Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 146 - SPECIALIZED HEALTH CARE DELIVERY SYSTEMS › Subpart B - SUPPORTIVE LIVING PROGRAM (SLP) SETTINGS › Section 146.205 - Definitions

Current through Register Vol. 48, No. 28, July 12, 2024
For purposes of this Part, the following terms shall be
				  defined as follows:
"Abuse" means the willful infliction of injury, unreasonable
				  confinement, intimidation, or punishment with resulting physical harm, pain or
				  mental anguish (
				  42
				  CFR 488.301 ).
"Activities of Daily Living" or "ADL" means eating, bathing,
				  dressing, transferring, toileting, walking and grooming.
"Advance Directive" means a power of attorney that gives a
				  designated individual decision-making powers upon a person's incompetence. The
				  Department of Public Health is required to make available a Uniform Do Not
				  Resuscitate Advance Directive that may be used in all settings, the Statutory
				  Will Declaration form, the Illinois Statutory Short Form Power of Attorney for
				  Health Care, the statutory Declaration of Mental Health Treatment Form, and the
				  summary of advance directives law in Illinois (Section 2310-600 of the
				  Department of Public Health Powers and Duties Law of the Civil Administrative
				  Code of Illinois [20 ILCS 2310 -600].
"Bank Nursing Facility Beds" means a choice by SLP providers
				  to participate by converting a distinct part of a nursing facility. Such
				  facilities shall be allowed to retain the Certificate of Need for nursing beds
				  that were converted.
"Complaint" means a phone call, letter or personal contact to
				  the Department from a resident, family member, resident representative or any
				  other interested person expressing a concern related to the health, safety or
				  well-being of one or more SLP residents.
"Comprehensive Resident Assessment Instrument" or "RAI" means
				  the Department designated resident assessment instrument designed for use in
				  SLP settings.
"Declaration of Mental Health Treatment" means a document
				  that lets a person state he or she wants to receive electroconvulsive treatment
				  (ECT) or psychotropic medicine when the person has a mental illness and is
				  unable to make decisions for himself or herself. It also allows a person to say
				  whether he or she wishes to be admitted to a mental health facility if unable
				  to make that decision.
"Department" means the Illinois Department of Healthcare and
				  Family Services.
"Determination of Need" or "DON" means the assessment tool
				  used by the Department or the Department's authorized representative to
				  determine functional needs of a resident or prospective resident of the SLP in
				  which the resident or prospective resident has been found to be in need of a
				  nursing facility level of care. A minimum score of 29 is required on the DON,
				  which indicates a nursing facility level of care, before payment may be
				  authorized for the SLP resident.
"Developmental Disability" or "DD" means a disability that is
				  attributable to a diagnosis of mental retardation or related condition such as
				  cerebral palsy or epilepsy that results in impairment of general intellectual
				  functioning or adaptive behavior. This condition is manifested before the age
				  of 22 and is likely to continue indefinitely. It results in substantial
				  functional limitations in three or more areas of major life activities, such as
				  self-care, understanding and use of language, learning, mobility,
				  self-direction, and capacity for independent living.
"Direct Care Staff" means staff that provides professional
				  nursing services, assistance with activities of daily living or other personal
				  needs or maintenance, or general supervision and oversight of the physical and
				  mental well being of an individual.
"Distinct Part" means a separate building or an entire wing
				  or other physically identifiable space of an existing nursing facility licensed
				  under the Nursing Home Care Act or the Hospital Licensing Act that is operated
				  as an SLP setting distinguishable from the rest of the facility. The distinct
				  part of a nursing facility will not be subject to provisions of the Nursing
				  Home Care Act. The distinct part of a hospital will be subject to provisions of
				  the Hospital Licensing Act while complying with provisions of this Subpart B.
				  Distinct part does not include the conversion of an entire nursing facility or
				  hospital.
"Do Not Resuscitate" or "DNR" means a medical treatment order
				  that says cardiopulmonary resuscitation (CPR) will not be attempted if a
				  person's heart and/or breathing stops.
"Durable Power of Attorney" means power of attorney given to
				  a person designated as another person's agent giving broad powers to make
				  health care decisions, including power to require, consent to or withdraw any
				  type of personal care or medical treatment for any physical or mental
				  condition, and to admit or discharge a person from any hospital, home or other
				  institution.
"Financial Exploitation" means the act of obtaining control
				  over a resident or his or her property and/or resources through deception or
				  intimidation to the disadvantage of the resident and/or the profit of another
				  and/or the intent of depriving the resident of the use, benefit or possession
				  of his or her property and/or resources.
"Follow-up Care" means the response to, and documentation of,
				  the service plan that is discussed with, and agreed to by, the resident and/or
				  the resident's guardian. It may include, but is not limited to, physician
				  referrals, revision of the service plan to incorporate nursing services, health
				  promotion counseling and teaching self care in meeting health needs.
"Freestanding Facility" means a separate building that is not
				  part of an existing nursing facility or hospital. Freestanding facility
				  includes new construction, an existing building or conversion of an entire
				  nursing facility or hospital into an SLP setting.
"Immediate Jeopardy" means a situation in which a provider's
				  noncompliance with one or more requirements of participation has caused, or is
				  likely to cause, serious injury, harm, impairment or death to a resident (
				  42
				  CFR 488.301 ).
"Instrumental Activities of Daily Living" or "IADL" means
				  activities related to independent living and includes preparing meals, managing
				  money, shopping for groceries or personal items, performing light or heavy
				  housework, and using a telephone.
"Licensed Nurse" means a person whose services are paid for
				  by an SLP and who is licensed as a registered nurse, registered professional
				  nurse, practical nurse or licensed practical nurse under the Nurse Practice Act
				  [225 ILCS 65].
"Living Will" means a document that tells a person's health
				  care professional whether the person wants death-delaying procedures used if
				  the person has a terminal condition, and the person is unable to state his or
				  her wishes. A terminal condition means an incurable and irreversible condition
				  such that death is imminent, and the application of any death delaying
				  procedures serves only to prolong the dying process. A living will allows for
				  the administration of medication, sustenance, or the performance of any medical
				  procedure deemed necessary by the person's attending physician to provide the
				  person with comfort care.
"Mandated Reporter" is anyone identified in the Elder Abuse
				  and Neglect Act [320 ILCS 20] that shall report suspected abuse while engaged
				  in carrying out professional duties. A mandated reporter includes, but is not
				  limited to, a professional or professional's designee while engaged in social
				  services and the care of an adult age 60 and over. It also includes, but is not
				  limited to, any occupation required to be licensed under the Dietetic and
				  Nutrition Services Practice Act [225 ILCS 30], Nurse Practice Act, and Nursing
				  Home Administrator Licensing and Disciplinary Act [225 ILCS 70], and field
				  personnel of the Departments of Healthcare and Family Services, Public Health
				  and Human Services and any county or municipal health department.
"Medicaid" means the Department's Medical Assistance
				  Program.
"Medicaid Resident" means a person with a physical disability
				  (as determined by the Social Security Administration) age 22 years and over or
				  a person who is age 65 years and over, who has been determined eligible for
				  Medicaid payment for SLP services. Eligibility for a person residing in an SLP
				  setting shall be determined in accordance with 89 Ill. Adm. Code
				  120.10 and
				  120.61 (excluding
				  subsection (f) of Section 120.61). Provisions for property transfers as
				  described at 89 Ill. Adm. Code
				  120.387
				  shall apply to a person residing in an SLP setting. Provisions for the
				  prevention of spousal impoverishment as described at 89 Ill. Adm. Code
				  120.379
				  shall apply to a person residing in an SLP setting.
"Medical Assistance Program" means the program administered
				  under Article V of the Illinois Public Aid Code [305 ILCS 5 /Art. V] or
				  successor programs and Title XIX of the Social Security Act (
				  42 USC
				  1396 ) and related federal and State rules
				  and regulations.
"Medication Error" includes, but is not limited to, incorrect
				  dosage, medication given at incorrect time, wrong medication given, wrong route
				  used or missed medication.
"Neglect" means a failure by the SLP provider to notify the
				  appropriate health care professional, to provide or arrange necessary services
				  to avoid physical or psychological harm to a resident, or to terminate the
				  residency of a resident whose needs can no longer by met by the SLP provider,
				  causing an avoidable decline in function. Neglect may be either passive
				  (non-malicious) or willful.
"Personal Allowance" means the $90 minimum protected monthly
				  amount of a Medicaid-eligible resident's income that is retained by
				  Medicaid-eligible residents for their personal use.
"Progress Notes" means notes used to document the decline or
				  improvement in a resident's status.
"Rehabilitated Nursing Facility" means the conversion of a
				  distinct part of an existing nursing facility into an SLP setting.
"Related Parties" means affiliates of an SLP provider;
				  entities for which investments are accounted for by the equity method by the
				  entire enterprise; trusts for the benefit of employees, such as pensions and
				  profit-sharing trusts that are managed by or under the trusteeship of
				  management; any general partner; management of the SLP setting; members of the
				  immediate families of principal owners of the SLP setting or its management;
				  and other parties with which the SLP provider may deal if one party controls or
				  can significantly influence management or operating policies of the other to an
				  extent that one of the transacting parties might be prevented from fully
				  pursuing its own separate interests. An entity or person shall be deemed by the
				  Department to be a related party if it can significantly influence management
				  or operating policies of the transacting parties or if it has an ownership
				  interest in one of the transacting parties and can significantly influence the
				  other to an extent that one or more of the transacting parties might be
				  prevented from fully pursuing its own separate interests.
"Resident" means a person living in an SLP setting, including
				  Medicaid residents as defined in this Section and individuals who are not
				  eligible for Medicaid payment for SLP services.
"Resident Assessment Instrument" or "RAI" or "Comprehensive
				  Resident Assessment Instrument" means the Department designated resident
				  assessment instrument designed for use in SLP settings.
"Room and Board" means the housing, utilities and meals
				  provided under the resident contract. Unless otherwise specified in the
				  resident contract, room and board does not include phone or cable
				  charges.
"Security Deposit" means a payment used to secure the payment
				  of rent or compensation for damage to property for residential property
				  containing 25 units or more (see Security Deposit Interest Act [765 ILCS 715
				  ]). A security deposit may also include a pet deposit to secure payment for
				  damage to the residential property. Damage to property shall not include normal
				  wear and tear to an apartment or any other part of the SLP setting.
"Serious Mental Illness" means:
A diagnosis of a major mental illness, such as schizophrenia,
				  schizoaffective disorder, bipolar disorder, major depression, panic disorders,
				  obsessive compulsive disorder, and any other disorder that could lead to a
				  chronic disability that is not a primary diagnosis of dementia. If the person
				  has both a dementia diagnosis and another psychiatric condition, the symptoms
				  of dementia must be significantly more progressed than symptoms of the
				  co-occurring psychiatric condition;
A disorder for which the duration is a significant life
				  disruption or that required major treatment episodes within the past two years.
				  This does not necessarily mean that the individual was hospitalized; and
That the disability or Level of Impairment is characterized
				  by active behavioral health symptoms, within the preceding six month period,
				  that significantly interfere with the individual's ability to interact
				  interpersonally, concentrate, follow through with goals or needs, and/or adapt
				  effectively to change.
"Services" means the personal and health care related
				  services provided by an SLP provider pursuant to Section
				  146.230.
"Service Plan" means the written plan of care on the
				  Department designated form that is developed for each resident based upon the
				  initial assessment, annual comprehensive resident assessment or quarterly
				  evaluation.
"Significant Change" means that there has been a decline or
				  improvement in a resident's status that will not normally resolve itself
				  without intervention by staff or by implementing standard disease-related
				  clinical interventions, and the decline or improvement impacts more than one
				  area of the resident's health status and requires revision of the Service
				  Plan.
"SSI" means Supplemental Security Income under Title XVI of
				  the Social Security Act.
"Subcontractor" means any person who assumes any duties and
				  responsibilities from an SLP provider for the performance of SLP services
				  pursuant to Section 146.230.
"Supportive Living Program" or "SLP" means a residential
				  setting that meets the requirements of this Subpart B or, for dementia care
				  settings, the requirements of this Subpart B and Subpart E.