Md. Code Regs. 10.07.09.02 - Definitions
A. In this chapter,
the following terms have the meanings indicated.
B. Terms Defined.
(1) Abuse of a Resident.
(a) "Abuse of a resident" means:
(i) The nontherapeutic infliction upon a
resident of physical pain or injury, for example, striking a resident;
or
(ii) A persistent course of
conduct intended to produce, or resulting in, mental or emotional distress to a
resident, for example, verbal intimidation of a resident.
(b) "Abuse of a resident" does not mean the
performance of an accepted medical procedure ordered by a physician or
administered by another licensed health care professional practicing within the
scope of the physician's or health care professional's license.
(2) "Abuse of funds" means the
misappropriation of a resident's assets or income. Misappropriation includes
spending the resident's assets or income:
(a)
Against or without the resident's consent, or, if the resident is incapable of
giving consent and has no agent with authority to give consent, when the
expenditure is not necessary for the direct and immediate benefit and welfare
of the resident; or
(b) For the use
and benefit of a person other than the resident, if the resident or agent has
not consented to the expense.
(3) "Agent" means a person who manages, uses,
or controls the funds or assets that legally may be used to pay an applicant's
or resident's share of costs or other charges for the facility's
services.
(4) "Certified" means the
designation attached to a nursing facility that has met the requirements for
participation as a skilled nursing facility in the Medicare Program or as a
nursing facility in the Medicaid Program.
(4-1) "Change in condition" means a significant change in the resident's physical, mental, or psychological status including, but not limited to:
(a) Life-threatening
conditions such as heart attack or stroke;
(b) Clinical complications such as the:
(i) Development of a pressure sore;
(ii) Onset or recurrent periods of
delirium;
(iii) Onset of recurrent
urinary tract infection;
(iv) Onset
of depression; and
(v) Onset of
aggressive or inappropriate behavior;
(c) The need to discontinue a medication or
treatment because of:
(i) Adverse
consequences; or
(ii) The need to
begin a new form of treatment;
(d) Evaluation at or admission to a hospital;
or
(e) Accidents that result in
injury having the potential for requiring a physician's intervention.
(5) "Chemical restraint" means use
of a psychopharmacologic drug to control behavior and not otherwise required to
treat medical symptoms.
(6)
"Comprehensive care facility" means a nursing facility that admits residents
suffering from disease or disabilities or advanced age, who require medical and
nursing services rendered by or under the supervision of a registered
nurse.
(7) "Consent" means an
express agreement by a resident who is capable of making an informed decision
or, in cases when the resident is not capable, by the resident's
representative.
(8) "Department"
means the Department of Health and Mental Hygiene.
(9) "Director" means the Director of the
Office on Aging.
(10) "Disabled
resident" means a nursing facility resident who lacks sufficient understanding
or capacity to make or communicate a responsible or informed decision on health
care or personal finances because of a physical or mental disability, or
because of substance abuse.
(11)
"Discharge" means the:
(a) Removal of a
resident from a nursing facility when the releasing nursing facility is no
longer responsible for the resident's care;
(b) Movement of a resident from a certified
bed to a noncertified bed;
(c)
Movement of a resident from a skilled nursing facility bed under the Medicare
Program to a bed not certified under that Program; or
(d) Movement of a resident from a bed
certified only for Medicaid to a distinct part of the facility that is a
skilled nursing facility under the Medicare Program.
(12) "Emergency" means a situation in which
the life, health, or safety of an individual is in imminent and serious
jeopardy.
(13) "Extended care
facility" means a nursing facility that:
(a)
Provides treatment services for residents requiring inpatient care but who do
not currently require continuous hospital services; and
(b) Admits residents who:
(i) Require extensive restorative or
rehabilitative services, or
(ii)
Have a terminal disease requiring extensive nursing care.
(14) Involuntary Transfer or
Discharge.
(a) "Involuntary transfer or
discharge" means a transfer or discharge of a resident that is initiated by a
nursing facility without the consent of the resident or, when applicable, the
resident's representative.
(b)
"Involuntary discharge" includes a discharge as described in Regulation .12E of
this chapter.
(15)
"Licensee" means a person licensed by the Department to operate a comprehensive
care facility or an extended care facility.
(16) "Licensing and Certification
Administration" means the survey and licensing agency, a unit of the Department
of Health and Mental Hygiene.
(17)
"Neglect" means failure to provide goods and services necessary to avoid
physical harm, mental anguish, or mental illness.
(18) "Nursing facility" means a comprehensive
care or extended care facility.
(19) "Office" means the Office on
Aging.
(20) "Physical restraint"
means a device, including material or equipment, attached or adjacent to a
resident's body, that the resident cannot remove easily and that restricts the
resident's freedom of movement.
(21) Private Pay.
(a) "Private pay" means a nursing facility's
acceptance of payment from a source other than the Medical Assistance
Program.
(b) "Private pay" includes
reimbursement by the Medicare Program or other third-party insurer.
(22) Relocation.
(a) "Relocation" means the movement of a
resident from one room to another within:
(i)
The same Medicare-certified facility;
(ii) A Medicaid-only certified nursing
facility; or
(iii) A licensed-only
nursing facility.
(b)
"Relocation" does not mean the movement of a resident if the effect of the
movement is to move the resident from:
(i) The
distinct part of the nursing facility that is a skilled nursing facility to a
distinct part of the nursing facility that is not a skilled nursing facility;
or
(ii) A bed that is certified for
Medicaid to a distinct part of the nursing facility that is a skilled nursing
facility.
(23) "Representative" means a person
referenced in Regulation .03 of this chapter.
(24) "Resident" means an individual who is
admitted or remains in residence for overnight care in a nursing
facility.
(25) "Resident funds"
means the assets and income of a resident or nursing home applicant that are
under the use, ownership, management, or control of the resident or resident's
agent.
(26) "Residents' Bill of
Rights" means the statement of basic rights of each resident of a nursing
facility as set forth in:
(a) Health-General
Article, §§19-343 -19-347 and 19-349-19-352, Annotated Code of
Maryland;
(b) Title XIX of the
Social Security Act, 42
U.S.C. §
1396(5)(c);
(c)
42 CFR §
483.10 et seq.; and
(d) The regulations in this
chapter.
(27) "Transfer"
has the meaning as described in §B(11) of this regulation.
Notes
Regulations .02 under COMAR 10.07.09 Patients' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities repealed and new Regulations .02 under COMAR 10.07.09 Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities adopted effective April 22, 1996 (23:8 Md. R. 605)
Regulation .02K adopted effective August 30, 1982 (9:17 Md. R. 1708)
Regulation .02B amended effective January 5, 2004 (30:26 Md. R. 1914)
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