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COMMONWEALTH OF PENNSYLVANIA

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28 Pa. Code § 201.3. Definitions.

§ 201.3. Definitions.

 The following words and terms, when used in this subpart, have the following meanings, unless the context clearly indicates otherwise:

   Abuse—As defined in 42 CFR 483.5 (relating to definitions).

   Act—The Health Care Facilities Act (35 P.S. § §  448.101—448.904b).

   Administration of medication—The giving of a dose of medication to a resident as a result of an order of a practitioner licensed by the Commonwealth to prescribe medications.

   Administrator—As defined in 42 CFR 483.70(d)(2) (relating to administration). The administrator shall be currently licensed and registered by the Department of State under the Nursing Home Administrators License Act (63 P.S. § §  1101—1114.2).

   Authorized person to administer medications—Persons qualified to administer medications in facilities are as follows:

     (i)   Physicians and dentists who are currently licensed by the Bureau of Professional and Occupational Affairs, Department of State.

     (ii)   Registered nurses who are currently licensed by the Bureau of Professional and Occupational Affairs, Department of State.

     (iii)   Practical nurses who have successfully passed the State Board of Nursing examination.

     (iv)   Practical nurses licensed by waiver in this Commonwealth who have successfully passed the United States Public Health Service Proficiency Examination.

     (v)   Practical nurses licensed by waiver in this Commonwealth who have successfully passed a medication course approved by the State Board of Nursing.

     (vi)   Student nurses of approved nursing programs who are functioning under the direct supervision of a member of the school faculty who is present in the facility.

     (vii)   Recent graduates of approved nursing programs who possess valid temporary practice permits and who are functioning under the direct supervision of a professional nurse who is present in the facility. The permits shall expire if the holders of the permits fail the licensing examinations.

     (viii)   Physician assistants and registered nurse practitioners who are certified by the Bureau of Professional and Occupational Affairs.

   Basement—A story or floor level below the main or street floor. If, due to grade differences, there are two levels qualifying as a street floor, a basement is a floor below the lower of the two street floors.

   CRNP—certified registered nurse practitioner—A registered nurse licensed in this Commonwealth who is certified by the State Board of Nursing and the State Board of Medicine as a CRNP, under The Professional Nursing Law (63 P.S. § §  211—225) and the Medical Practice Act of 1985 (63 P.S. § §  422.1—422.45).

   Charge nurse—A person designated by the facility who is experienced in nursing service administration and supervision and in areas such as rehabilitative or geriatric nursing or who acquires the preparation through formal staff development programs and who is licensed by the Commonwealth as one of the following:

     (i)   An RN.

     (ii)   An RN licensed by another state as an RN and who has applied for endorsement from the State Board of Nursing and has received written notice that the application has been received by the State Board of Nursing. This subparagraph applies for 1 year, or until Commonwealth licensure is completed, whichever period is shorter.

     (iii)   [Reserved].

     (iv)   An LPN designated by the facility as a charge nurse on the night tour of duty in a facility with a census of 59 or less in accordance with §  211.12 (relating to nursing services).

   Clinical laboratory—As defined in 42 U.S.C.A. §  263a(a).

   Construction, alteration or renovation—The erection, building, remodeling, modernization, improvement, extension or expansion of a facility, or the conversion of a building or portion thereof to a facility. The term does not include part-for-part replacement or regular facility maintenance.

   Controlled substance—A drug, substance or immediate precursor included in Schedules I—V of the Controlled Substance, Drug, Device and Cosmetic Act (35 P.S. § §  780-101—780-144).

   Corridor—A passageway, hallway or other common avenue used by residents and personnel to travel between buildings or sections of the same building to reach a common exit or service area. The service area includes, but is not limited to, living room, kitchen, bathroom, therapy rooms and storage areas not immediately adjoining the resident’s sleeping quarters.

   Department—The Department of Health of the Commonwealth.

   Director of nursing services—An RN designated by a facility under 42 CFR 483.35(b)(2) (relating to nursing services) and has 1 year of experience or education in nursing service administration and supervision, as well as additional education or experience in areas such as rehabilitative or geriatric nursing, and participates annually in continuing nursing education.

   Discharge—The movement of a resident from a bed in one certified facility to a bed in another certified facility or other location in the community, when return to the original facility is not expected.

   Elopement—When a resident leaves the premises or a safe area without authorization.

   Exit or exitway—A means of egress which is lighted and has three components: an exit access (corridor leading to the exit), an exit (a door) and an exit discharge (door to the street or public way).

   Exploitation—As defined in 42 CFR 483.5.

   Facility—A licensed long-term care nursing facility as defined in Chapter 8 of the act (35 P.S. § §  448.801—448.821).

   Full-time—A minimum of a 35-hour work week.

   Full compliance—Means total compliance.

   Health care practitioner—As defined in section 103 of the act (35 P.S. §  448.103).

   Interdisciplinary team—As defined in 42 CFR 483.21(b)(2)(ii) (relating to comprehensive person-centered care planning).

   Intimidation—As defined in section 3 of the Older Adults Protective Services Act (35 P.S. §  10225.103).

   Involuntary seclusion—Separation of a resident from other residents or from the resident’s room or confinement with or without roommates against the resident’s will, or the will of the resident’s representative, excluding emergency or short term monitored separation from other residents for a limited period of time as a therapeutic intervention to reduce agitation until professional staff can develop a plan of care to meet the resident’s needs.

   LPN—licensed practical nurse—A practical nurse licensed to practice under the Practical Nurse Law (63 P.S. § §  651—667.8) and the regulations of the State Board of Nursing in 49 Pa. Code Chapter 21, Subchapter B (relating to practical nurses).

   Licensee—The individual, partnership, association or corporate entity including a public agency or religious or fraternal or philanthropic organization authorized to operate a licensed facility.

   Long-term care ombudsman—An individual at the State or local level who is responsible for carrying out the duties and functions under section 3058g of the State Long-Term Care Ombudsman Program (42 U.S.C.A. §  3058g).

   Medication—A substance meeting one of the following qualifications:

     (i)   Is recognized in the official United States pharmacopeia, or official National formulary or a supplement to either of them.

     (ii)   Is intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease in man or other animals.

     (iii)   Is other than food and intended to affect the structure or a function of the human body or other animal body.

     (iv)   Is intended for use as a component of an article specified in subparagraphs (i), (ii) or (iii), but not including devices or their components, parts or accessories.

   Medication administration—An act in which a single dose of a prescribed medication or biological is given to a resident by an authorized person in accordance with statutes and regulations governing the act. The complete act of administration entails removing an individual dose from a previously dispensed, properly labeled container, verifying it with the physician’s orders, giving the individual dose to the proper resident and promptly recording the time and dose given.

   Medication dispensing—An act by a practitioner or a person who is licensed in this Commonwealth to dispense medications under the Pharmacy Act (63 P.S. § §  390-1—390-13) entailing the interpretation of an order for a medication or biological and, under that order, the proper selecting, measuring, labeling, packaging and issuance of the medication or biological for a resident or for a service unit of the facility.

   Mental abuse—Includes humiliation, harassment, threats of punishment or deprivation.

   Misappropriation of resident property—As defined in 42 CFR 483.5.

   Mistreatment—As defined in 42 CFR 483.5.

   NFPA—National Fire Protection Association.

   Neglect—As defined in 42 CFR 483.5.

   Non-prescription medication—An over-the-counter medication legally purchased without a prescription.

   Nurse aide—An individual, as defined in 42 CFR 483.5, providing nursing or nursing-related services to residents in a facility who:

     (i)   Does not have a license to practice professional or practical nursing in this Commonwealth.

     (ii)   Does not volunteer services for no pay.

     (iii)   Has met the requisite training and competency evaluation requirements as defined in 42 CFR 483.35 (relating to nursing services).

     (iv)   Appears on the Commonwealth’s Nurse Aide Registry.

     (v)   Has no substantiated findings of abuse, neglect or misappropriation of resident property recorded in the Nurse Aide Registry.

   Nursing care—A planned program to meet the physical and emotional needs of the resident. The term includes procedures that require nursing skills and techniques applied by properly trained personnel.

   Nursing service personnel—Registered nurses, licensed practical nurses and nurse aides.

   Person—As defined in section 103 of the act.

   Pharmacist—A person licensed by the State Board of Pharmacy to engage in the practice of pharmacy.

   Pharmacy—A place properly licensed by the State Board of Pharmacy where the practice of pharmacy is conducted.

   Physical abuse—Includes hitting, slapping, pinching and kicking. The term also includes controlling behavior through corporal punishment.

   Physician assistant—An individual certified as a physician assistant by the State Board of Medicine under the Medical Practice Act of 1985, or by the State Board of Osteopathic Medical Examiners under the Osteopathic Medical Practice Act (63 P.S. § §  271.1—271.18).

   Practitioner—A health care practitioner as defined in section 103 of the act.

   Prescription—A written or verbal order for medications issued by a health care practitioner in the course of professional practice.

   Qualified dietician—As defined in 42 CFR 483.60(a)(1) (relating to food and nutrition services).

   Qualified social worker—As defined in 42 CFR 483.70(p).

   Qualified therapeutic recreation specialist—As defined in 42 CFR 483.24(c) (relating to quality of life).

   RN—registered nurse—An individual licensed to practice professional nursing under The Professional Nursing Law and the regulations of the State Board of Nursing in 49 Pa. Code Chapter 21, Subchapter A (relating to registered nurses).

   Resident—A person who is admitted to a licensed long-term care nursing facility for observation, treatment or care for illness, disease, injury or other disability.

   Resident representative—As defined in 42 CFR 483.5.

   Restraint—A restraint can be physical or chemical.

     (i)   A physical restraint includes any manual method, physical or mechanical device, equipment or material that is attached or adjacent to the resident’s body, cannot be removed easily by the resident, and restricts the resident’s freedom of movement or normal access to the resident’s body.

     (ii)   A chemical restraint includes any medication that is used for discipline or convenience and not required to treat medical symptoms.

   Serious bodily injury—As defined in section 3 of the Older Adults Protective Services Act.

   Serious physical injury—As defined in section 3 of the Older Adults Protective Services Act.

   Sexual abuse—Non-consensual contact of any type with a resident, including sexual harassment, sexual coercion or sexual assault.

   Substantial compliance

     (i)   cited deficiencies are, individually and in combined effect, of a minor nature such that neither the deficiencies nor efforts toward their correction will interfere with or adversely affect normal facility operations or adversely affect any resident’s health or safety; and

     (ii)   the facility has implemented a plan of correction approved by the Department.

   Transfer—The movement of a resident from a bed in one certified facility to a bed in another certified facility when the resident expects to return to the original facility.

   Verbal abuse—Use of oral, written or gestured language that willfully includes disparaging and derogatory terms to residents or their families, or within their hearing distance, regardless of their age, ability to comprehend or disability. Examples of verbal abuse include:

     (i)   Threats of harm.

     (ii)   Saying things to frighten a resident, such as telling a resident that the resident will never be able to see the resident’s family again.

Authority

   The provisions of this §  201.3 amended under sections 102, 201(12), 601, 801.1 and 803 of the Health Care Facilities Act (35 P.S. § §  448.102, 448.201(12), 448.601, 448.801a and 448.803); and section 2102(a) and (g) of The Administrative Code of 1929 (71 P.S. §  532(a) and (g)).

Source

   The provisions of this §  201.3 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. 2233; amended October 1, 1976, effective October 2, 1976, 6 Pa.B. 2441; amended February 11, 1977, effective February 12, 1977, 7 Pa.B. 437; amended May 6, 1977, effective May 7, 1977, 7 Pa.B. 1236; amended May 26, 1978, effective May 27, 1978, 8 Pa.B. 1466; amended July 6, 1979, effective July 7, 1979, 9 Pa.B. 2252; amended April 23, 1982, effective April 24, 1982, 12 Pa.B. 1316; amended January 31, 1987, effective July 1, 1987, 17 Pa.B. 514; corrected June 19, 1987, 17 Pa.B. 2462; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. 3999; amended December 23, 2022, effective July 1, 2023, 52 Pa.B. 8043. Immediately preceding text appears at serial pages (258315) to (258322) and (412135).

Cross References

   This section cited in 28 Pa. Code §  211.9 (relating to pharmacy services).



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