investigation have been
corrected.
(11) "Scope" means the frequency, incidence, or extent of the
occurrence of a deficiency in a facility.
(12) "Severity" is the seriousness of a deficiency, which means
the degree of actual or potential negative impact on a resident (as measured by
negative outcomes or rights violations) or the degree to which his/her highest
practicable physical, mental, or psychosocial well-being has been
compromised.
(13) "State Survey Agency" means the Georgia Department of
Human Resources.
(14) "Subsequent finding" means a violation or deficiency found
on a resurvey. The deficiency must exist at the time of the resurvey or
revisit. If a deficiency cited in an Initial Finding is found upon resurvey or
revisit, a rebuttable presumption arises that the deficiency continued
throughout the period of time between the initial survey or visit and the
resurvey or revisit.
(15) "Substandard quality of care" means a finding by the
Department or the State Survey Agency of one or more deficiencies, the
existence of which limit(s) the facility's ability to deliver adequate care or
services.
(16) "Survey" means a review of a case-mix stratified sample of
nursing facility residents to determine the quality of care furnished as
measured by indicators of medical, nursing, and rehabilitative care, dietary
and nutrition services, activities, and social participation, and sanitation,
infection control, and physical environment. Such survey shall include an exit
interview in which the surveyor and the facility shall attempt to resolve any
conflicts regarding findings by the surveyor(s).
(17) "Surveyor" means a professional authorized by the State
Survey Agency to conduct surveys or complaint investigations to determine
compliance with Program Requirements.
(18) "Termination of the facility's participation" means
exclusion of a facility from participation as a provider under the Georgia
State Plan for Medical Assistance as a result of one or more
deficiencies.
Notes
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