Compilation of Rules and Regulations of the State of Georgia › Department 111 - RULES OF DEPARTMENT OF COMMUNITY HEALTH › Chapter 111-8 - HEALTHCARE FACILITY REGULATION › Subject 111-8-1 - RULES AND REGULATIONS FOR ADULT DAY CENTERS › Rule 111-8-1-.04 - Definitions

Current through Rules and Regulations filed through June 27, 2024
(1) In these rules,
				unless the context otherwise requires, the words and phrases set forth herein
				shall mean the following:
(a) "Abuse" means
				any intentional or grossly negligent act or series of acts or intentional or
				grossly negligent omission to act which causes injury to a participant,
				including but not limited to assault or battery, failure to provide treatment
				or care, or sexual harassment.
(b)
				"Activities of daily living" means bathing, shaving, brushing teeth, combing
				hair, toileting, dressing, eating, grooming, taking medications, and transfers
				and/or ambulation.
(c) "Adult"
				means a person 18 years or older or an emancipated minor.
(d) "Adult day care (ADC)" means the
				provision of a comprehensive plan of services that meets the needs of aging
				adults as defined in paragraph (g) of these definitions under a social model,
				as defined in paragraph (ll) of these definitions. This term shall not include
				programs which provide day habilitation and treatment services exclusively for
				individuals with developmental disabilities.
(e) "Adult day center" or "center" means a
				facility serving aging adults that provides adult day care or adult day health
				services, as defined in paragraphs (d) and (f) of these definitions, for
				compensation to three or more persons. Adult day centers may operate in more
				than one location if classified and approved by the Department as a mobile
				adult day center. This term shall not include a respite care services
				program.
(f) "Adult day health
				services (ADHS)" means the provision of a comprehensive plan of services that
				meets the needs of aging adults under a medical model as defined in paragraph
				(v) of these definitions. This term shall not include programs which provide
				day habilitation and treatment services exclusively for individuals with
				developmental disabilities.
(g)
				"Aging adults" means persons 60 years of age or older or mature adults below
				the age of 60 whose needs and interests are substantially similar to persons 60
				years of age or older who have physical or mental limitations that restrict
				their abilities to perform the normal activities of daily living and impede
				independent living.
(h) "Assistance
				with self-administration" means staff can provide assistance as outlined in
				Rule 111-8-1-.19.
(i) "Capacity" means the number of
				participants for which a center has been licensed to provide care and services
				at any given time.
(j) "Days" means
				calendar days, not workdays, unless otherwise noted in the text.
(k) "Department" means the Georgia Department
				of Community Health.
(l)
				"Dietitian" means a registered dietitian, with current registration by the
				Commission on Dietetic Registration of the American Dietetic Association; and a
				licensed dietitian, with current licensure by the Georgia Board of Examiners of
				Licensed Dietitians.
(m) "Direct
				care staff" means any individual who provides direct services to participants,
				including, but not limited to the Director, a licensed nurse, the activities
				director, aides, and volunteers.
(n) "Director" means the person designated by
				the governing body as responsible for the overall operation of a
				center.
(o) "Disaster preparedness
				plan" means a written document which identifies potential hazards or events,
				that should they occur, would cause an emergency situation at the center; and
				proposes, for each identified emergency situation, a course of action so as to
				minimize the threat to health and safety of the participants.
(p) "Exploitation" means an unjust or
				improper use of another person or the person's property through undue
				influence, coercion, harassment, duress, deception, false representation, false
				pretense, or other similar means for one's own personal advantage.
(q) "Facility" means an adult day center,
				unless otherwise specified.
(r)
				"Governing body" means the Board of Trustees, the partnership, the corporation,
				the association, or the person or group of persons who maintain and control the
				center and who are legally responsible for the operation of the
				center.
(s) "Individual plan of
				care" means a document describing the participant's needs, services to be
				provided by the adult day center and, for adult day health services,
				identification of the therapeutic service provider who will deliver the
				required services, the expected outcomes and frequency of re-evaluation of the
				plan.
(t) "Licensed practical nurse
				(LPN)" means a person who provides care relating to the maintenance of health
				and prevention of illness under the supervision of a physician, dentist,
				podiatrist or registered nurse (RN).
(u) "Long-term care facility" means any
				skilled nursing home, intermediate care home, personal care home or assisted
				living community licensed by the Department.
(v) "Medical model" means a comprehensive
				program that provides adults with the basic social, rehabilitative, health and
				personal care services needed to sustain the essential activities of daily
				living and to restore or maintain optimal capacity for self-care. Such program
				of care shall be based on individual plans of care and shall be provided for
				less than 24 hours per day.
(w)
				"Mobile adult day center" means a program of services offered by an adult day
				center which utilizes a designated staff that travels from one central location
				to off-site locations to provide adult day services as described in these
				rules. The mobile adult day center transports the necessary staff and/or
				volunteers, participant records, supplies and program materials to each
				off-site location for the provision of services. The services offered by a
				mobile adult day center may either be adult day care services or adult day
				health services, or both, and are offered four days per week or less at any one
				location.
(x) "Neglect" means a
				failure to act or omission to act that caused or may cause physical harm,
				emotional injury or death.
(y)
				"Nurse" means a registered nurse (RN) or licensed practical nurse (LPN)
				licensed in the state of Georgia.
(z) "Nursing services" means services
				provided by licensed nursing personnel and may include therapy services.
				Nursing services may also include observation, promotion and maintenance of
				health, dressing changes, prevention of illness and disability, management of
				health care during acute and chronic phases of illness, guidance and counseling
				of individuals and participants' representatives, administration of medications
				and referral to physicians, other health care providers, and community
				resources when appropriate.
(aa)
				"Participant" means an adult receiving services in the adult day
				center.
(bb) "Physician's orders"
				means an order that is signed and dated by a medical doctor (MD), doctor of
				osteopathy (DO) or other person(s) authorized by law who is licensed to
				practice medicine in the state of Georgia.
(cc) "Primary caregiver" means the one
				identified relative or other person in a relationship of responsibility, such
				as an agent under a valid durable power of attorney for health care or health
				care agent under a valid advance directive for health care, who has assumed the
				primary responsibility for the provision of care needed to maintain the
				physical or mental health of an aging adult, who lives in the same residence
				with such individual, and who does not receive financial compensation for the
				care provided.
(dd) "Proxy
				caregiver" means an unlicensed person who has been determined to have the
				necessary knowledge and skills acquired through training by a licensed
				healthcare professional to perform documented health maintenance activities,
				including specialized procedures, for an individual with a disability who has
				delegated to the designated proxy caregiver the performance of such health
				maintenance activities through execution of a written informed consent by the
				individual with a disability or a person legally authorized to act on behalf of
				such individual with a disability.
(ee) "Registered nurse (RN)" means a person
				currently licensed by the Georgia Board of Nursing or successor entity to
				practice professional nursing.
(ff)
				"Representative" means anyone that the participant identifies as having
				authority to make decisions on his or her behalf.
(gg) "Resident" means any person receiving
				treatment or care in a long-term care facility.
(hh) "Respite care services program" means a
				program for aging adults who can function in a group setting and who can feed
				and toilet themselves with or without the assistance of a personal aide
				accompanying them and which:
1. Is operated by
				a nonprofit organization;
2.
				Provides no more than 25 hours of services per week;
3. Is managed by a director who has completed
				an adult day care services training and orientation program approved by the
				Department;
4. Is staffed primarily
				by volunteers; and
5. Has as its
				sole purpose to provide primary caregivers of aging adults with relief from
				normal caregiving duties and responsibilities.
(ii) "Restraint" means any manual or physical
				device, material, or equipment attached or adjacent to the participant's body
				that the individual cannot remove easily which restricts freedom or normal
				access to one's body or a drug or medication when it is used as a restriction
				to manage the participant's behavior or restrict the participant's freedom of
				movement and is not standard treatment or dosage for the participant's
				condition.
(jj) "Serious injury"
				means an injury requiring emergency medical intervention or treatment by
				medical personnel, either at an urgent care facility, at an emergency room or a
				medical office.
(kk) "Social
				activities" means therapeutic, educational, cultural enrichment, recreational,
				and other activities on site or in the community in a planned program to meet
				the social needs and interests of the participant.
(ll) "Social model" means a program that
				addresses primarily the basic social and recreational activities needed to be
				provided to aging adults, but also provides, as required, limited personal care
				assistance, supervision, or assistance essential for sustaining the activities
				of daily living. Such programs of care shall be based on individual plans of
				care and shall be provided for less than 24 hours per day.
(mm) "Staff" means, as appropriate to their
				roles and responsibilities, all people who provide supervision, care,
				treatment, and services in the center including permanent, temporary, and
				part-time employees, as well as contracted individuals and health profession
				students. The definition of staff does not include licensed independent
				practitioners who are not paid employees, contract employees or
				volunteers.
(nn) "Standard
				Precautions" means a system of precautions or set of guidelines designed to
				reduce exposure to and transmission of microorganisms from both recognized and
				unrecognized sources of potential infections.
(oo) "Volunteer" means an individual who
				performs or offers to perform a service for the center out of his/her own free
				will and without payment.