Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 158.000 - Licensure of Adult Day Health Programs › Section 158.004 - Definitions

Current through Register 1525, July 5, 2024
Activities of Daily Living (ADL)
means
				personal care activities including but not limited to bathing, dressing,
				grooming, toileting, transfers, ambulation, personal hygiene, and
				eating.
Adult Day Health Program (Program)
means any entity, however organized, whether conducted for profit or not for
				profit that:
(1) Is community-based and non-residential;
(2) Provides nursing care, supervision, and health related
				support services in a structured group setting to persons 18 years of age or
				older who have physical, cognitive, or behavioral health impairments;
				and
(3) Supports families and other caregivers thereby enabling the
				participant to live in the community.
Adult Day Health Services (Services)
means the services that a Program provides or performs for participants in
				accordance with
				105 CMR 158.000.
Applicant
means any person who applies
				to the Department for a license to operate a Program. In the case of an
				applicant which is not a natural person, the term
Applicant
shall also mean any shareholder owning 5% or
				more; any officer and any director of any corporate applicant; any limited
				partner owning 5% or more and any general partner of any partnership applicant;
				any trustees of any trust applicant; any sole proprietor of any applicant which
				is a sole proprietorship; any mortgagee in possession; and any executor or
				administrator of any applicant which is an estate. Applicant also means a
				person filing a Notice of Intent form.
Aversive Interventions
means any
				intervention technique based upon behavior modification principles, which
				applies painful, seclusion or intrusive methods, stimuli, or punishments to a
				participant in order to correct, decrease, or eliminate any undesirable
				behaviors.
Chemical Restraints
means a drug that
				is used for discipline or convenience and not required to treat medical
				symptoms.
Commissioner
means the Commissioner of
				the Department of Public Health.
Convenience
means any action taken by
				a Program staff to control or manage a participant's behavior that requires a
				lesser amount of effort by Program personnel and is not in the participant's
				best interest.
Department
means the Department of
				Public Health of the Commonwealth of Massachusetts.
Direct Care Staff
include nurses,
				program aides, social workers and any individual(s) supervised by a social
				worker in accordance with
				258 CMR
				12.00:
Scope of Practice
, and
				activities directors.
Discharge
means the termination of
				enrollment at a Program without an intention or expectation that the
				participant will return to the Program.
Discipline
means any action taken by a
				Program for the purpose of punishing or penalizing a participant.
Elopement
means that a participant who
				requires supervision has left the Program premises or safe area without the
				necessary supervision to do so.
Emergency
means a situation or
				condition which presents imminent danger of death or serious physical harm to
				one or more individuals.
Felony
means a crime which is deemed a
				felony in the state in which the crime was committed or by the federal
				government.
Health Record
means the cumulative
				required documentation maintained at a Program regarding the delivery of care
				and services to a participant, as specified in
				105 CMR 158.000.
Influenza Vaccine or Vaccination
means
				immunization by either influenza vaccine, inactivated or live; attenuated
				influenza vaccine including seasonal influenza vaccine, and/or other influenza
				vaccine pursuant to
				105 CMR
				158.030(L).
Jeopardy
means a situation or
				condition which the Commissioner or his or her designee has determined presents
				an imminent threat to the health or safety of participants.
Legally Authorized Representative
means the person or agency authorized to make health care decisions for a
				participant pursuant to an executed health care proxy or pursuant to an order
				of a Massachusetts court.
License
means any license to operate a
				Program, issued by the Department, including an original or a renewal
				license.
Licensed Practical Nurse
means a nurse
				who is currently licensed by the Massachusetts Board of Registration in
				Nursing, pursuant to M.G.L. c. 112, § 74A, to practice as a licensed
				practical nurse in Massachusetts.
Licensed Prescriber
means a health
				care provider who is legally authorized to prescribe medication pursuant to
				M.G.L c. 94C and other state and federal laws.
Licensee
means any person holding a
				license to operate a Program. In the case of a licensee which is not a natural
				person, the term
Licensee
shall also mean any
				shareholder owning 5% or more, any officer, and any director of any corporate
				licensee; any limited partner owning 5% or more and any general partner of a
				partnership licensee; any trustee of any trust licensee; any sole proprietor of
				any licensee which is a sole proprietorship; any mortgagee in possession and
				any executor or administrator of any licensee which is an estate.
Massachusetts Medical Orders for Life Sustaining
				Treatments (MOLST)
means the Department sponsored program to
				improve the communication and adherence to participants' expressed preferences
				regarding life sustaining treatments, by providing a standardized, easily
				recognized MOLST form documenting the care planning conversations between a
				participant or, if incapacitated, the participant's authorized representative
				for MOLST and the physician, nurse practitioner, or authorized physician
				assistant.
Medical Symptom
means an indication or
				characteristic of a physical or psychological condition.
Medication Error
means a failure to
				administer a medication as prescribed, including the failure to administer the
				correct medication or the failure to administer the medication:
(1) Within appropriate time frames;
(2) In the correct dosage;
(3) In accordance with accepted practice;
(4) To the correct participant; or
(5) In the correct route.
Notice of Intent
means a form supplied
				by the Department through which an applicant notifies the Department of his or
				her intent to acquire a Program and/or to apply for a license to operate a
				Program.
Nurse Practitioner
means a registered
				nurse authorized to practice as a nurse practitioner by the Board of
				Registration in Nursing pursuant to M.G.L. c. 112, § 80B and
				244 CMR 4.00:
The
				Practice of Nursing in the Expanded Role
.
Original License
means the first
				license issued to a Program by the Department pursuant to
				105 CMR 158.000.
Parti
cipant
means any individual
				enrolled in a Program licensed by the Department.
Parti
cipant Area
means the physical
				space within the Program used for provision of Services, therapeutic
				activities, and dining. The Participant Area does not include reception areas,
				storage areas, offices, restrooms, corridors, or services areas.
Person
means any natural person,
				corporation, society, association, partnership, or other entity.
Personnel
means an individual or
				individuals employed by or affiliated with a Program, whether directly, by
				contract with another entity, or as an independent contractor, paid or
				unpaid.
Pharmacist
means a person licensed by
				the Board of Registration in Pharmacy in accordance with M.G.L. c. 112, §
				24.
Physical Restraints
means any manual
				method or physical or mechanical device, material, or equipment attached to or
				adjacent to a participant's body that the participant cannot remove, which
				restricts freedom of movement or normal access to one's body.
Physician
means a doctor of medicine
				or doctor of osteopathy who is registered to practice medicine in Massachusetts
				pursuant to M.G.L. c. 112, § 2.
Physician Assistant
means a physician
				assistant authorized to practice by the Board of Registration of Physician
				Assistants, pursuant to M.G.L. c. 112, § 9I.
Primary Care Provider
means a health
				care professional qualified to provide general medical care for common health
				care problems, who supervises, coordinates, prescribes or otherwise provides or
				proposes health care services, initiates referrals for specialist care and
				maintains continuity of care within the scope of practice.
Program Aide
means any individual who
				meets the following criteria:
(1) Is 18 years of age or older and has at least a high school
				diploma or its equivalent;
(2) Meets the requirements stated in
				105 CMR
				158.033(F); and
(3) Provides delegated nursing or nursing related services to
				participants in a Program as described at
				105 CMR
				158.033(F).
Program Capacity
means the maximum
				number of participants that may be in the care of the Program at any one time
				based on the square footage specified in
				105 CMR
				158.026.
Program Director
means a person
				responsible for general administration of daily operations of a Program, as
				specified at
				105 CMR
				158.030(K).
Qualified Cook
means an individual
				who:
(1) As described in
				105 CMR 590.000:
State Sanitary Code Chapter X - Minimum Sanitation Standards for Food
				Establishments
, has passed a certified food protection manager test
				that is part of an accredited program recognized by the Department;
(2) Has been issued a Massachusetts certificate of allergen
				awareness training by an allergen awareness training verification program
				recognized by the Department; and
(3) Has a minimum of six months of supervisory experience in
				the planning, preparation, and service of food, including therapeutic diets.
Registered Dietitian
means a
				registered dietitian licensed under M.G.L. c. 112, §§ 201 through
				210.
Registered Nurse
means a nurse who is
				currently registered pursuant to M.G.L. c. 112, § 74 to practice as a
				registered nurse in Massachusetts.
Rehabilitation Services
means services
				provided by physical therapists, occupational therapists, and speech, hearing
				and language therapists for the purpose of maximum reduction of physical or
				mental disability and restoration of the participant to maximum functional
				level.
Renewal License
means any license
				issued after an original license to a Program by the Department pursuant to
				105 CMR 158.000.
Restorative Nursing
means the process
				of providing, in a coordinated manner, comprehensive services deemed
				appropriate to the needs of an individual with a disability, to achieve
				objectives of improved health and welfare with the realization of his or her
				maximum physical, psychological, and functional potential.
Self-administration
means a
				participant taking or applying his or her medication in the manner directed by
				the prescribing provider, with no more than minimal assistance or direction
				from nursing staff, in accordance with Program policies and procedures.
Service Coordination
means an
				interdisciplinary, collaborative process to assess, plan, implement,
				coordinate, monitor, and evaluate the services required to meet a participant's
				needs, including the medically-related physical, mental, behavioral,
				environmental, and other service needs of a participant at the time of
				enrollment, during treatment and care in the Program, or at the time of
				discharge.
Significant Change
means a major
				decline or improvement in the participant's health status that will not
				normally resolve itself without further intervention by staff or by
				implementing standard disease-related clinical interventions, that has an
				impact on more than one area of the participant's health status, and requires
				review or revision of the plan of care, or both.
Social Worker
means an individual who
				meets the qualifications set forth in M.G.L. c. 112, § 131, and
				258 CMR 9.00:
Licensure Requirements and Procedures
and who is licensed by
				the Board of Social Workers to perform or provide social work services in
				accordance with
				258
				CMR 12.01:
Scope of Professional
				Practice - Licensed Independent Clinical Social Worker (LICSW)
, 12.02:
Scope of Professional Practice - Licensed Certified Social Worker
				(LCSW)
, or 12.03: Scope of Professional Practice - Licensed Social
				Worker (LSW).
Transfer of Ownership
means a transfer
				of a majority interest in the ownership of a Program. In the case of a
				corporation, transfer of ownership includes the transfer of a majority of the
				stock thereof. In the case of a partnership, transfer of ownership includes the
				transfer of a majority of the partnership interest. In the case of a trust,
				transfer of ownership includes change of the trustee, or majority of trustees.
				In the case of a non-profit corporation, such changes in the corporate
				membership or directors as the Department determines to constitute a shift of
				5% or more in control of the Program. A transfer of ownership shall also be
				deemed to have occurred where foreclosure proceedings have been instituted by a
				mortgagee in possession.