Section R414-14A-2 - DefinitionsIn addition to the definitions in Rule R414-1, the following definitions apply to this rule.
(1) "Adult" means a member who is 21 years of age or older.(2) "Attending physician" means: (a) an individual identified by the member when the member elects to receive hospice care as having the most significant role in determining and delivering the member's medical care; and(b) a healthcare practitioner who is: (i) a physician who is a doctor of medicine or osteopathy; or(ii) a nurse practitioner or physician assistant who meets proper training, education, and experience requirements within their scope of licensing.(3) "Cap period" means the 12-month period ending September 30 used in the application of the cap on overall hospice reimbursement specified in 42 CFR 418.309.(4) "Consecutive months" means any number of months in a row wherein a hospice agency provides hospice care under the Medicaid benefit, including any portion of a month.(5) "Continuous home care day" means a day in which a member, who has elected to receive hospice care at home, receives a minimum of eight aggregate hours of care from the hospice provider during a 24-hour day, which begins and ends at midnight. The eight aggregate hours of care must be predominantly nursing care provided by either a registered nurse or licensed practical nurse.(6) "General inpatient care day" means a day when a member with elected hospice care receives general inpatient care for pain control or acute or chronic symptom management that is not manageable in the member's place of residence or another outpatient setting.(7) "Hospice agency" means an agency licensed under Rule R432-750 and is primarily engaged in providing hospice care to terminally ill individuals.(8) "Inpatient respite care day" means a day when a member with elected hospice care receives short-term inpatient care necessary to relieve family members or other persons caring for the member at their place of residence.(9) "Palliative care" means patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care addresses physical, intellectual, emotional, social, and spiritual needs while facilitating patient autonomy, access to information, and choice.(10) "Pediatric" means a member who is under 21 years of age.(11) "Pediatric hospice agency" means an enrolled hospice agency that has trained employees in providing hospice care to patients who are younger than 21 years of age.(12) "Representative" means an individual who is authorized under state law to make health care decisions on behalf of a member, including initiating, continuing, refusing, or terminating medical treatments for a member who cannot make these decisions.(13) "Terminally ill" means a medical prognosis to live no more than six months if the illness runs its ordinary course.Utah Admin. Code R414-14A-2
Amended by Utah State Bulletin Number 2022-20, effective 9/30/2022