Virginia Administrative Code › Title 22 - SOCIAL SERVICES › Agency 40 - DEPARTMENT OF SOCIAL SERVICES › Chapter 745 - ASSESSMENT IN ASSISTED LIVING FACILITIES › Part I - Definitions › Section 22VAC40-745-10 - Definitions

Current through Register Vol. 40, No. 24, July 15, 2024
The following words and terms, when used in this chapter,
					 shall have the following meanings, unless the context clearly indicates
					 otherwise:
"Activities of daily living (ADLs)" means bathing,
					 dressing, toileting, transferring, bowel control, bladder control, and
					 eating/feeding. A person's degree of independence in performing these
					 activities is a part of determining appropriate level of care and
					 services.
"Applicant" means an adult planning to reside in an
					 assisted living facility.
"Assessment" means a standardized approach using common
					 definitions to gather sufficient information about applicants to and residents
					 of assisted living facilities to determine the need for appropriate level of
					 care and services.
"Assisted living care" means a level of service provided by
					 an assisted living facility for adults who may have physical or mental
					 impairments and require at least moderate assistance with the activities of
					 daily living. Moderate assistance means dependency in two or more of the
					 activities of daily living. Included in this level of service are individuals
					 who are dependent in behavior pattern (i.e., abusive, aggressive,
					 disruptive).
"Assisted living facility (ALF)" means any public or
					 private assisted living facility that is required to be licensed as an assisted
					 living facility by the Department of Social Services under Chapter 17 (§
					 63.2-1700 et seq.) of Title 63.2 of the Code of Virginia, specifically, any
					 congregate residential setting that provides or coordinates personal and health
					 care services, 24-hour supervision, and assistance (scheduled and unscheduled)
					 for the maintenance or care of four or more adults who are aged, infirm or
					 disabled and who are cared for in a primarily residential setting, except (i) a
					 facility or portion of a facility licensed by the State Board of Health or the
					 Department of Behavioral Health and Developmental Services, but including any
					 portion of such facility not so licensed; (ii) the home or residence of an
					 individual who cares for or maintains only persons related to him by blood or
					 marriage; (iii) a facility or portion of a facility serving infirm or disabled
					 persons between the ages of 18 and 21, or 22 if enrolled in an educational
					 program for the handicapped pursuant to § 22.1-214 of the Code of
					 Virginia, when such facility is licensed by the department as a children's
					 residential facility under Chapter 17 (§ 63.2-1700 et seq.) of Title 63.2
					 of the Code of Virginia, but including any portion of the facility not so
					 licensed; and (iv) any housing project for persons 62 years of age or older or
					 the disabled that provides no more than basic coordination of care services and
					 is funded by the U.S. Department of Housing and Urban Development, by the U.S.
					 Department of Agriculture, or by the Virginia Housing Development Authority.
					 Included in this definition are any two or more places, establishments or
					 institutions owned or operated by a single entity and providing maintenance or
					 care to a combined total of four or more aged, infirm or disabled adults.
					 Maintenance or care means the protection, general supervision and oversight of
					 the physical and mental well-being of an aged, infirm or disabled
					 individual.
"Assisted living facility administrator" means any
					 individual charged with the general administration of an assisted living
					 facility, regardless of whether he has an ownership interest in the facility
					 and meets the requirements of 22VAC40-72.
"Auxiliary Grants Program" means a state and locally funded
					 assistance program to supplement income of a Supplemental Security Income (SSI)
					 recipient or adult who would be eligible for SSI except for excess income, who
					 resides in an assisted living facility with an approved rate.
"Case management" means multiple functions designed to link
					 individuals to appropriate services. Case management may include a variety of
					 common components such as initial screening of need, comprehensive assessment
					 of needs, development and implementation of a plan of care, service monitoring,
					 and follow-up.
"Case management agency" means a public human service
					 agency which employs or contracts for case management.
"Case manager" means an employee of a public human services
					 agency who is qualified and designated to develop and coordinate plans of
					 care.
"Consultation" means the process of seeking and receiving
					 information and guidance from appropriate human services agencies and other
					 professionals when assessment data indicate certain social, physical and mental
					 health conditions.
"Department" or "DSS" means the Virginia Department of
					 Social Services.
"Dependent" means, for activities of daily living (ADLs)
					 and instrumental activities of daily living (IADLs), the individual needs the
					 assistance of another person or needs the assistance of another person and
					 equipment or device to safely complete the activity. For medication
					 administration, dependent means the individual needs to have medications
					 administered or monitored by another person or professional staff. For behavior
					 pattern, dependent means the person's behavior is aggressive, abusive, or
					 disruptive.
"Discharge" means the movement of a resident out of the
					 assisted living facility.
"Emergency placement" means the temporary status of an
					 individual in an assisted living facility when the person's health and safety
					 would be jeopardized by not permitting entry into the facility until
					 requirements for admission have been met.
"Facility" means an assisted living facility.
"Independent physician" means a physician who is chosen by
					 the resident of the assisted living facility and who has no financial interest
					 in the assisted living facility, directly or indirectly, as an owner, officer,
					 or employee or as an independent contractor with the facility.
"Instrumental activities of daily living (IADLs)" means
					 meal preparation, housekeeping, laundry, and money management. A person's
					 degree of independence in performing these activities is a part of determining
					 appropriate level of care and services.
"Maximum physical assistance" means that an individual has
					 a rating of total dependence in four or more of the seven activities of daily
					 living as documented on the uniform assessment instrument.
"Medication administration" means the degree of assistance
					 required to take medications and is a part of determining the need for
					 appropriate level of care and services.
"Private pay" means that a resident of an assisted living
					 facility is not eligible for benefits under the Auxiliary Grants
					 Program.
"Public human services agency" means an agency established
					 or authorized by the General Assembly under Chapters 2 and 3 (§§
					 63.2-203 et seq. and 63.2-300 et seq.) of Title 63.2, Chapter 14 (§
					 51.5-116 et seq.) of Title 51.5, Chapters 1 and 5 (§§ 37.2-100 et
					 seq. and 37.2-500 et seq.) of Title 37.2, or Article 5 (§ 32.1-30 et seq.)
					 of Chapter 1 of Title 32.1, or hospitals operated by the state under Chapters
					 6.1 and 9 (§§ 23-50.4 et seq. and 23-62 et seq.) of Title 23 of the
					 Code of Virginia and supported wholly or principally by public funds, including
					 but not limited to funds provided expressly for the purposes of case
					 management.
"Public pay" means that a resident of an assisted living
					 facility is eligible for benefits under the Auxiliary Grants Program.
"Qualified assessor" means an individual who is authorized
					 to perform an assessment, reassessment, or change in level of care for an
					 applicant to or resident of an assisted living facility. For public pay
					 individuals, a qualified assessor is an employee of a public human services
					 agency trained in the completion of the uniform assessment instrument. For
					 private pay individuals, a qualified assessor is staff of the assisted living
					 facility trained in the completion of the uniform assessment instrument or an
					 independent private physician.
"Reassessment" means an update of information at any time
					 after the initial assessment. In addition to a periodic reassessment, a
					 reassessment should be completed whenever there is a significant change in the
					 resident's condition.
"Resident" means an individual who resides in an assisted
					 living facility.
"Residential living care" means a level of service provided
					 by an assisted living facility for adults who may have physical or mental
					 impairments and require only minimal assistance with the activities of daily
					 living. Minimal assistance means dependency in only one activity of daily
					 living or dependency in one or more of the selected instrumental activities of
					 daily living. Included in this level of service are individuals who are
					 dependent in medication administration as documented on the uniform assessment
					 instrument. This definition includes independent living facilities that
					 voluntarily become licensed.
"Significant change" means a change in a resident's
					 condition that is expected to last longer than 30 days. It does not include
					 short-term changes that resolve with or without intervention, a short-term
					 acute illness or episodic event, or a well-established, predictive, cyclic
					 pattern of clinical signs and symptoms associated with a previously diagnosed
					 condition where an appropriate course of treatment is in progress.
"Targeted case management" means the provision of ongoing
					 case management services by an employee of a public human services agency
					 contracting with the Department of Medical Assistance Services to an auxiliary
					 grant resident of an assisted living facility who meets the criteria set forth
					 in 12VAC30-50-470.
"Total dependence" means the individual is entirely unable
					 to participate in the performance of an activity of daily living.
"Uniform assessment instrument" means the
					 department-designated assessment form. There is an alternate version of the
					 uniform assessment instrument which may be used for private pay residents;
					 social and financial information which is not relevant because of the
					 resident's payment status is not included on this version.
"User's Manual: Virginia Uniform Assessment Instrument"
					 means the department-designated handbook containing common definitions and
					 procedures for completing the department-designated assessment form.
"Virginia Department of Medical Assistance Services (DMAS)"
					 means the single state agency designated to administer the Medical Assistance
					 Services Program in Virginia.
Statutory Authority
§ 63.2-217 of the Code of Virginia.