N.H. Code Admin. R. He-P 805.03 – Definitions

(a) “Abuse” means any one of the following:
1. (1) “Emotional abuse” means the misuse of power, authority, or both, verbal harassment, or confinement which results or could result in the mental anguish or emotional distress of residents;
2. (2) “Physical abuse” means the misuse of physical force which results or could result in physical injury to residents; or
3. (3) “Sexual abuse” means contact or interaction of a sexual nature involving residents without their consent.
(b) “Activities of daily living (ADL)” means basic daily routine tasks such as eating, transferring, toileting, bathing, dressing, and medication management.
(c) “Addition” means an increase in the building area, aggregate floor area, building height, or number of stories of a structure.
(d) “Administer” means an act whereby one or more doses of a medication is instilled into the body, applied to the body of, or otherwise given to a person for immediate consumption or use by an individual authorized by law, including RSA 318-B and RSA 326-B.
(e) “Administrative remedy” means an action imposed upon a licensee in response to non-compliance with RSA 151 and He-P 805.
(f) “Administrator” means the licensee or individual appointed by the licensee to be responsible for all aspects of the daily operation of the licensed premises.
(g) “Admission” means the point in time when a resident, who has been accepted by a licensee for the provision of services, physically moves into the facility.
(h) “Advance directive” means a legal document allowing a person to give directions about future medical care or to designate another person to make medical decisions if they should lose the capacity to make health care decisions. This term includes “living wills” and “durable powers of attorney for health care”, in accordance with RSA 137-J, or a “surrogate decision-maker” in accordance with RSA 137-J:35.
(i) “Adverse drug reaction” means harm caused by a drug at normal doses.
(j) “Affiliated parties” means companies or individuals that serve as operators, landlords, management companies or advisors, real estate or consulting companies, members of limited liability companies, administrative services companies, lenders and companies providing financial guarantees, or captive or affiliated insurance companies. This term includes “related parties”.
(k) “Agent” means an adult to whom authority to make health care decisions is delegated under an activated durable power of attorney for health care executed in accordance with RSA 137-J, or a surrogate decision-maker identified under RSA 137-J:35-37.
(l) “Applicant” means an individual, agency, partnership, corporation, government entity, association, or other legal entity seeking a license to operate an SRHCF pursuant to RSA 151.
(m) “Area of non-compliance” means any action, failure to act, or other set of circumstances that cause a licensee to be out of compliance with RSA 151, He-P 805, or other federal or state requirements.
(n) “Assessment” means an evaluation of the resident to determine the care and services that are needed.
(o) “Care assessment for residential services (CARES) tool” means the document developed by the department to assess the needs of a resident or prospective resident as required by RSA 151:5-a, I.
(p) “Care plan” means a documented guide developed by the licensee or their personnel, in consultation with the resident or the resident’s guardian, personal representative, or agent, if any, as a result of the assessment process for the provision of care and services as required by He-P 805.16(e) - (j).
(q) “Change of ownership” means the transfer of the controlling interest of an established SRHCF to any individual, agency, partnership, corporation, government entity, association, or other legal entity.
(r) “Chemical restraints” means any drug or medication that is used as a restriction to manage a resident’s behavior or restrict the resident’s freedom of movement and is not a standard treatment or dosage for the resident’s condition.
(s) “Clinical laboratory improvement amendments (CLIA)” means the requirements outlined at 42 CFR Part 493 which set forth the conditions that all laboratories must meet to be certified to perform testing on human specimens.
(t) “Commissioner” means the commissioner of the New Hampshire department of health and human services, or their designee.
(u) “Controlling interest” means greater than 50% ownership interest.
(v) “Core services” means those services provided by the licensee that are included in the basic rate.
(w) “Days” means calendar days unless otherwise specified in the rule.
(x) “Demonstrated competency” means the ability of the employee to demonstrate to an evaluator their ability to complete the required task in a way that reflects the minimum standard to achieve a certificate of completion for a course or to pass a post-test for a training provided.
(y) “Department” means the New Hampshire department of health and human services.
(z) “Direct care” means the hands on care or services provided to a resident, including but not limited to medical, nursing, psychological, or rehabilitative treatments.
(aa) “Direct care personnel” means any person providing hands-on clinical care or hands-on services to a resident including but not limited to medical, psychological, or rehabilitative treatments, bathing, transfer assistance, feeding, dressing, toileting, and grooming.
(ab) “Directed plan of correction” means a plan developed and written by the department that specifies the necessary actions the licensee must take to correct identified areas of non-compliance.
(ac) “Discharge” means moving a resident from a licensed facility or entity to a non-licensed facility or entity.
(ad) “Do not resuscitate order (DNR order)” means an order, signed by a licensed provider, that in the event of an actual or imminent cardiac or respiratory arrest, chest compression, and ventricular defibrillation will not be performed, the resident will not be intubated or manually ventilated, and there will be no administration of resuscitation drugs. This term also includes “do not attempt resuscitation order (DNAR order)”.
(ae) “Drug diversion” means the use of controlled substances for anything other than the intended purpose or not administered to the person to whom it was prescribed.
(af) “Elopement” means when a resident leaves the licensed premises or a safe area unsupervised or unnoticed, without the authorization of the licensee’s personnel.
(ag) “Emergency plan” means a document outlining the responsibilities of personnel in an emergency.
(ah) “Employee” means anyone employed by the licensee and for whom the licensee has direct supervisory authority.
(ai) “Enforcement action” means the imposition of an administrative fine, the denial of an application, or the revocation or suspension of a license in response to non-compliance with RSA 151 or He-P 805.
(aj) “Equipment” means any plumbing, heating, electrical, ventilating, air-conditioning, refrigerating, and fire protection equipment, and any elevators, dumbwaiters, escalators, boilers, pressure vessels, or other mechanical facilities or installations related to building services, not to include portable refrigerators. This term includes “fixtures”.
(ak) “Exploitation” means the illegal use of a resident’s person or property for another person’s profit or advantage, or the breach of a fiduciary relationship through the use of a person or person’s property for any purpose not in the proper and lawful execution of a trust, including, but not limited to, situations where a person obtains money, property, or services from a resident through the use of undue influence, harassment, duress, deception, or fraud.
(al) “Facility” means “facility” as defined in RSA 151:19, II.
(am) “Guardian” means a person appointed in accordance with RSA 464-A to make informed decisions relative to the resident’s health care and other personal needs.
(an) “Health care occupancy” means the use of a building or structure, or a portion thereof, to provide care or supervision to persons who are or are not capable of self-preservation without physical assistance.
(ao) “Household member” means the caregiver, all family members, and any other individuals age 17 or older, other than residents that reside at the licensed premises for more than 30 days.
(ap) “Independent contractor” means an individual or business entity providing service to the licensee or its residents but not employed by the licensee.
(aq) “Infectious waste” means “infectious waste” as defined in Env-Sw 103.28 and described in Env-Sw 904.
(ar) “Informed consent” means the decision by a resident, or their guardian, personal representative, or agent, to agree to a proposed course of treatment, after they have received full disclosure of the facts, including information about risks and benefits of the treatment and available alternatives, needed to make the decision intelligently.
(as) “In-service” means an educational program, which is designed to increase the knowledge, skills, and overall effectiveness of personnel.
(at) “Inspection” means the process used by the department to determine an applicant’s or a licensee's compliance with RSA 151, He-P 805, and all other federal and state requirements or to respond to allegations, pursuant to RSA 151:6, of non-compliance with RSA 151 and He-P 805.
(au) “Laboratory” means a facility, or space within a facility, used for the biological, microbiological, serological, chemical, immunohematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of disease.
(av) “License” means the document issued to an applicant or licensee which authorizes operation in accordance with RSA 151 and He-P 805, and includes the name of the licensee, the name of the business, the physical address, the license category, the effective date, the name of the administrator, the type(s) of services authorized, the number of beds the facility is licensed for, and license number.
(aw) “Licensed practitioner” means a:
1. (1) Medical doctor;
2. (2) Physician's assistant;
3. (3) Advanced practice registered nurse (APRN);
4. (4) Doctor of osteopathy;
5. (5) Doctor of naturopathic medicine; or
6. (6) Any other professional licensed by law with prescriptive powers.
(ax) “Licensed premises” means the physical location that the department has approved for the licensee to conduct operations in accordance with its license.
(ay) “Licensee” means any person or legal entity to which a license has been issued pursuant to RSA 151.
(az) “Licensing classification” means the specific category of services authorized by a license.
(ba) “Life safety code” means the adoption by reference of the life safety code, as published by the National Fire Protection Association and as amended by the state board of fire control and ratified by the general court pursuant to RSA 153:5.
(bb) “Mechanical restraint” means locked, secured, or alarmed SRHCFs or units within an SRHCF, or anklets, bracelets, or similar devices that cause a door to automatically lock when approached, thereby preventing a resident from freely exiting the SRHCF or unit within.
(bc) “Medical director” means a licensed practitioner licensed in New Hampshire in accordance with RSA 329 or 326-B who is responsible for overseeing the quality of medical care and services in a SRHCF.
(bd) “Medication” means a substance available with or without a prescription, which is used as a curative, remedial, or palliative supportive substance.
(be) “Medication error” means any deviation in the administration of a medication as prescribed or in the documentation of such administration, with the exception of a resident’s refusal.
(bf) “Modification” means the reconfiguration of any space, the addition, relocation, or elimination of any door or window, the addition or elimination of load-bearing elements, the reconfiguration or extension of any system, or the installation of any additional equipment. The term does not include “repair” or “replacement” of interior finishes.
(bg) “Neglect” means an act or omission that results or could result in the deprivation of essential services or supports necessary to maintain the minimum mental, emotional, or physical health and safety of a resident.
(bh) “Notice to correct” means a report issued pursuant to RSA 151:6-a, II, following a life safety code inspection when a facility is found to be out of compliance with applicable life safety codes or rules.
(bi) “Nursing care plan” means a written guide developed by a nurse in consultation with the resident and the resident’s guardian, personal representative, or agent, that lists the interventions necessary to meet the resident’s nursing needs.
(bj) “Orders” means an electronic or written document, or a verbal direction, by a licensed practitioner for medications, treatments, recommendations, and referrals, and signed by the licensed practitioner using terms such as authorized by, authenticated by, approved by, reviewed by, or any other term that denotes approval by the licensed practitioner.
(bk) “Over-the-counter medications” means non-prescription medications.
(bl) “Owner” means any person, corporation, association, or any other legal entity, whether organized for profit or not, holding or claiming ownership of, or title to, a license.
(bm) “Patient rights” means the privileges and responsibilities possessed by each resident provided by RSA 151:21. This term includes “resident rights”.
(bn) “Patient’s personal representative” means “patient’s personal representative” as defined in RSA 151:19, V namely, “a person, other than the licensee of, an employee of, or a person having direct or indirect ownership interest, in a facility, who is designated in writing by a patient or patient’s legal guardian for a specific, limited purpose or for the general purpose of assisting the patient in the exercise of any rights”. This term includes “personal representative”.
(bo) “Performance-based design” means an engineering approach to fire protection design and construction based on:
1. (1) Established fire safety goals and objectives;
2. (2) Deterministic and probabilistic analysis of fire scenarios; and
3. (3) Quantitative assessment of design alternatives against the fire safety goals and objectives using accepted engineering tools, methodologies, and performance criteria.
(bp) “Personal care” means services that are non-medical, hands-on services provided to a resident including, but not limited to, assistance with activities of daily living.
(bq) “Personnel” means an individual(s), who is employed by the licensee, a volunteer, or an independent contractor who provides direct care or personal care services to a resident(s).
(br) “Physical restraint” means any manual method or physical or mechanical device, material, or equipment attached to or adjacent to the resident’s body that the individual cannot remove easily which restricts freedom of movement or normal access to one’s body.
(bs) “Plan of correction (POC)” means a plan developed and written by the licensee, which specifies the actions that will be taken to correct areas of non-compliance with applicable rules or codes identified at the time of a clinical or life safety inspection conducted pursuant to RSA 151:6-a or during the course of a complaint investigation conducted pursuant to RSA 151:6.
(bt) “Point of care devices” means a system of devices used to obtain medical, diagnostic results including but not limited to:
1. (1) A lancing or finger stick device to get blood specimen;
2. (2) A test strip or reagents to apply a specimen to for testing; or
3. (3) A meter or monitor to calculate and show the results, including:
  1. a. Blood glucose meters, also called “glucometers”;
  2. b. Prothrombin Time (PT) and International Normalized Ratio (INR) anticoagulation meters; or
  3. c. A Cholesterol meter.
(bu) “Point of care testing (POCT)” means laboratory testing performed using either manual methods or hand held instruments at or near the point of care, at the time and place of resident care.
(bv) “Pro re nata (PRN) medication” means medication administered as circumstances might require in accordance with the licensed practitioner’s orders.
(bw) “Procedure” means a licensee’s written, standardized method of performing duties and providing services.
(bx) “Protective care” means the provision of resident monitoring services, including but not limited to:
1. (1) Knowledge of resident whereabouts; and
2. (2) Minimizing the likelihood of accident or injury.
(by) “Qualified personnel” means personnel that have been trained and have demonstrated competency to adequately perform tasks which they are assigned such as, nursing staff, clinical staff, housekeeping staff trained in infection control, and kitchen staff trained in food safety protocols.
(bz) “Reconstruction” means the reconfiguration of a space that affects an exit or a corridor shared by more than one occupant space, or the reconfiguration of a space such that the rehabilitation work area is not permitted to be occupied because existing means of egress and fire protection systems, or their equivalent, are not in place or continuously maintained.
(ca) “Rehabilitation” means any of the following, as defined in this section, undertaken in an existing building:
1. (1) Addition;
2. (2) Modification;
3. (3) Reconstruction;
4. (4) Renovation; and
5. (5) Repair.
(cb) “Renovation” means the replacement in kind or strengthening of building elements, or upgrading of building elements, material, equipment, or fixtures, without involving the reconfiguration of spaces.
(cc) “Repair” means the patching, restoration, or painting of materials, elements, equipment, or fixtures for the purpose of maintaining such materials, elements, equipment, or fixtures in good or sound condition.
(cd) “Reportable incident” means an occurrence of any of the following while the resident is either in the SRHCF or in the care of SRHCF personnel:
1. (1) The unanticipated death of the resident;
2. (2) An injury to a resident that is of a suspicious nature under circumstances where the injury was not observed by any person or the cause of the injury could not be explained by the resident;
3. (3) The elopement of a resident;
4. (4) Medication error which resulted in serious bodily injury; and
5. (5) Drug diversion.
(ce) “Resident” means any person admitted to or in any way receiving care, services, or both who resides in a SRHCF.
(cf) “Residential board and care” means an occupancy used for lodging and boarding of 4 or more residents, not related by blood or marriage to the owners or operators, for the purpose of providing personal care services.
(cg) “Resident record” means a separate file maintained for each resident, which includes all documentation required by RSA 151 and He-P 805 and as required by other federal and state law.
(ch) Respite care” means the admission of a person from their primary residence to an SRHCF, on either a planned or emergency basis, for a period not to exceed 30 days in order to relieve the primary caregiver from the demands of providing home-based care.
(ci) “Self administration of medication with assistance” means the resident takes their own medication(s) after being prompted by personnel, but without requiring physical assistance from others.
(cj) “Self administration of medication without assistance” means an act whereby the resident takes their own medication(s) without the assistance of another person.
(ck) “Self directed medication administration” means an act whereby a resident, who has a physical limitation that prohibits them from self-administering, directs personnel to physically assist in the medication process excluding assisting with infusions, injections, or filling insulin syringes.
(cl) “Self-preservation capability” means the ability of a resident to act on an innate desire to protect oneself from harm without staff intervention.
(cm) “Serious bodily injury” means an injury involving extreme physical pain, involving substantial risk of death, involving protracted loss or impairment of the function of a bodily member, organ, or mental faculty, or requiring medical intervention such as surgery, hospitalization, or physical
rehabilitation.
(cn) “Service” means a specific activity performed by the licensee, either directly or indirectly, to benefit or assist a resident.
(co) “Significant change” means a decline or improvement in a resident’s status that:
1. (1) Will not normally resolve itself without further intervention by personnel or by implementing standard disease-related clinical interventions;
2. (2) Impacts more than one area of the resident’s health status; and
3. (3) Requires interdisciplinary review or revision of the care plan.
(cp) “State building code” means “state building code” as defined in RSA 155-A:1, IV.
(cq) “State fire code” means “state fire code” as defined in RSA 153:1 and as amended by rules adopted pursuant to RSA 153:5.
(cr) “State monitoring” means the placement of individuals by the department at an SRHCF to monitor the operation and conditions of the facility.
(cs) “Stock medication” means over-the-counter medication available for use by more than one resident.
(ct) “Supported residential health care facility (SRHCF)” means a long-term care residence providing personal assistance at the supported residential care level pursuant to RSA 151:9, VII(a)(2).
(cu) “Therapeutic diet” means a diet ordered by a licensed practitioner or other licensed professional with prescriptive authority as part of the treatment for disease, clinical conditions, or increasing or decreasing specific nutrients in the food consumed by the resident.
(cv) “Transfer” means “transfer” as defined in RSA 151:19, VII.
(cw) “Unanticipated death” means the death of a resident that is not related to their diagnosis or underlying condition.
(cx) “Underwriters laboratories (UL) listed” means that the global safety certification company UL has confirmed that the product is safe for use.
(cy) “Visitor” means a family member or non-related person who comes to visit one or more resident(s) temporarily, for their social well-being, amusement, or distraction.
(cz) “Volunteer” means an unpaid person who assists with food services, entertainment, or activities, and who does not provide direct care or assist with direct care. This term does not include visitors or those persons or organized groups who provide religious services.

Source. #2261, eff 1-17-83; ss by #3193, eff 1-28-86; ss by #5317, EMERGENCY, eff 1-29-92, EXPIRED: 5-28-92 New. #5513, eff 11-25-92; ss by #5665, eff 7-14-93; ss by #6895, INTERIM, eff 11-26-98, EXPIRED: 3-26-99 New. #8746, eff 10-25-06; ss by #10813, eff 4-21-15; ss by #13333, eff 1-25-22; ss by #14358, eff 8-28-25, EXPIRES: 8-28-35