Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 3 - PREADMISSION SCREENING (PAS) › Section R9-28-301 - Definitions

Current through Register Vol. 30, No. 28, July 12, 2024
A. Common
				definitions. In addition to definitions contained in A.R.S. Title 36, Chapter
				29, and 9 A.A.C. 28, Article 1, the words and phrases in this Article have the
				following meanings for an individual who is elderly or physically disabled
				(EPD) or developmentally disabled (DD) unless the context explicitly requires
				another meaning:
"Applicant" is defined in A.A.C.
				  R9-22-101.
"Assessor" means a social worker as defined in this
				  subsection or a licensed registered nurse (RN) who:
Is employed by the Administration to conduct PAS
				  assessments,
Completes a minimum of 30 hours of classroom training in both
				  EPD and DD PAS for a total of 60 hours, and
Receives intensive oversight and monitoring by the
				  Administration during the first 30 days of employment and ongoing oversight by
				  the Administration during all periods of employment.
"Current" means belonging to the present time.
"Disruptive behavior" means inappropriate behavior by the
				  applicant or member including urinating or defecating in inappropriate places,
				  sexual behavior inappropriate to time, place, or person or excessive whining,
				  crying, or screaming that interferes with an applicant's or member's normal
				  activities or the activities of others and requires intervention to stop or
				  interrupt the behavior.
"Frequency" means the number of times a specific behavior
				  occurs within a specified interval.
"Functional assessment" means an evaluation of information
				  about an applicant's or member's ability to perform activities related
				  to:
Developmental milestones,
Activities of daily living,
Communication, and
Behavior.
"Immediate risk of institutionalization" means the status of
				  an applicant or member under A.R.S. §
										36-2934(A)(5)
				   and as specified in A.R.S. §
										36-2936
				  and in the Administration's Section 1115 Waiver with Centers for Medicare and
				  Medicaid Services (CMS).
"Intervention" means therapeutic treatment, including the use
				  of medication, behavior modification, and physical restraints to control
				  behavior. Intervention may be formal or informal and includes actions taken by
				  friends or family to control the behavior.
"Medical assessment" means an evaluation of an applicant's or
				  member's medical condition and the applicant's or member's need for medical
				  services.
"Medical or nursing services and treatments" or "services and
				  treatments" means specific, ongoing medical, psychiatric, or nursing
				  intervention used actively to resolve or prevent deterioration of a medical
				  condition. Durable medical equipment and activities of daily living assistive
				  devices are not treatment unless the equipment or device is used specifically
				  and actively to resolve the existing medical condition.
"Physician consultant" means a physician who contracts with
				  the Administration.
"Social worker" means an individual with two years of case
				  management-related experience or a baccalaureate or master's degree in:
Social work,
Rehabilitation,
Counseling,
Education,
Sociology,
Psychology, or
Other closely related field.
"Special diet" means a diet planned by a dietitian,
				  nutritionist, or nurse that includes high fiber, low sodium, or pureed
				  food.
"Toileting" means the process involved in an applicant's or
				  member's managing of the elimination of urine and feces in an appropriate
				  place.
"Vision" means the ability to perceive objects with the
				  eyes.
B. EPD. In addition to
				definitions contained in subsection (A), the following also apply to an
				applicant or member who is EPD:
"Aggression" means physically attacking another,
				  including:
Throwing an object,
Punching,
Biting,
Pushing,
Pinching,
Pulling hair,
Scratching, and
Physically threatening behavior.
"Bathing" means the process of washing, rinsing, and drying
				  all parts of the body, including an applicant's or member's ability to transfer
				  to a tub or shower and to obtain bath water and equipment.
"Continence" means the applicant's or member's ability to
				  control the discharge of body waste from bladder and bowel.
"Dressing" means the physical process of choosing, putting
				  on, securing fasteners, and removing clothing and footwear. Dressing includes
				  choosing a weather-appropriate article of clothing but excludes aesthetic
				  concerns. Dressing includes the applicant's or member's ability to put on
				  artificial limbs, braces, and other appliances that are needed daily.
"Eating" means the process of putting food and fluids by any
				  means into the digestive system.
"Emotional and cognitive functioning" means an applicant's or
				  member's orientation and mental state, as evidenced by aggressive,
				  self-injurious, wandering, disruptive, and resistive behaviors.
"EPD" means an applicant or member who is elderly or
				  physically disabled.
"Grooming" means an applicant's or member's process of
				  tending to appearance. Grooming includes: combing or brushing hair; washing
				  face and hands; shaving; oral hygiene (including denture care); and menstrual
				  care. Grooming does not include aesthetics such as styling hair, skin care,
				  nail care, and applying cosmetics.
"Mobility" means the extent of an applicant's or member's
				  purposeful movement within a residential environment.
"Orientation" means an applicant's or member's awareness of
				  self in relation to person, place, and time.
"Physically disabled" means an applicant or member who is
				  determined to be physically impaired by the Administration through the PAS
				  assessment as allowed under the Administration's Section 1115 Waiver with
				  CMS.
"Resistiveness" means inappropriately obstinate and
				  uncooperative behaviors, including passive or active obstinate behaviors, or
				  refusing to participate in self-care or to take necessary medications.
				  Resistiveness does not include difficulties with auditory processing or
				  reasonable expressions of self-advocacy.
"Self-injurious behavior" means repeated self-induced,
				  abusive behavior that is directed toward infliction of immediate physical harm
				  to the body.
"Sensory" means of or relating to the senses.
"Transferring" means an applicant's or member's ability to
				  move horizontally or vertically between two surfaces within a residential
				  environment, excluding transfer for toileting or bathing.
"Wandering" means an applicant's or member's moving about
				  with no rational purpose and with a tendency to go beyond the physical
				  parameter of the residential environment.
C. DD. In addition to definitions contained
				in subsection (A), the following also apply to an applicant or member who is
				DD:
"Acute" means an active medical condition having a sudden
				  onset, lasting a short time, and requiring immediate medical
				  intervention.
"Aggression" means physically attacking another,
				  including:
Throwing objects,
Punching,
Biting,
Pushing,
Pinching,
Pulling hair, and
Scratching.
"Ambulation" means the ability to walk and includes quality
				  of the walking and the degree of independence in walking.
"Bathing or showering" means an applicant's or member's
				  ability to complete the bathing process including drawing the bath water,
				  washing, rinsing, and drying all parts of the body, and washing the
				  hair.
"Clarity of communication" means an ability to speak in
				  recognizable language or use a formal symbolic substitution, such as
				  American-Sign Language.
"Community mobility" means the applicant's or member's
				  ability to move about a neighborhood or community independently, by any mode of
				  transportation.
"Crawling and standing" means an applicant's or member's
				  ability to crawl and stand with or without support.
"DD" means developmentally disabled.
"Developmental milestone" means a measure of an applicant's
				  or member's functional abilities, including:
Fine motor skills,
Gross motor skills,
Communication,
Socialization,
Daily living skills, and
Behaviors.
"Dressing" means the ability to put on and remove an article
				  of clothing. Dressing does not include the ability to put on or remove braces
				  nor does it reflect an applicant's or member's ability to match colors or
				  choose clothing appropriate for the weather.
"Eating or drinking" means the process of putting food and
				  fluid by any means into the digestive system.
"Expressive verbal communication" means an applicant's or
				  member's ability to communicate thoughts with words or sounds.
"Food preparation" means the ability to prepare a simple meal
				  including a sandwich, cereal, or a frozen meal.
"Hand use" means the applicant's or member's ability to use
				  both hands, or one hand if an applicant or member has only one hand or has the
				  use of only one hand.
"History" means a medical condition that occurred in the
				  past, regardless of whether the medical condition required treatment in the
				  past, and is not now active.
"Personal hygiene" means the process of tending to one's
				  appearance. Personal hygiene may include: combing or brushing hair, washing
				  face and hands, shaving, performing routine nail care, oral hygiene including
				  denture care, and menstrual care. This does not include aesthetics such as
				  styling hair, skin care, and applying cosmetics.
"Rolling and sitting" means an applicant's or member's
				  ability to roll and sit independently or with the physical support of another
				  person or with a device such as a pillow or specially-designed chair.
"Running or wandering away" means an applicant or member
				  leaving a physical environment without notifying or receiving permission from
				  the appropriate individuals.
"Self-injurious behavior" means an applicant's or member's
				  repeated behavior that causes injury to the applicant or member.
"Verbal or physical threatening" means any behavior in which
				  an applicant or member uses words, sounds, or action to threaten harm to self,
				  others, or an object.
"Wheelchair mobility" means an applicant's or member's
				  mobility using a wheelchair and does not include the ability to transfer to and
				  from the wheelchair.