Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 70 - Adult Day Services › Rule 481-70.1 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
In addition to the definitions in 481-Chapter 67 and Iowa
				  Code chapter 231D, the following definitions apply.
"Accredited"
means that the program has
				  received accreditation from an accreditation entity recognized in subrule
				  70.14(1).
"Adult day services"
or
"adult day
				  services program"
or
"program"
means an organized
				  program providing a variety of health-related care, social services, and other
				  related support services for 16 hours or less in a 24-hour period to two or
				  more persons with a functional impairment on a regularly scheduled, contractual
				  basis.
"Applicable requirements"
means Iowa Code
				  chapter 231D, this chapter, and 481-Chapter 67 and includes any other
				  applicable administrative rules and provisions of the Iowa Code.
"CARF"
means the Commission on
				  Accreditation of Rehabilitation Facilities.
"Change of ownership"
means the purchase,
				  transfer, assignment or lease of a certified adult day services program and
				  includes a change in the management company responsible for the day-to-day
				  operation of the program, if the management company is ultimately responsible
				  for any enforcement action taken by the department.
"Cognitive disorder"
means a disorder
				  characterized by cognitive dysfunction presumed to be the result of illness
				  that does not meet criteria for dementia, delirium, or amnestic
				  disorder.
"Contractual agreement"
means a written
				  agreement between the program and the participant or legal
				  representative.
"Dementia-specific adult day services
				  program"
means an adult day services program certified under this
				  chapter that:
1. Serves fewer than 55 participants and has 5 or more
				  participants who have dementia between Stages 4 and 7 on the Global
				  Deterioration Scale, or
2. Serves 55 or more participants and 10 percent or more of
				  the participants have dementia between Stages 4 and 7 on the Global
				  Deterioration Scale, or
3. Holds itself out as providing specialized care for
				  persons with dementia, such as Alzheimer's disease, in a dedicated
				  setting.
"Functional impairment"
means a
				  psychological, cognitive, or physical impairment that creates an inability to
				  perform personal and instrumental activities of daily living and associated
				  tasks and that necessitates some form of supervision or assistance or
				  both.
"Maximal assistance with activities of daily
				  living"
means routine total dependence on staff for the performance of
				  a minimum of four activities of daily living for a period that exceeds 21
				  days.
"Medically unstable"
means that a
				  participant has a condition or conditions:
1. Indicating physiological frailty as determined by the
				  program's staff in consultation with a physician or physician extender;
2. Resulting in three or more significant hospitalizations
				  within a consecutive three-month period for more than observation; and
3. Requiring frequent supervision of the participant for
				  more than 21 days by a registered nurse.
For example, a participant who has a condition such as
				  congestive heart failure which results in three or more significant
				  hospitalizations during a quarter and which requires that the participant
				  receive frequent supervision may be considered medically unstable.
"Nonaccredited"
means that the program has
				  been certified under the provisions of this chapter but has not received
				  accreditation from the accreditation entity recognized in subrule
				  70.14(1).
"Participant"
means an individual who is the
				  recipient of services provided by an adult day services program.
"Participant's legal representative"
means
				  a person appointed by the court to act on behalf of a participant, or a person
				  acting pursuant to a power of attorney.
"Unmanageable incontinence"
means a
				  condition that requires staff provision of total care for an incontinent
				  participant who lacks the ability to assist in bladder or bowel continence
				  care.
"Unmanageable verbal abuse"
means repeated
				  verbalizations against participants or staff that persist despite all
				  interventions and negatively affect the program.
"Unmanageable verbal abuse"
includes but is
				  not limited to threats, frequent use of profane language, or unwelcome sexually
				  oriented remarks.
"Visiting day(s)"
means up to 16 hours in a
				  two-day period during which a person may visit a program prior to admission for
				  the purpose of assessing eligibility for the program and personal
				  satisfaction.