Tenn. Comp. R. & Regs. 0720-38-.01 - DEFINITIONS

(1) "Abuse" means the willful infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain or mental anguish.

(2) "Activities of Daily Living (ADL's)" means those activities which indicate a resident' s independence in eating, dressing, personal hygiene, bathing, toileting, ambulating, and medication management.

(3) "Adequate evacuation" means the ability of the TBI residential home provider or the Administrator, including such additional minimum staff as may be required by the Board in regulation, to evacuate all residents from the dwelling within five (5) minutes.

(4) "Administering medication" means the direct application of a single dose of a medication to the body of a resident by injection, inhalation, ingestion, topical application or by any other means and the placement of a single dose of medication into a container.

(5) "Adult" means a person 18 years of age or older.

(6) "Adult care home (ACH)" means a single family residence licensed pursuant to this act in which twenty-four (24) hour residential care, including assistance with activities of daily living, is provided in a homelike environment to no more than five (5) elderly or disabled adults.

(7) "Assessment" means a procedure for determining the nature and extent of the problem(s) and needs of a resident or potential resident to ascertain if the TBI residential home can adequately address those problems, meet those needs, and secure information for use in the development of the individual care plan.

(8) "Board" means the Board for Licensing Health Care Facilities.

(9) "Cardiopulmonary resuscitation (CPR)" means the administering of any means or device to restore or support cardiopulmonary functions in a resident, whether by mechanical devices, chest compressions, mouth-to-mouth resuscitation, cardiac massage, tracheal intubation, manual or mechanical ventilators or respirators, defibrillation, the administration of drugs and/or chemical agents intended to restore cardiac and/or respiratory functions in a resident where cardiac or respiratory arrest has occurred or is believed to be imminent.

(10) "CBIS" means a Certified Brain Injury Specialist who is certified by the Academy of Certified Brain Injury Specialists.

(11) "Disabled" means a resident who suffers from the effects of a traumatic brain injury.

(12) "Do-not-resuscitate resuscitation order (DNR)" means a written order, other than a POST, not to resuscitate a patient in cardiac or respiratory arrest in accordance with accepted medical practices.

(13) "Elderly" means an individual who is fifty-five (55) years of age or older.

(14) "Emergency" means any situation or condition which presents an imminent danger of death or serious physical or mental harm to residents.

(15) "Exploitation" shall have the same meaning as set forth in T.C.A. § 68-11-1002.

(16) "Health care" means any care, treatment, service or procedure to maintain, diagnose, treat, or otherwise affect a resident's physical or mental condition, and includes medical care as defined in T.C.A. § 32-11-103(5).

(17) "Health care decision" means a resident's consent, refusal of consent, or withdrawal of consent to health care.

(18) "Health care decision-maker" means, in the case of a resident who lacks capacity, the resident's health care decision-maker is one of the following: the resident's health care agent as specified in an advance directive; the resident's court-appointed guardian or conservator with health care decision-making authority; the resident's surrogate as determined pursuant to T.C.A. § 68-11-1806; or the resident's designated physician pursuant to T.C.A. § 68-11-1802(a)(4).

(19) "Home like" means an environment that promotes the dignity, security and comfort of residents through the provision of personalized care and services and encourages independence, choice and decision-making by the residents.

(20) "Infectious waste" means solid or liquid waste which contains pathogens with sufficient virulence and quantity such that exposure could result in an infectious disease.

(21) "Licensed health care professional" means any health care professional currently licensed by the State of Tennessee to practice within the scope of a regulated profession, such as a nurse practitioner, registered nurse, licensed practical nurse, (nurses may be licensed or hold multistate licensure pursuant to T.C.A. §§ 63-7-101, et seq.), dietitian, dentist, occupational therapist, pharmacist, physical therapist, physician, physician assistant, psychologist, clinical social worker, respiratory therapist, speech-language pathologist, and emergency medical services personnel.

(22) "Licensee" means the person, association, partnership, corporation, company or public agency to which the license is issued. For the purposes of these rules, the term "licensee" is synonymous to "TBI residential home provider."

(23) "Medical record" means documentation of nursing notes, when applicable; medical histories; treatment records; care needs summaries; physician orders; and records of treatment and medication ordered and given which must be maintained by the TBI residential home, regardless of whether such services are rendered by TBI residential home staff or by arrangement with an outside source.

(24) "Misappropriation of patient/resident property" means the deliberate misplacement, exploitation or wrongful, temporary or permanent use of an individual's belongings or money without the individual's consent.

(25) "NFPA" means the National Fire Protection Association.

(26) "Neglect" means the failure to provide goods and services necessary to avoid physical harm, mental anguish or mental illness; however, the withholding of authorization for or provision of medical care to any terminally ill person who has executed an irrevocable living will in accordance with the Tennessee Right to Natural Death Law, or other applicable state law, if the provision of such medical care would conflict with the terms of the living will, shall not be deemed "neglect" for purposes of these rules.

(27) "Occupant" means anyone residing in or using a TBI residential home.

(28) "Person" means an individual, association, estate, trust, corporation, partnership, joint venture, government, governmental subdivision, agency, or instrumentality, or any other legal or commercial entity.

(29) "Physician assistant" means a person who has graduated from a physician assistant educational program accredited by the Accreditation Review Commission on Education for the Physician Assistant, has passed the Physician Assistant National Certifying Examination, and is currently licensed in Tennessee as a physician assistant under title 63, chapter 19.

(30) "Physician orders for scope of treatment or POST" means written orders that:

(a) Are on a form approved by the Board for Licensing Health Care Facilities;

(b) Apply regardless of the treatment setting and that are signed as required herein by the patient's physician, physician assistant, nurse practitioner, or clinical nurse specialist; and

(c)

1. Specify whether, in the event the patient suffers cardiac or respiratory arrest, cardiopulmonary resuscitation should or should not be attempted;

2. Specify other medical interventions that are to be provided or withheld; or

3. Specify both 1 and 2.

(31) "Power of Attorney for Health Care" means the legal designation of an agent to make health care decisions for the resident who grants such power under T.C.A. §§ 34-6-201, et seq.

(32) "Resident" means an adult residing at the TBI residential home who suffers from the effects of a traumatic brain injury.

(33) "Residential care" means care rendered to residents who need supervision or assistance in activities of daily living. Residential care does not include nursing or medical care.

(34) "Retaliation" means increasing charges, decreasing services, rights or privileges; taking or threatening to take any action to coerce or compel the resident to leave the home; or abusing or threatening to harass or abuse a resident in any manner.

(35) "Self-administration of medication" means assistance in reading labels, opening dosage packaging, reminding residents of their medication, and observing the resident while taking medication in accordance with the plan of care.

(36) "Specialized services" means services provided to residents suffering from the effects of a traumatic brain injury.

(37) "Supervising health care provider" means the health care provider who has undertaken primary responsibility for a resident's health care.

(38) "Surrogate" means an individual, other than a resident's agent or guardian, authorized to make a health care decision for the resident pursuant to T.C.A. § 68-11-1806.

(39) "Traumatic brain injury (TBI)" means an acquired injury to the brain caused by an external physical force resulting in total or partial disability or impairment. Traumatic brain injury includes open and closed head injuries and may result in seizures, and/or mild, moderate, or severe impairment in one (1) or more areas including cognition, language, memory, attention, reasoning, abstract thinking, judgment, problem-solving, sensory, perceptual and motor abilities, psychosocial behavior, physical functions, information processing, and speech. Such term does not include brain injuries induced by birth trauma, but may include brain injuries caused by anoxia and other related causes, infectious disease not of a degenerative nature, brain tumor, toxic chemical or drug reaction.

(40) "Traumatic brain injury residential home" means a facility owned and operated by a community-based traumatic brain injury (TBI) adult care home provider in which residential care, including assistance with activities of daily living, is provided in a homelike environment to disabled adults suffering from the effects of a traumatic brain injury as defined in § 68-55101.

(41) "Traumatic brain injury residential home provider" means a person who is twenty-one (21) years of age or older that owns and operates a TBI residential home. A traumatic brain injury residential home provider shall hold national certification by the Academy of Certified Brain Injury Specialists as a Certified Brian Injury Specialist (CBIS) or hold a current professional license as a physician, nurse practitioner, registered nurse, licensed rehabilitation professional, or licensed mental health professional who is trained and experienced in the care and rehabilitation of disabled adults suffering from the effects of a traumatic brain injury.

(42) "Treating health care provider" means a health care provider directly or indirectly involved in providing health care to a resident at the time such care is needed by the resident.

Notes

Tenn. Comp. R. & Regs. 0720-38-.01

Original rule filed October 28, 2015; effective January 26, 2016. Amendments filed March 26, 2019; effective June 24, 2019. Transferred from chapter 1200-08-37 pursuant to Public Chapter 1119 of 2022 effective 7/1/2022.

Authority: T.C.A. §§ 68-11-201, 68-11-202, and 68-11-273.