Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.1 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
In addition to the definitions in 481-Chapter 67 and Iowa
				  Code chapter 231C, the following definitions apply.
"Accredited"
means that the program has
				  received accreditation from an accreditation entity recognized in subrule
				  69.14(1).
"Applicable requirements "
means Iowa Code
				  chapter 231C, this chapter, and 481-Chapter 67 and includes any other
				  applicable administrative rules and provisions of the Iowa Code.
"Assisted living"
or
"program
				  "
means provision of housing with services, which may include but are
				  not limited to health-related care, personal care, and assistance with
				  instrumental activities of daily living, to three or more tenants in a physical
				  structure which provides a homelike environment. "Assisted living" also
				  includes encouragement of family involvement, tenant self-direction, and tenant
				  participation in decisions that emphasize choice, dignity, privacy,
				  individuality, shared risk, and independence. "Assisted living" includes the
				  provision of housing and assistance with instrumental activities of daily
				  living only if personal care or health-related care is also included. "Assisted
				  living" includes 24 hours per day response staff to meet scheduled and
				  unscheduled or unpredictable needs in a manner that promotes maximum dignity
				  and independence and provides supervision, safety, and security.
"CARF"
means the Commission on Accreditation
				  of Rehabilitation Facilities.
"Change of ownership"
means the purchase,
				  transfer, assignment or lease of a certified assisted living 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 the criteria for dementia, delirium, or amnestic
				  disorder.
"Dementia-specific assisted living program "
means an assisted living program certified under this chapter that:
1. Serves fewer than 55 tenants and has 5 or more tenants who
				  have dementia between Stages 4 and 7 on the Global Deterioration Scale,
				  or
2. Serves 55 or more tenants and 10 percent or more of the
				  tenants 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.
"Dwelling unit"
means a single unit which
				  provides complete, independent living facilities for one or more persons,
				  including permanent provisions for living, sleeping and sanitation, and which
				  may include permanent provisions for eating and cooking. "Sanitation" for
				  purposes of this definition means bathroom fixtures as required by this
				  chapter.
"In the proximate area"
means located within
				  a five minutes or less response time.
"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 tenant
				  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 tenant for more than
				  21 days by a registered nurse. For example, a tenant 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 tenant 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 an accreditation entity recognized in subrule
				  69.14(1).
"Unmanageable incontinence "
means a
				  condition that requires staff provision of total care for an incontinent tenant
				  who lacks the ability to assist in bladder or bowel continence care.
"Unmanageable verbal abuse "
means repeated
				  verbalizations against tenants or staff that persist despite all interventions
				  and that negatively affect the program. "Unmanageable verbal abuse" includes
				  but is not limited to threats, frequent use of profane language, or unwelcome
				  sexually oriented remarks.