Section R9-10-101. Definitions

In addition to the definitions in A.R.S. § 36-401(A), the following definitions apply in this Chapter unless otherwise specified:

1.        “Abortion clinic” has the same meaning as in A.R.S. § 36-449.01.

2.        “Abuse” means:

a.         The same:

8.        “Admission” means, after completion of an individual’s screening or registration by a health care institution, the individual begins receiving physical health services or behavioral health services and is accepted as a patient of the health care institution.

9.        “Adult” has the same meaning as in A.R.S. § 1-215.

10.     “Adult behavioral health therapeutic home” means a resi- dence that provides room and board, assists in acquiring daily living skills, coordinates transportation to scheduled appointments, monitors behaviors, assists in the self- administration of medication, and provides feedback to a case manager related to behavior for an individual 18 years of age or older based on the individual’s behavioral health issue and need for behavioral health services and may provide behavioral health services under the clinical oversight of a behavioral health professional.

11.     “Adverse reaction” means an unexpected outcome that threatens the health or safety of a patient as a result of a medical service, nursing service, or health-related service provided to the patient.

12.     “Ancillary services” means services other than medical services, nursing services, or health-related services pro- vided to a patient.

13.     “Anesthesiologist” means  a  physician granted clinical privileges to administer anesthesia.

14.     “Applicant” means a governing authority requesting:

a.         Approval of a health care institution’s architectural plans and specifications, or

b.        A health care institution license.

15.     “Application packet” means the information, documents, and fees required by the Department for the:

a.         Approval of a health care institution's modification or construction, or

b.        Licensing of a health care institution.

16.     “Assessment” means an analysis of a patient’s need for physical health services or behavioral health services to determine which services a health care institution will provide to the patient.

17.     “Assistance in the self-administration of medication” means restricting a patient’s access to the patient’s medi- cation and providing support to the patient while the patient takes the medication to ensure that the medication is taken as ordered.

18.     “Attending physician” means a physician designated by a patient to participate in or coordinate the medical services provided to the patient.

19.     “Authenticate” means to establish authorship of a docu- ment or an entry in a medical record by:

a.         A written signature;

b.        An individual’s initials, if the individual’s written signature appears on the document or in the medical record;

c.         A rubber-stamp signature; or

d.        An electronic signature code.

20.     “Authorized service” means specific medical services, nursing services, or health-related services provided by a specific health care institution class or subclass for which the health care institution is required to obtain approval from the Department before providing the medical ser- vices, nursing services, or health-related services.

21.     “Available” means:

a.         For an individual, the ability to be contacted and to provide an immediate response by any means possi- ble;

b.        For equipment and supplies, physically retrievable at a health care institution; and

c.         For a document, retrievable by a health care institu- tion or accessible according to the applicable time- frames in this Chapter.

22.     “Behavioral care”:

a.         Means limited behavioral health services, provided to a patient whose primary admitting diagnosis is related to the patient’s need for physical health ser- vices, that include:

i.         Assistance with the patient’s psychosocial interactions to manage the patient’s behavior that can be performed by an individual without a professional license or certificate including:

(1)     Direction provided by a behavioral health professional, and

(2)     Medication ordered by a medical practi- tioner or behavioral health professional; or

ii.        Behavioral health services provided by a behavioral health professional on an intermit- tent basis to address the patient’s significant psychological or behavioral response to an identifiable stressor or stressors; and

b.        Does not  include court-ordered behavioral health services.

23.     “Behavioral health facility” means a behavioral health inpatient facility, a behavioral health residential facility, a substance abuse transitional facility, a behavioral health specialized transitional facility, an outpatient treatment center that only provides behavioral health services, an adult behavioral health therapeutic home, a behavioral health respite home, or a counseling facility.

24.     “Behavioral health inpatient facility” means a health care institution that provides continuous treatment to an indi- vidual experiencing a behavioral health issue that causes the individual to:

a.         Have a limited or reduced ability to meet the indi- vidual's basic physical needs;

b.        Suffer harm that significantly impairs the individ- ual’s judgment, reason, behavior, or capacity to rec- ognize reality;

c.         Be a danger to self;

d.        Be a danger to others;

e.         Be persistently or acutely disabled as defined in

A.R.S. § 36-501; or

f.         Be gravely disabled.

25.     “Behavioral health issue” means an individual’s condi- tion related to a mental disorder, a personality disorder, substance abuse, or a significant psychological or behav- ioral response to an identifiable stressor or stressors.

26.     “Behavioral health observation/stabilization services” means crisis services provided, in an outpatient setting, to an individual whose behavior or condition indicates that the individual:

a.         Requires nursing services,

b.        May require medical services, and

c.         May be a danger to others or a danger to self.

27.     “Behavioral health paraprofessional” means an individual who is not a behavioral health professional who provides, at or for a health care institution, under supervision by a behavioral health professional, the following services to a patient to address the patient's behavioral health issue:

a.         Services that, if provided in a setting other than a health care institution would be required to be pro- vided by an individual licensed under A.R.S, Title 32, Chapter 33; or

b.        Health-related services.

28.     “Behavioral health professional” means:

a.         An individual licensed under A.R.S. Title 32, Chap- ter 33, whose scope of practice allows the individual to:

i.         Independently engage in the practice of behav- ioral health as defined in A.R.S. § 32-3251; or

ii.        Except for a licensed substance abuse techni- cian, engage in the practice of behavioral health as defined in A.R.S. § 32-3251 under direct supervision as defined in A.A.C. R4-6-101;

b.        A psychiatrist as defined in A.R.S. § 36-501;

c.         A psychologist as defined in A.R.S. § 32-2061;

d.        A physician;

e.         A behavior analyst as defined in A.R.S. § 32-2091;

f.         A registered nurse practitioner licensed as an adult psychiatric and mental health nurse; or

g.        A registered nurse.

29.     “Behavioral health residential facility” means a health care institution that provides treatment to an individual experiencing a behavioral health issue that:

a.         Limits the individual’s ability to be independent, or

b.        Causes the individual to require treatment to main- tain or enhance independence.

30.     “Behavioral health respite home” means a residence where respite care services, which may include assistance in the self-administration of medication, are provided to an individual based on the individual’s behavioral health issue and need for behavioral health services.

31.     “Behavioral health services” means medical services, nursing services, health-related services, or ancillary ser- vices provided to an individual to address the individual’s behavioral health issue.

32.     “Behavioral health staff” means a:

a.         Behavioral health paraprofessional,

b.        Behavioral health technician, or

c.         Personnel member in a nursing care institution or assisted living facility who provides behavioral care.

33.     “Behavioral health technician” means an individual who is not a behavioral health professional who provides, at or for a health care institution, with clinical oversight by a behavioral health professional, the following services to a patient to address the patient’s behavioral health issue:

a.         Services that, if provided in a setting other than a health care institution would be required to be pro-

vided by an individual licensed under A.R.S, Title 32, Chapter 33; or

b.        Health-related services.

34.     “Biohazardous medical waste” has the same meaning as in A.A.C. R18-13-1401.

35.     “Calendar day” means each day, not including the day of the act, event, or default from which a designated period of time begins to run, but including the last day of the period unless it is a Saturday, Sunday, statewide furlough day, or legal holiday, in which case the period runs until the end of the next day that is not a Saturday, Sunday, statewide furlough day, or legal holiday.

36.     “Case manager” means an individual assigned by an entity other than a health care institution to coordinate the physical health services or behavioral health services pro- vided to a patient at the health care institution.

37.     “Certification” means, in this Article, a written statement that an item or a system complies with the applicable requirements incorporated by reference in A.A.C. R9-1- 412.

38.     “Certified health physicist” means an individual recog- nized by the American Board of Health Physics as com- plying with the health physics criteria and examination requirements established by the American Board of Health Physics.

39.     “Change in ownership” means conveyance of the ability to appoint, elect, or otherwise designate a health care institution’s governing authority from an owner of the health care institution to another person.

40.     “Chief administrative officer” or “administrator” means an individual designated by a governing authority to implement the governing authority’s direction in a health care institution.

41.     “Clinical laboratory services” means the biological, microbiological, serological, chemical, immunohemato- logical, hematological, biophysical, cytological, patho- logical, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of a disease or impairment of a human being, or for the assessment of the health of a human being, including procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body.

42.     “Clinical oversight” means:

a.         Monitoring the behavioral health services provided by a behavioral health technician to ensure that the behavioral health technician is providing the behav- ioral health services according to the health care institution’s policies and procedures,

b.        Providing on-going review of a behavioral health technician’s skills and knowledge related to the pro- vision of behavioral health services,

c.         Providing guidance to improve a behavioral health technician’s skills and knowledge related to the pro- vision of behavioral health services, and

d.        Recommending training for a behavior health tech- nician to improve the behavioral health technician’s skills and knowledge related to the provision of behavioral health services.

43.     “Clinical privileges” means authorization to a medical staff member to provide medical services granted by a governing authority or according to medical staff bylaws.

44.     “Collaborating health care institution” means a health care institution licensed to provide outpatient behavioral health services that has a written agreement with an adult

behavioral health therapeutic home or a behavioral health respite home to:

a.         Coordinate behavioral health services provided to a resident at the adult behavioral health therapeutic home or a recipient at a behavioral health respite home, and

b.        Work with the provider to ensure a resident at the adult behavioral health therapeutic home or a recipi- ent at a behavioral health respite home receives behavioral health services according to the resident’s treatment plan.

45.     “Communicable disease” has the same meaning as in

A.R.S. § 36-661.

46.     “Conspicuously posted” means placed:

a.         At a location that is visible and accessible; and

b.        Unless otherwise specified in the rules, within the area where the public enters the premises of a health care institution.

47.     “Consultation” means an evaluation of a patient requested by a medical staff member or personnel mem- ber.

48.     “Contracted services” means medical services, nursing services, health-related services, ancillary services, or environmental services provided according to a docu- mented agreement between a health care institution and the person providing the medical services, nursing ser- vices, health-related services, ancillary services, or envi- ronmental services.

49.     “Contractor” has the same meaning as in A.R.S. § 32- 1101.

50.     “Controlled   substance”  has  the  same  meaning  as  in

A.R.S. § 36-2501.

51.     “Counseling” has the same meaning as “practice of pro- fessional counseling” in A.R.S. § 32-3251.

52.     “Counseling facility” means a health care institution that only provides counseling, which may include:

a.         DUI screening, education, or treatment accord- ing to the requirements in 9 A.A.C. 20, Article 1; or

b.        Misdemeanor domestic violence offender treatment according to the requirements in 9 A.A.C. 20, Arti- cle 2.

53.     “Court-ordered evaluation” has the same meaning as “evaluation” in A.R.S. § 36-501.

54.     “Court-ordered pre-petition screening” has the same meaning as in A.R.S. § 36-501.

55.     “Court-ordered treatment” means treatment provided according to A.R.S. Title 36, Chapter 5.

56.     “Crisis services” means immediate and unscheduled behavioral health services provided to a patient to address an acute behavioral health issue affecting the patient.

57.     “Current” means up-to-date, extending to the present time.

58.     “Daily living skills” means activities necessary for an individual to live independently and include meal prepa- ration, laundry, housecleaning, home maintenance, money management, and appropriate social interactions.

59.     “Danger to others” has the same meaning as in A.R.S. § 36-501.

60.     “Danger to self” has the same meaning as in A.R.S. § 36- 501.

61.     “Detoxification services” means behavioral health ser- vices and medical services provided to an individual to:

a.         Reduce or eliminate the individual’s dependence on alcohol or other drugs, or

b.        Provide treatment for the individual's signs or symp- toms of withdrawal from alcohol or other drugs.

62.     “Diagnostic procedure” means a method or process per- formed to determine whether an individual has a medical condition or behavioral health issue.

63.     “Dialysis” means the process of removing dissolved sub- stances from a patient’s body by diffusion from one fluid compartment to another across a semi-permeable mem- brane.

64.     “Dialysis services” means medical services, nursing ser- vices, and health-related services provided to a patient receiving dialysis.

65.     “Dialysis station” means a designated treatment area approved by the Department for use by a patient receiv- ing dialysis or dialysis services.

66.     “Dialyzer” means an apparatus containing semi-perme- able membranes used as a filter to remove wastes and excess fluid from a patient’s blood.

67.     “Disaster” means an unexpected occurrence that adversely affects a health care institution’s ability to pro- vide services.

68.     “Discharge” means a documented termination of services to a patient by a health care institution.

69.     “Discharge instructions” means documented information relevant to a patient’s medical condition or behavioral health issue provided by a health care institution to the patient or the patient’s representative at the time of the patient’s discharge.

70.     “Discharge planning” means a process of establishing goals and objectives for a patient in preparation for the patient’s discharge.

71.     “Discharge summary” means a documented brief review of services provided to a patient, current patient status, and reasons for the patient’s discharge.

72.     “Disinfect” means to clean in order to prevent the growth of or to destroy disease-causing microorganisms.

73.     “Documentation” or “documented” means information in written, photographic, electronic, or other permanent form.

74.     “Drill” means a response to a planned, simulated event.

75.     “Drug” has the same meaning as in A.R.S. § 32-1901.

76.     “Electronic” has the same meaning as in A.R.S. § 44- 7002.

77.     “Electronic signature” has the same meaning as in A.R.S.

§ 44-7002.

78.     “Emergency” means an immediate threat to the life or health of a patient.

79.     “Emergency medical services provider” has the same meaning as in A.R.S. § 36-2201.

80.     “Environmental services” means activities such as house- keeping, laundry, facility maintenance, or equipment maintenance.

81.     “Equipment” means, in this Article, an apparatus, a device, a machine, or a unit that is required to comply with  the  specifications   incorporated  by  reference   in

A.A.C. R9-1-412.

82.     “Exploitation” has the same meaning as in A.R.S. § 46- 451.

83.     “Factory-built  building”   has  the  same  meaning  as  in

A.R.S. § 41-2142.

84.     “Family” or “family member” means an individual’s spouse, sibling, child, parent, grandparent, or another individual designated by the individual.

85.     “Food services” means the storage, preparation, serving, and cleaning up of food intended for consumption in a health care institution.

86.     “Garbage” has the same meaning as in A.A.C. R18-13- 302.

87.     “General consent” means documentation of an agreement from an individual or the individual’s representative to receive physical health services to address the individ- ual’s medical condition or behavioral health services to address the individual’s behavioral health issues.

88.     “General hospital” means a subclass of hospital that pro- vides surgical services and emergency services.

89.     “Gravely disabled” has the same meaning as in A.R.S. § 36-501.

90.     “Hazard” or “hazardous” means a condition or situation where a patient or other individual may suffer physical injury.

91.     “Health  care   directive”  has  the  same  meaning  as  in

A.R.S. § 36-3201.

92.     “Hemodialysis” means the process for removing wastes and excess fluids from a patient’s blood by passing the blood through a dialyzer.

93.     “Home health agency” has the same meaning as in A.R.S.

§ 36-151.

94.     “Home health aide” means an individual employed by a home health agency to provide home health services under the direction of a registered nurse or therapist.

95.     “Home health aide services” means those tasks that are provided to a patient by a home health aide under the direction of a registered nurse or therapist.

96.     “Home  health   services”  has  the  same  meaning  as  in

A.R.S. § 36-151.

97.     “Hospice inpatient facility” means a subclass of hospice that provides hospice services to a patient on a continuous basis with the expectation that the patient will remain on the hospice’s premises for 24 hours or more.

98.     “Hospital” means a class of health care institution that provides, through an organized medical staff, inpatient beds, medical services, continuous nursing services, and diagnosis or treatment to a patient.

99.     “Immediate” means without delay.

100.  “Incident” means an unexpected occurrence that harms or has the potential to harm a patient, while the patient is:

a.         On the premises of a health care institution, or

b.        Not on the premises of a health care institution but directly receiving physical health services or behav- ioral health services from a personnel member who is providing the physical health services or behav- ioral health services on behalf of the health care institution.

101.  “Infection control” means to identify, prevent, monitor, and minimize infections.

102.  “Informed consent” means:

a.         Advising a patient of a proposed treatment, surgical procedure, psychotropic drug, or diagnostic proce- dure; alternatives to the treatment, surgical proce- dure, psychotropic drug, or diagnostic procedure; and associated risks and possible complications; and

b.        Obtaining documented authorization for the pro- posed treatment, surgical procedure, psychotropic drug, or diagnostic procedure from the patient or the patient’s representative.

103.  “In-service education” means organized instruction or information that is related to physical health services or behavioral health services and that is provided to a medi- cal staff member, personnel member, employee, or volun- teer.

104.  “Interval note” means documentation updating a patient’s:

a.         Medical condition after a medical history and physi- cal examination is performed, or

b.        Behavioral health issue after an assessment is per- formed.

105.  “Isolation” means the separation, during the communica- ble period, of infected individuals from others, to limit the transmission of infectious agents.

106.  “Leased facility” means a facility occupied or used during a set time period in exchange for compensation.

107.  “License” means:

a.         Written approval issued by the Department to a per- son to operate a class or subclass of health care insti- tution at a specific location; or

b.        Written approval issued to an individual to practice a profession in this state.

108.  “Licensed occupancy” means the total number of individ- uals for whom a health care institution is authorized by the Department to provide crisis services in a unit provid- ing behavioral health observation/stabilization services.

109.  “Licensee” means an owner approved by the Department to operate a health care institution.

110.  “Manage” means to implement policies and procedures established by a governing authority, an administrator, or an individual providing direction to a personnel member.

111.  “Medical condition” means the state of a patient’s physi- cal or mental health, including the patient’s illness, injury, or disease.

112.  “Medical director” means a physician who is responsible for the coordination of medical services provided to patients in a health care institution.

113.  “Medical history” means an account of a patient’s health, including past and present illnesses, diseases, or medical conditions.

114.  “Medical practitioner” means a physician, physician assistant, or registered nurse practitioner.

115.  “Medical record” has the same meaning as “medical records” in A.R.S. § 12-2291.

116.  “Medical staff” means physicians and other individuals licensed pursuant to A.R.S. Title 32 who have clinical privileges at a health care institution.

117.  “Medical staff by-laws” means standards, approved by the medical staff and the governing authority, that provide the framework for the organization, responsibilities, and self-governance of the medical staff.

118.  “Medical staff member” means an individual who is part of the medical staff of a health care institution.

119.  “Medication” means one of the following used to main- tain health or to prevent or treat a medical condition or behavioral health issue:

a.         Biologicals as defined in A.A.C. R18-13-1401,

b.        Prescription medication as defined in A.R.S. § 32- 1901, or

c       Nonprescription medication as defined in A.R.S. § 32-1901.

120.  “Medication administration” means restricting a patient’s access to the patient’s medication and providing the med- ication to the patient or applying the medication to the patient’s body, as ordered by a medical practitioner.

121.  “Medication error” means:

a.         The failure to administer an ordered medication;

b.        The administration of a medication not ordered; or

c.         The administration of a medication:

i.         In an incorrect dosage,

ii.        More than 60 minutes before or after the ordered time of administration unless ordered to do so, or

iii.      By an incorrect route of administration.

122.  “Mental disorder” means the same as in A.R.S. § 36-501.

123.  “Mobile clinic” means a movable structure that:

a.         Is not physically attached to a health care institu- tion’s facility;

b.        Provides medical services, nursing services, or health related service to an outpatient under the direction of the health care institution’s personnel; and

c.         Is not intended to remain in one location indefi- nitely.

124.  “Monitor” or “monitoring” means to check systemati- cally on a specific condition or situation.

125.  “Neglect” has the same meaning:

a.         For an individual less than 18 years of age, as in

A.R.S. § 8-201; and

b.        For an individual 18 years of age or older, as in

A.R.S. § 46-451.

126.  “Nephrologist” means a physician who is board eligible or board certified in nephrology by a professional creden- tialing board.

127.  “Nurse” has the same meaning as “registered nurse” or “practical nurse” as defined in A.R.S. § 32-1601.

128.  “Nursing personnel” means individuals authorized according to A.R.S. § Title 32, Chapter 15 to provide nursing services.

129.  “Observation chair” means a physical piece of equipment that:

a.         Is located in a designated area where behavioral health observation/stabilization services are pro- vided,

b.        Allows an individual to fully recline, and

c.         Is used by the individual while receiving crisis ser- vices.

130.   “Occupational therapist” has the same meaning as in

A.R.S. § 32-3401.

131.  “Occupational therapist assistant” has the same meaning as in A.R.S. § 32-3401.

132.  “Ombudsman” means a resident advocate who performs the duties described in A.R.S. § 46-452.02.

133.  “On-call” means a time during which an individual is available and required to come to a health care institution when requested by the health care institution.

134.  “Opioid treatment” means providing medical services, nursing services, health-related services, and ancillary services to a patient receiving an opioid agonist treatment medication for opiate addiction.

135.  “Opioid agonist treatment medication” means a prescrip- tion medication that is approved by the U.S. Food and Drug Administration under 21 U.S.C. § 355 for use in the treatment of opiate addiction.

136.  “Order” means instructions to provide

a.         Physical health services to a patient from a medical practitioner or as otherwise provided by law; or

b.        Behavioral health services to a patient from a behav- ioral health professional.

137.  “Orientation” means the initial instruction and informa- tion provided to an individual before the individual starts work or volunteer services in a health care institution.

138.  “Outing” means a social or recreational activity that:

a.         Occurs away from the premises,

b.        Is not part of a behavioral health inpatient facility’s or behavioral health residential facility’s daily rou- tine, and

c.         Lasts longer than four hours.

139.  “Outpatient surgical center” means a class of health care institution that has the facility, staffing, and equipment to provide  surgery  and   anesthesia  services  to   a  patient

whose recovery, in the opinions of the patient’s surgeon and, if an anesthesiologist would be providing anesthesia services to the patient, the anesthesiologist, does not require inpatient care in a hospital.

140.  “Outpatient treatment center” means a class of health care institution without inpatient beds that provides physical health services or behavioral health services for the diag- nosis and treatment of patients.

141.  “Overall time-frame” means the same as in A.R.S. § 41- 1072.

142.  “Owner” means a person who appoints, elects, or desig- nates a health care institution’s governing authority.

143.  “Participant” means a patient receiving physical health services or behavioral health services from an adult day health care facility or a substance abuse transitional facil- ity.

144.  “Participant’s representative” means the same as “patient’s representative” for a participant.

145.  “Patient,” means an individual receiving physical health services or behavioral health services from a health care institution.

146.  “Patient follow-up instructions” means information rele- vant to a patient’s medical condition or behavioral health issue that is provided to the patient, the patient’s repre- sentative, or a health care institution.

147.  “Patient’s representative,” means:

a.         A patient’s legal guardian;

b.        If a patient is less than 18 years of age and not an emancipated minor, the patient’s parent;

c.         If a patient is 18 years of age or older or an emanci- pated minor, an individual acting on behalf of the patient with the written consent of the patient or patient’s legal guardian; or

d.        A surrogate as defined in A.R.S. § 36-3201.

148.  “Person” means the same as in A.R.S. § 1-215 and includes a governmental agency.

149.  Personnel member” means, except as defined in specific Articles in this Chapter and excluding a medical staff member, a student, or an intern, an individual providing physical health services or behavioral health services to a patient.

150.  “Pest control program” means activities that minimize the presence of insects and vermin in a health care institution to ensure that a patient’s health and safety is not at risk.

151.  “Pharmacist” has the same meaning as in A.R.S. § 32- 1901.

152.  “Physical examination” means to observe, test, or inspect an individual’s body to evaluate health or determine cause of illness, injury, or disease.

153.  “Physical health services” means medical services, nurs- ing services, health-related services, or ancillary services provided to an individual to address the individual’s med- ical condition.

154.  “Physical therapist” has the same meaning as in A.R.S. § 32-2001.

155.  “Physical therapist assistant” has the same meaning as in

A.R.S. § 32-2001.

156.  “Physician assistant” has the same meaning as in A.R.S. § 32-2501.

157.  “Premises” means property that is designated by an appli- cant or licensee and licensed by the Department as part of a health care institution where physical health services or behavioral health services are provided to a patient.

158.  “Professional credentialing board” means a non-govern- mental organization that designates individuals who have

met or exceeded established standards for experience and competency in a specific field.

159.  “Progress note” means documentation by a medical staff member, nurse, or personnel member of:

a.         An observed patient response to a physical health service or behavioral health service provided to the patient,

b.        A patient’s significant change in condition, or

c.         Observed behavior of a patient related to the patient’s medical condition or behavioral health issue.

160.  “PRN” means pro re nata or given as needed.

161.  “Project” means specific construction or modification of a facility stated on an architectural plans and specifica- tions approval application.

162.  “Provider” means an individual to whom the Department issues a license to operate an adult behavioral health ther- apeutic home or a behavioral health respite home in the individual’s place of residence.

163.  “Provisional license” means the Department’s written approval to operate a health care institution issued to an applicant or licensee that is not in substantial compliance with the applicable laws and rules for the health care institution.

164.  “Psychotropic medication” means a chemical substance that:

a.         Crosses the blood-brain barrier and acts primarily on the central nervous system where it affects brain function, resulting in alterations in perception, mood, consciousness, cognition, and behavior; and

b.        Is provided to a patient to address the patient’s behavioral health issue.

165.  “Quality management program” means ongoing activities designed and implemented by a health care institution to improve the delivery of medical services, nursing ser- vices, health-related services, and ancillary services pro- vided by the health care institution.

166.  “Recovery care center” has the same meaning as in A.R.S. § 36-448.51.

167.  “Referral” means providing an individual with a list of the class or subclass of health care institution or type of health care professional that may be able to provide the behavioral health services or physical health services that the individual may need and may include the name or names of specific health care institutions or health care professionals.

168.  “Registered dietitian” means an individual approved to work as a dietitian by the American Dietetic Associa- tion’s Commission on Dietetic Registration.

169.  “Registered nurse” has the same meaning as in A.R.S. § 32-1601.

170.  “Registered nurse practitioner” has the same meaning as

A.R.S. § 32-1601.

171.  “Regular basis” means at recurring, fixed, or uniform intervals.

172.  “Research” means the use of a human subject in the sys- tematic study, observation, or evaluation of factors related to the prevention, assessment, treatment, or under- standing of a medical condition or behavioral health issue.

173.  “Resident” means an individual living in and receiving physical health services or behavioral health services from a nursing care institution, a behavioral health resi- dential facility, an assisted living facility, or an adult behavioral health therapeutic home.

174.  “Resident’s representative” means the same as “patient’s representative” for a resident.

175.  “Respiratory care services” has the same meaning as “practice of respiratory care” as defined in A.R.S. § 32- 3501.

176.  “Respiratory  therapist”  has  the  same  meaning  as  in

A.R.S. § 32-3501.

177.  “Restraint” means any physical or chemical method of restricting a patient’s  freedom of movement, physical activity, or access to the patient’s own body.

178.  “Risk” means potential for an adverse outcome.

179.  “Room” means space contained by a floor, a ceiling, and walls extending from the floor to the ceiling that has at least one door.

180.  “Rural general hospital” means a subclass of hospital having 50 or fewer inpatient beds and located more than 20 surface miles from a general hospital or another rural general hospital that requests to be and is licensed as a rural general hospital rather than a general hospital.

181.  “Satellite facility” has the same meaning as in A.R.S. § 36-422.

182.  “Scope of services” means a list of the behavioral health services or physical health services the governing author- ity of a health care institution has designated as being available to a patient at the health care institution.

183.  “Seclusion” means the involuntary solitary confinement of a patient in a room or an area where the patient is pre- vented from leaving.

184.  “Self-administration of medication” means a patient hav- ing access to and control of the patient’s medication and may include the patient receiving limited support while taking the medication.

185.  “Sexual abuse” means the same as in A.R.S. § 13- 1404(A).

186.  “Sexual assault” means the same as in A.R.S. § 13- 1406(A).

187.  “Shift” means the beginning and ending time of a contin- uous work period established by a health care institution’s policies and procedures.

188.  “Signature” means:

a.         A handwritten or stamped representation of an indi- vidual’s name or a symbol intended to represent an individual’s name, or

b.        An electronic signature.

189.  “Significant change” means an observable deterioration or improvement in a patient’s physical, cognitive, behav- ioral, or functional condition that may require an alter- ation to the physical health services or behavioral health services provided to the patient.

190.  “Speech-language pathologist” means an individual licensed according A.R.S. Title 35, Chapter 17, Article 4 to engage in the practice of speech-language pathology, as defined in A.R.S. § 36-1901.

191.  “Special hospital” means a subclass of hospital that:

a.         Is licensed to provide hospital services within a spe- cific branch of medicine; or

b.        Limits admission according to age, gender, type of disease, or medical condition.

192.  “Student” means an individual attending an educational institution and working under supervision in a health care institution through an arrangement between the health care institution and the educational institution.

193.  “Substantial” when used in connection with a modifica- tion means:

a.         A change in a health care institution’s licensed capacity, licensed occupancy, or the number of dial- ysis stations;

b.        An addition or deletion of an authorized service;

c.         A change in the physical plant, including facilities or equipment, that costs more than $300,000; or

d.        A change in the building where a health care institu- tion is located that affects compliance with applica- ble physical plant codes and standards incorporated by reference in A.A.C. R9-1-412.

194.  “Substance abuse” means an individual’s misuse of alco- hol or other drug or chemical that:

a.         Alters the individual’s behavior or mental function- ing;

b.        Has the potential to cause the individual to be psy- chologically or physiologically dependent on alco- hol or other drug or chemical; and

c.         Impairs, reduces, or destroys the individual’s social or economic functioning.

195.  “Substance abuse transitional facility” means a class of health care institution that provides behavioral health ser- vices to an individual over 18 years of age who is intoxi- cated or may have a substance abuse problem.

196.  “Supportive services” has the same meaning as in A.R.S.

§ 36-151.

197.   “Substantive review time-frame” means the same as in

A.R.S. § 41-1072.

198.  “Surgical procedure” means the excision or incision of a patient’s body for the:

a.         Correction of a deformity or defect,

b.        Repair of an injury, or

c.         Diagnosis, amelioration, or cure of disease.

199.  “Swimming pool” has the same meaning as “semipublic swimming pool” in A.A.C. R18-5-201.

200.  “System” means interrelated, interacting, or interdepen- dent elements that form a whole.

201.  “Tax ID number” means a numeric identifier that a per- son uses to report financial information to the United States Internal Revenue Service.

202.  “Telemedicine” has the same meaning as in A.R.S. § 36- 3601.

203.  “Therapeutic diet” means foods or the manner in which food is to be prepared that are ordered for a patient.

204.  “Therapist” means an occupational therapist, a physical therapist, a respiratory therapist, or a speech-language pathologist.

205.  “Time out” means providing a patient a voluntary oppor- tunity to regain self-control in a designated area from which the patient is not physically prevented from leav- ing.

206.  “Transfer” means a health care institution discharging a patient and sending the patient to another licensed health care institution as an inpatient or resident without intend- ing that the patient be returned to the sending health care institution.

207.  “Transport” means a licensed health care institution:

a.         Sending a patient to a receiving licensed health care institution for outpatient services with the intent of the patient returning to the sending licensed health care institution, or

b.        Discharging a patient to return to a sending licensed health care institution after the patient received out- patient services from the receiving licensed health care institution.

208.  “Treatment” means a procedure or method to cure, improve, or palliate an individual’s medical condition or behavioral health issue.

209.  “Treatment plan” means a description of the specific physical health services or behavioral health services that a health care institution anticipates providing to a patient.

210.  “Unclassified health care institution” means a health care institution not classified or subclassified in statute or in rule.

211.  “Vascular access” means the point on a patient’s body where blood lines are connected for hemodialysis.

212.  “Volunteer” means an individual authorized by a health care institution to work for the health care institution on a regular basis without compensation from the health care institution and does not include a medical staff member who has clinical privileges at the health care institution.

213.  “Working day” means a Monday, Tuesday, Wednesday, Thursday, or Friday that is not a state and federal holiday or a statewide furlough day.

Historical Note

New Section made by final rulemaking at 8 A.A.R. 3559, effective August 1, 2002 (Supp. 02-3). Amended by exempt rulemaking at 19 A.A.R. 2015, effective October 1, 2013 (Supp. 13-2). Amended by exempt rulemaking at

20 A.A.R. 1409, pursuant to Laws 2013, Ch. 10, § 13;

effective July 1, 2014 (Supp. 14-2). Amended by exempt

rulemaking at 20 A.A.R. 3535, pursuant to Laws 2014,

Ch. 233, § 5; effective January 1, 2015 (Supp. 14-4).