Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 87 - Adult Brain Injury Facilities Licensing Standards › Subchapter A - General Provisions › Section I-8703 - Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
Abuse
-the willful infliction of physical
						or mental injury on an individual by other parties, including but not limited
						to such means as sexual abuse, exploitation, or extortion of funds or other
						things of value, unreasonable confinement and/or intimidation to such an extent
						that his/her health, self-determination or emotional well-being is
						endangered.
Acquired Brain Injury
-an injury to the
						brain that has occurred after birth and is not hereditary, congenital, or
						degenerative. The injury commonly results in a change in neuronal activity,
						which affects the physical integrity, the metabolic activity or the functional
						ability of the cell. It can also result in the disturbance of behavioral or
						emotional functioning. These impairments may be either temporary or permanent
						and cause partial or total functional disability or psychosocial
						maladjustments. The term does not refer to brain injuries induced by birth
						trauma.
Activities of Daily Living
(
ADLs
)-activities considered the basic, vital, daily
						activities for persons and are identified as bathing, grooming, dressing,
						dining, toileting and ambulation/transfer.
Adult
-an individual 18 years of age or
						older.
Adult Brain Injury (ABI) Facility
-any of
						the following:
1.
residential level of care
-a facility
						publicly or privately owned, located at one or more geographic addresses,
						providing a rehabilitative treatment environment which serves four or more
						adults who suffer from brain injury and at least one of whom is not related to
						the operator. Services shall include personal assistance or supervision for a
						period of 24 hours continuously per day preparing them for community
						integration. Such services shall be provided by adult brain injury facilities
						licensed to provide residential level of care services;
2.
community living level of care
-a home
						or apartment publicly or privately owned, providing a rehabilitative treatment
						environment which serves one to six adults who suffer from brain injury and at
						least one of whom is not related to the operator. Services may include personal
						assistance or supervision for a period of up to 24 hours continuously per day
						in a home or apartment setting preparing them for community integration:
a. the apartment or home shall contain, at a minimum, a
						living/dining/bedroom area, kitchen/kitchenette, bathroom and storage
						space;
b. there shall be no more than three bedrooms in an
						apartment and no more than six beds per home;
c. such treatment environment shall be provided by adult
						brain injury facilities licensed to provide community living level of care
						services;
3.
outpatient level of care
-a facility
						publicly or privately owned providing an outpatient rehabilitative treatment
						environment which serves adults who suffer from brain injury, at least one of
						whom is not related to the operator, in an outpatient day treatment setting in
						order to advance the individuals independence for higher level of community or
						transition to a greater level of independence in community or vocational
						function. Such services shall be provided by adult brain injury facilities
						licensed to provide outpatient level of care services.
Assistance with Activities of Daily
						Living
-services that provide assistance with activities of daily
						living. Such assistance may be the actual performance of the task for the
						individual, providing hands-on assistance with the performance of the tasks, or
						supervision and prompting to allow the individual to self-perform such
						tasks.
Behavioral Services
-services that
						identify maladaptive behaviors which interfere with the persons safe
						integration into the community and the formulation of an inclusive behavior
						management program to decrease identified maladaptive behaviors.
Brain Injury
-an acquired or traumatic
						injury to the brain. Such term does not include brain dysfunction caused by
						congenital disorders, degenerative disorders or birth trauma but may include
						brain injuries caused by anoxia due to trauma.
Cessation of Business
-the ABI facility
						is non-operational and/or has stopped offering or providing services to the
						community.
Client
-an individual receiving care from
						an ABI facility who is medically stable and does not require an I V, a
						functioning feeding tube, or other artificial or mechanical supports for life
						sustaining processes.
Cognitive Rehabilitation
-a systematic,
						functionally oriented service of therapeutic cognitive activities based on an
						assessment and an understanding of the behavior of a client. Services are
						directed to achieve functional improvement by either:
1. reinforcing, strengthening or re-establishing
						previously learned patterns of behavior; or
2. establishing new patterns of cognitive activity or
						mechanisms to compensate for impaired neurological systems.
Community Integration
-the participation
						in the mainstream of community life and maintaining social relationships with
						family members, peers and others in the community who do not have brain
						injuries. Integration also means that clients have equal access to and full
						participation in community resources and activities available to the general
						public at the maximum amount of safety and independence as possible.
Department
(
LDH
)-the
						Louisiana Department of Health, formerly known as Department of Health and
						Hospitals or DHH.
Direct Care Staff
-an employee of the
						facility, either contracted or directly employed, who provides personal care
						services to the clients. Such services may include, but are not limited to,
						assistance with ADLs and IADLs.
Director
-the person designated by the
						owner or governing body as responsible for carrying out the day-today
						management, administration, supervision and operation of the facility.
Employed
-performance of a job or task
						for compensation, such as wages or a salary. An employed person may be one who
						is contracted or one who is hired directly.
Functional Limitations
-actual behaviors
						or mental or physical disabilities exhibited by adults with brain injuries or
						conditions presented by their environment, or both, that shall be modified or
						minimized in order for clients to fulfill their potential or maximize their
						functioning.
Head Injury
-a traumatic or acquired
						brain injury.
Health Standards Section
(
HSS
)-the agency or office within the Louisiana Department of
						Health with the responsibility for the inspection and licensure of adult brain
						injury facilities.
Impairment
-any loss or abnormality of
						psychological, cognitive, physiological, or anatomical structure or
						functioning.
Instrumental Activities of Daily Living
(
IADLs
)-activities considered to be instrumental, essential
						activities for persons, but are not usually considered as basic or vital
						activities of daily living, and may not be daily activities. Such activities
						include, but are not limited to:
1. socialization;
2. managing personal affairs;
3 financial management;
4 shopping;
5. housekeeping; and
6. appropriate transportation, correspondence, behavior
						and health management, etc.
Medication Management Program
-a
						systematic, functionally, oriented program formulated in consultation with the
						clients primary provider and implemented by staff, either contracted or
						directly employed, and trained by a nursing director. The program shall be
						based upon an assessment and understanding of the behaviors of the client and
						recognition of the unique medical and pharmacological needs of the client. It
						shall also mean an incorporation of the most appropriate level of assistance
						necessary to advance towards independence.
Neglect
-the failure to provide food,
						shelter, clothing, medical or other health services, appropriate security and
						supervision or other personal services necessary for a clients
						well-being.
Non-Ope
rational
-the ABI facility is not
						open and available for business operation as stated on the licensing
						application and business location signage.
Nursing Director
-a person who meets the
						legal requirement of a registered nurse (RN) in the state of Louisiana.
Personal Care
-services and supports
						including but not limited to:
1. bathing, hair care, skin care, shaving, nail care,
						oral hygiene, overall hygiene and activities of daily living;
2. interventions to assist with eating and bowel and
						bladder management;
3. positioning;
4. care of adaptive personal care devices; and
5. an appropriate level of supervision.
Primary Provider
-a provider,
						board-certified in his/her specialty, who currently holds a valid license in
						Louisiana and is responsible for overseeing the decision making process for
						admission and continued stay of clients.
Rehabilitation
-the process of providing
						those comprehensive services deemed appropriate to the needs of a client in a
						coordinated manner in a program designed to achieve functional objectives of
						improved health, welfare, maximum physical, cognitive, social, psychological
						and community functioning.
Rehabilitative Treatment Environment
-a
						rehabilitation setting that provides for all of the following:
1. a provision of a range of choices, with personal
						preference, self-determination and dignity of risks receiving full respect and
						consideration;
2. a variety of social interactions that promote
						community integration;
3. an environment of peer support and mentorship;
4. professional team involvement;
5. a physical environment conducive to enhancing the
						functional abilities of the client;
6 necessary therapeutic services which may include social
						work, behavioral services, speech therapy, physical therapy, occupational
						therapy, vocational services and therapeutic recreational services;
NOTE: All therapeutic providers shall be licensed under
						state and, if applicable, national boards.
7. a medication management program;
8. cognitive rehabilitation activities; and
9. the identification of functional limitations.
Representative
-a person who
						voluntarily, with the clients written authorization, may act upon the clients
						direction regarding matters concerning the health and welfare of the client,
						including having access to personal records contained in the clients file and
						receiving information and notices about the clients overall care and condition.
1. No member of the governing body, administration or
						staff, either contracted or directly employed, of an ABI facility or any member
						of their family may serve as the representative for a client unless they are
						related to the client by blood or marriage.
2. In the case of an individual that has been
						interdicted, the representative is the court-appointed curator or his/her
						designee.
Support
-activities, materials,
						equipment, or other services designed and implemented to assist the client with
						a brain injury. Examples include, but are not limited to:
1. instruction;
2. training;
3. assistive technology; or
4. removal of architectural barriers.
Therapeutic Recreational
						Services
-services that identify leisure activities and assistance in
						modifying and adapting identified leisure activities to allow safe
						participation by the client as a means to improve quality of life and aid in
						integration into the community.
Traumatic Brain Injury
-an insult to the
						brain, not of a degenerative or congenital nature, caused by an external
						physical force that may produce a diminished or altered state of consciousness,
						which results in an impairment of cognitive abilities or physical functioning.
						It can also result in the disturbance of behavioral or emotional functioning.
						These impairments may be either temporary or permanent and cause partial or
						total functioning disability, or psychosocial maladjustment.
Vocational Services
-services provided
						directly or through cooperating agencies to a client in accordance with his
						individualized plan and designed to improve or enhance skills and behaviors
						necessary for successful placement in a volunteer or work
						setting.
AUTHORITY NOTE:
						Promulgated in accordance with R.S. 36:254 and
						40:2120.31-40.