Code of Massachusetts Regulations › 651 CMR - EXECUTIVE OFFICE OF ELDER AFFAIRS › Title 651 CMR 12.00 - Certification Procedures and Standards for Assisted Living Residences › Section 12.02 - Definitions

Current through Register 1525, July 5, 2024
When used in
				651 CMR 12.00, unless the
				context otherwise requires, the following terms shall have the following
				meanings:
Abuse
. Consistent with the Elder
				Protective Services regulations,
				651 CMR 5.00:
Elder
				Abuse Reporting and Protective Services Program
, an act or omission
				including, but not limited to, emotional abuse, financial exploitation,
				neglect, physical abuse, sexual abuse, and/or self-neglect.
Activities of Daily Living (ADL)
.
				Tasks related to bathing, dressing, grooming, ambulation, eating, toileting and
				other similar tasks related to personal care needs.
Administrative Fee
. Any charge billed
				to and payable by a Resident as a condition of admission, excluding room,
				board, and services.
Alteration
. Any of the following
				changes made after the date of the Residence's last Certification:
(a) a change in the number of Units;
(b) a substantial change in the configuration of Units;
(c) a substantial change in the premises; and
(d) a substantial change in the operating plan.
Applicant
. A person or legal entity
				applying to EOEA for Certification as a Sponsor of an Assisted Living
				Residence.
Assisted Living Residence or
				Residence
. Any entity, however organized, whether conducted for
				profit or not for profit, which meets all of the following criteria:
(a) provides room and board;
(b) provides, directly by its employees or through arrangements
				with another organization which the entity may or may not control or own,
				Personal Care Services for three or more adults who are not related by
				consanguinity or affinity to their care provider; and
(c) collects payments or third-party reimbursements from or on
				behalf of Residents to pay for the provision of assistance with the Activities
				of Daily Living, or arranges for the same.
Bathing Facility
. A room equipped with
				a showerhead or a bathtub to enable one person to take a shower or a
				bath.
Certification
. EOEA's initial
				approval, or subsequent renewal of that approval, of the qualifications of an
				Applicant or Sponsor to operate and maintain an Assisted Living Residence
				subject to the requirements of St. 1994, c. 354, and
				651 CMR 12.00.
Certified Provider of Ancillary Health
				Services
. A person or legal entity certified to provide home
				health care services or hospice care services under Title XVIII of the Social
				Security Act 49, Stat. 620 (1935) or an entity licensed under M.G.L. c. 111
				that provides physician services, pharmacy services, restorative therapies,
				podiatry, hospice services, and/or home health aide services.
Computation of Time
. In computing any
				period of time under
				651 CMR 12.00, the day of the
				act which initiates the running of the time period shall not be counted. The
				last day of the time period shall be included, unless it is a Saturday, Sunday
				or legal holiday or any other day on which EOEA is closed, in which case the
				period shall run until the end of the next business day. When the time period
				is less than seven days, any days when EOEA is closed shall be excluded from
				the computation.
Controlled Substances
. For the
				purposes of
				651 CMR 12.00, controlled
				substances shall include all Class II controlled substances identified by 21
				U.S.C. c. 13, and any Class I controlled substances identified by 21 U.S.C. c.
				13, that may be legally prescribed according to the laws of the
				Commonwealth.
Elderly Housing
. Any residential
				premises available for lease by elderly or disabled individuals which is
				financed or subsidized in whole or in part by state or federal housing programs
				established primarily to furnish housing rather than housing and personal
				services, and which was never licensed under M.G.L. c. 111.
EOEA.
The Executive Office of Elder
				Affairs.
EOHHS Agency
. The Executive Office of
				Health and Human Services (EOHHS) or any department, agency, commission,
				office, board, division, or any other body within EOHHS as set out in M.G.L. c.
				6A, § 16.
Evidence Informed Falls Prevention
				Program
. The use of the best available knowledge and research to
				guide the design and implementation of a program to assess Resident risk for
				falls and establish preventive measures and situational procedures.
Floater
. A staff member of the
				Residence who is available on an ad hoc basis to assist in times of unusually
				heavy workload or emergency situations and is not specifically assigned to a
				group of Residents or unit.
Health Care Proxy
. A person identified
				by a document delegating the authority to make health care decisions to an
				agent, executed in accordance with the requirements of M.G.L. c. 201D.
Instrumental Activities of Daily Living
				(IADL)
. Tasks related to meal preparation, housekeeping, clothes
				laundering, shopping for food and other items, telephoning, use of
				transportation, and other similar tasks related to environmental needs.
Legal Representative
. Guardian,
				Conservator, or attorney in-fact under a Power of Attorney, as
				appropriate.
Limited Medication Administration
				(LMA)
. The administration of medication to a Resident which is not
				otherwise prohibited by M.G.L. c. 19D or
				651 CMR 12.00 LMA may only be
				provided in a Residence by a family member, an individual designated in writing
				by the Resident or Resident's Legal Representative, a practitioner as defined
				in M.G.L. 94C, or a nurse registered or licensed under the provisions of M.G.L.
				c. 112, § 74 or § 74A to the extent allowed by laws, regulations and
				standards governing nursing practice in Massachusetts.
Lodging
. The provision of a single or
				a double living Unit.
Manager
. The individual who has
				general administrative charge of an Assisted Living Residence.
Modification of Certification
. A
				change to or limitation on the scope of a Sponsor's authority to operate an
				Assisted Living Residence.
Mutual Aid
. A coordinated and
				collaborative effort between local Assisted Living Residences to provide
				support and assist with the management of evacuations and resource/asset needs,
				including the identification of substitute housing for use during an extended
				evacuation of Residents.
Newly Constructed
. A building or
				buildings for which a person or entity received a building permit on or after
				June 1, 1995 and seeks Certification as an Assisted Living Residence; provided
				that a building or buildings for which a person or entity at any time is or was
				providing facilities or services other than those of an Assisted Living
				Residence shall not be considered newly constructed for the purpose of the
				physical requirements for an Assisted Living Residence under M.G.L. c. 19D,
				§ 16 or
				651 CMR
				12.04(1).
Personal Care Service
. Assistance with
				one or more of the Activities of Daily Living and Self-administered Medication
				Management, either through physical support or supervision. Supervision
				includes reminding or observing Residents while they perform activities.
Residency Agreement
. The written
				contract between an Assisted Living Residence and a Resident or prospective
				Resident on either a temporary (
e.g.
, for respite care) or
				more permanent basis.
Resident
. An individual who resides in
				an Assisted Living Residence and who receives housing and Resident Services
				and, when the context requires or permits, such individual's Legal
				Representative. An individual who resides in an Assisted Living Residence or
				Special Care Residence for any period of time shall be entitled to all the
				rights and privileges accorded under
				651 CMR 12.00 regardless of
				the anticipated length of the residency.
Resident Representative
. An individual
				who is authorized by the Resident to help him or her fully participate in
				planning services or paying fees. The Resident Representative shall not be
				employed by the Residence, nor affiliated with the Sponsor unless related to
				the Resident by kinship or marriage. The Resident Representative shall not act
				on behalf of a Resident in circumstances warranting a Legal Representative. The
				Residence shall not treat the Resident Representative as personally liable for
				payment of Resident fees without having first obtained the Resident
				Representative's written agreement to act as a guarantor or surety.
Resident Services
. Services to assist
				Residents with Activities of Daily Living (ADL), Instrumental Activities of
				Daily Living (IADL), Self-administered Medication Management (SAMM), or other
				similar services, but does not include optional services such as concierge
				services, recreational or leisure services. Resident Services are provided
				either through physical assistance or staff supervision.
Restraint
. For the purposes of
				651 CMR 12.00, any action
				taken by the Assisted Living Residence for the purpose or punishing or
				penalizing a Resident, or to control or manage a Resident's behavior with
				lesser effort by the Assisted Living Residence that is not in the Resident's
				best interest by means of:
(a) manual method or physical or mechanical device, material,
				or equipment attached or adjacent to the Resident's body that the individual
				cannot remove easily which restricts the Resident's freedom of movement or
				normal access to his or her body; or
(b) any drug not required to treat medical symptoms and not
				requested by the Resident.
Secretary
. The Secretary of the
				Executive Office of Elder Affairs of the Commonwealth of Massachusetts.
Self-administered Medication Management
				(SAMM)
. A process which includes reminding Residents to take
				medication, opening containers for Residents, opening prepackaged medication
				for Residents, reading the medication label to Residents, and observing
				Residents while they take the medication.
Service Coordinator
. The individual(s)
				responsible for supporting the coordination of Resident care, including the
				preparation and periodic review and revision of each Resident's service
				plan.
Significant Negative Effect
. The
				consequence of a situation in which a Resident experienced a significant risk
				of death or serious physical or emotional harm. The consequences of such
				situations include, but are not limited to, accidental injury; Unanticipated
				Death; suicide or suicide attempt; a physical or sexual assault by or against a
				Resident; a complaint of Resident abuse, suspected Resident abuse, or referral
				of a complaint of Resident abuse to a local or state authority; a medication
				error requiring medical attention; SAMM or LMA error with an adverse effect
				requiring medical attention; elopement with an absence of greater than 30
				minutes; misuse of a Resident's funds by the Residence or its staff; an
				outbreak of a serious communicable disease that is listed in
				105 CMR
				300.100:
Diseases Reportable to Local
				Boards of Health
; an employee of a residence found to be infected with
				a disease in a communicable form that is listed in
				105 CMR
				300.100; pest infestation; food poisoning as
				defined in
				105 CMR 300.020:
Definitions
; and fire or structural damage to the
				Residence.
Skilled Nursing Care
. Skilled services
				described in
				130 CMR
				456.409(A):
Skilled
				Services
.
Special Care Residence
. The Residence
				in its entirety or any separate and distinct section or sections within the
				Residence that provide(s) an enhanced level of supports and services for one or
				more Residents to address their specialized needs due to cognitive or other
				impairments.
Special Care Unit
. A portion of a
				Special Care Residence designed for and occupied pursuant to a Residency
				Agreement by one or two individuals as the private living quarters of such
				individuals.
Sponsor
. The person or legal entity
				named in the Certification of an Assisted Living Residence.
Transfer of Ownership
. Transfer of a
				majority interest in the ownership of an Assisted Living Residence. In the case
				of an individual, transfer of ownership; in the case of a corporation, transfer
				of a majority of the stock thereof; in the case of a partnership, transfer of a
				majority of the partnership interest; in the case of a trust, change of the
				trustee, or majority of trustees shall constitute transfer of ownership. A
				transfer of ownership shall also be deemed to have occurred where foreclosure
				proceedings have been instituted and consummated by a mortgagee in possession
				of the premises, or when bankruptcy proceedings have been initiated.
Unanticipated Death
. The death of a
				resident resulting from any cause not directly related to an existing diagnosis
				or prognosis.
Unit
. A portion of an Assisted Living
				Residence designed for and occupied pursuant to a Residency Agreement by one or
				two individuals as the private living quarters of such
				individuals.