Hawaii Administrative Rules › Title 11 - DEPARTMENT OF HEALTH › Subtitle 1 - GENERAL DEPARTMENTAL PROVISIONS › Chapter 90 - ASSISTED LIVING FACILITY › Section 11-90-2 - Definitions

Current through June, 2024
As used in this chapter: "Abuse" means actual or imminent
				  physical injury, psychological abuse or neglect, sexual abuse, financial
				  exploitation, negligent treatment, or maltreatment as further defined in
				  section
				  346-222, HRS.
"Activities of Daily Living" or "ADL" means those personal
				  functional activities required by an individual for continued well-being
				  including eating, dressing, personal hygiene, mobility, toileting, and behavior
				  management.
"Aging in place" means the process of remaining in his or
				  her living environment ("home") despite the physical or mental decline that may
				  occur due to the aging process. For aging in place to occur, needed services
				  are provided, increased or adjusted to compensate for the physical or mental
				  decline of the individual within the ability of the facility.
"Assistance" means the resident can perform some part of an
				  activity, but cannot do it entirely alone.
"Assisted living" means encouraging and supporting
				  individuals to live independently and receive services and assistance to
				  maintain independence. All individuals have a right to live independently with
				  respect for their privacy and dignity, and to live in a setting free from
				  restraints.
"Assisted living facility" means an assisted living facility
				  as defined in section
				  321-15.1, HRS. This
				  facility shall consist of a building complex offering dwelling units to
				  individuals and services to allow residents to maintain an independent assisted
				  living lifestyle. The environment of an assisted living facility shall include
				  one in which meals are provided, staff are available on a 24-hour basis and
				  services are based on the individual needs of each resident. Each resident,
				  family member, and significant others shall work together with facility staff
				  to assess what is needed to support the resident so that the resident can
				  achieve his or her greatest capacity for living independently. The facility
				  shall be designed to maximize the independence and self-esteem of
				  limited-mobility persons who feel that they are no longer able to live on their
				  own.
"Choice" means viable options created for residents to
				  enable them to exercise greater control over their lives.
"Department" means the department of health.
"Dependent" means the resident cannot perform any part of an
				  activity; the activity must be done entirely by someone else.
"Dietitian" means a person who is registered or eligible for
				  registration by the Commission on Dietetic Registration of the American
				  Dietetic Association.
"Dignity" means providing support in such a way as to
				  validate the self-worth of the individual. Dignity is supported by designing a
				  residential program that delivers services in a manner which shows courtesy and
				  respect for a resident's right to make decisions.
"Direct care staff" means an employee of an assisted living
				  facility who is responsible and available for providing services directly to
				  residents including assistance with activities of daily living, such as
				  assistance with bathing, dressing, grooming, eating, money management, or
				  recreation.
"Director" means the director of health or the director's
				  designated representative.
"Emergency" means a life-threatening situation. It also
				  means those conditions specific to a resident which are identified in the
				  resident's care plan as requiring emergency care which may include behavior
				  that poses a danger to staff or others.
"Health care services" means the provision of services in an
				  assisted living facility that assist the individual in achieving and
				  maintaining the highest state of positive well-being (i.e., psychological,
				  social, physical, and spiritual) and functional status. This may include
				  nursing assessments and the monitoring and delegation of nursing tasks by
				  registered nurses pursuant to chapter 457, HRS, care management, records
				  management, and coordinating basic health care and social services per
				  residents in such settings.
"Homelike" means a type of environment which promotes the
				  dignity, security, and comfort of residents through the provision of
				  personalized care and services to encourage independence, choice and
				  decision-making by each resident. A homelike environment is also supported by
				  the use of residential building materials and furnishings.
"Independence" means supporting resident capabilities and
				  facilitating use of their abilities.
Independence is supported by creating barrier free
				  structures and careful design of assistive devices.
"Independent" means the resident can perform the ADL with
				  assistance.
"Individuality" means recognizing variability in residents'
				  needs and preferences and having flexibility to organize services in response
				  to such needs and preferences.
"Legal representative or designee" means an attorney at law,
				  a person holding a general power of attorney or special power of attorney for
				  health care, guardian, conservator, or any person appointed by a court to
				  manage the personal or financial affairs of the resident or person or agency
				  legally responsible for the welfare or support of the resident, other than the
				  facility.
"License" means an assisted living facility license.
"Licensed nurse" means a person who is licensed as a
				  registered nurse in the State of Hawaii pursuant to chapter 457, HRS.
"Licensee" means the person or entity (the owners) to whom a
				  license to operate an assisted living facility is issued and who is legally
				  responsible for the operation of the facility.
"Managed risk" means a formal process of negotiating and
				  developing a plan to address resident needs, decisions, or preferences to
				  reduce the probability of a poor outcome for the resident or of putting others
				  at risk for adverse consequences.
"Misappropriation of resident's property" means the illegal
				  or improper use of a client's funds or property for profit or advantage.
"Modified diet" means a diet for a diabetic, a low fat diet,
				  low sodium diet, or soft diet, or a special diet otherwise ordered by a
				  physician.
"Neglect" means a type of action or conduct, performed
				  without the resident's informed consent, which results in the deprivation of
				  food, water, medication, medical services, shelter, or other services necessary
				  to maintain minimum physical or mental health.
"Negotiated Plan of Care or Service Plan or Agreement" means
				  a written plan for services developed with the resident or significant others
				  and which includes a recognition of the resident's capabilities and choices.
				  The plan defines the division of responsibility in the implementation of
				  services and specifies measurable goals.
"Personal care" means the following two categories of
				  activities:
(1) Activities of daily living such as ambulation, mobility,
				  transfer and lifting, positioning and turning, bowel and bladder care,
				  toileting, bathing, dressing, grooming, feeding, exercise, and range of motion;
				  and
(2) Instrumental activities of daily living which are
				  directly related to the well-being of the resident such as meal preparation,
				  bed, kitchen and bathroom cleanliness, housekeeping, laundry, essential
				  errands, transportation, medication assistance, and maintenance of health
				  records.
"Physician" means a person who is licensed to practice
				  medicine or osteopathy under chapter 453 or chapter 460, HRS.
"Primary care provider" means a person who is licensed to
				  practice medicine or osteopathy under chapter 453 or chapter 460, HRS, or a
				  person who is licensed and recognized as an advanced practice registered nurse
				  under chapter 457.
"Privacy" means a specific area or time over which the
				  resident maintains a large degree of control. Privacy is supported with
				  services that are delivered with respect for the resident's civil
				  rights.
"Resident" means any person who is receiving room, board,
				  care, and services in an assisted living facility for a fee on a 24-hour
				  basis.
"Self-administration of medication" means the act of a
				  resident placing medication in or on his or her own body without assistance.
				  This means the resident manages and takes his or her own medications, the
				  resident identifies his or her own medication, the time and manner of
				  administration.
"Service plan" means a written plan for services developed
				  with input from a facility staff representative, the resident or significant
				  other (if the resident consents) and includes recognition of the resident's
				  capabilities and choices. The plan defines the division of responsibility in
				  the implementation of the services to be provided and specifies measurable
				  goals. The service plan also specifies who will be responsible for providing
				  services and when and how often care and services will be provided or arranged.
				  The plan shall be developed at the time of admission and shall be reviewed and
				  updated at least semi-annually or when the condition of the resident changes,
				  or when the need arises.
"Services" means activities or care provided by the facility
				  which assist the residents in developing appropriate skills to increase or
				  maintain their level of functioning or which assist them in performing personal
				  care or activities of daily living.
"Social work services" means the professional activity of
				  helping individuals, groups, or communities to enhance or restore their
				  capacity for social functioning and to create societal conditions favorable to
				  their goals.
"Unlicensed assistive personnel" means an individual who is
				  not licensed to practice nursing, but who provides tasks of nursing care in the
				  State of Hawaii pursuant to chapter 457, HRS.
"Waiver" means an exemption from a specific rule for a
				  duration not longer than one year which may be permitted a facility, for a
				  specified period of time, at the discretion of the director.
Whenever the singular is used in this chapter it may include
				  the plural.