Virginia Administrative Code › Title 22 - SOCIAL SERVICES › Agency 30 - DEPARTMENT FOR AGING AND REHABILITATIVE SERVICES › Chapter 110 - ASSESSMENT IN ASSISTED LIVING FACILITIES › Part I - Definitions › Section 22VAC30-110-10 - 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" or "ADLs" means bathing,
					 dressing, toileting, transferring, bowel control, bladder control, and
					 eating/feeding. An individual's degree of independence in performing these
					 activities is a part of determining appropriate level of care and
					 services.
"Administrator" means the licensee or person designated by
					 the licensee who is responsible for the general administration and management
					 of an assisted living facility and who oversees the day-to-day operation of the
					 facility, including compliance with all regulations for assisted living
					 facilities.
"Assessment" means a standardized approach using common
					 definitions to gather sufficient information about an individual applying to or
					 residing in an assisted living facility 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 to individuals who may have physical or mental
					 impairments and require at least moderate assistance with the activities of
					 daily living. Included in this level of service are individuals who are
					 dependent in behavior pattern (i.e., abusive, aggressive, disruptive) as
					 documented on the uniform assessment instrument.
"Assisted living facility" or "ALF" means 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 or infirm or who
					 have disabilities 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
					 individuals who are infirm or who have disabilities between the ages of 18 and
					 21 years, or 22 years if enrolled in an educational program for individuals
					 with disabilities pursuant to §
										22.1-214 of the Code of
					 Virginia, when such facility is licensed by the Department of Social Services
					 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 individuals who are 62 years of age
					 or older or individuals with disabilities 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
					 adults who are aged or infirm or who have disabilities. Maintenance or care
					 means the protection, general supervision, and oversight of the physical and
					 mental well-being of an individual who is aged or infirm or who has a
					 disability.
"Auxiliary Grants Program" means a state and locally funded
					 assistance program to supplement the income of an individual who is receiving
					 Supplemental Security Income (SSI) or an individual who would be eligible for
					 SSI except for excess income, and who resides in an ALF, an adult foster care
					 home, or supportive housing setting with an established rate in the
					 Appropriation Act. The total number of individuals within the Commonwealth of
					 Virginia eligible to receive auxiliary grants in a supportive housing setting
					 shall not exceed the number individuals designated in the Virginia law and the
					 signed agreement between the department and the Social Security
					 Administration.
"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 that employs a case manager or contracts for case management.
"Case manager" means an employee of a public human services
					 agency who is qualified to perform assessments and to develop and coordinate
					 plans of care.
"Department" or "DARS" means the Virginia Department for
					 Aging and Rehabilitative Services.
"Department designated case management system" means the
					 official state automated computer system that collects and maintains
					 information on assessments conducted by employees of the local department who
					 meet the definition of qualified assessor.
"Dependent" means the individual needs the assistance of
					 another person or needs the assistance of another person and equipment or a
					 device to safely complete an ADL or IADL. 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 individual's behavior is aggressive, abusive, or
					 disruptive.
"Discharge" means the process that ends an individual's
					 stay in the ALF.
"Emergency placement" means the temporary status of an
					 individual in an ALF when the individual's health and safety would be
					 jeopardized by denying entry into the facility until requirements for admission
					 have been met.
"Face-to-face" means interacting with an individual in need
					 of an assessment in a manner that enables the qualified assessor or case
					 manager to observe the individual's behavior and ability to perform ADLs and
					 IADLs.
"Facility" means an ALF.
"Independent physician" means a physician who is chosen by
					 an individual residing in the ALF and who has no financial interest in the ALF,
					 directly or indirectly, as an owner, officer, or employee or as an independent
					 contractor with the facility.
"Instrumental activities of daily living" or "IADLs" means
					 for the purposes of this chapter, meal preparation, housekeeping, laundry, and
					 money management. An individual's degree of independence in performing these
					 activities is a part of determining appropriate level of care and
					 services.
"Local department" means any local department of social
					 services in the Commonwealth of Virginia.
"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 for purposes of this
					 chapter, assessing the degree of assistance an individual requires to take
					 medications in order to determine the individual's appropriate level of
					 care.
"Minimal assistance" means dependency in only one ADL or
					 dependency in one or more IADLs as documented on the uniform assessment
					 instrument. Included in this level of services are individuals who are
					 dependent in medication administration as documented on the UAI.
"Moderate assistance" means dependency in two or more ADLs
					 as documented on the UAI.
"Private pay" means that an individual residing in an ALF
					 is not eligible for the Auxiliary Grants Program.
"Prohibited conditions" means physical or mental health
					 conditions or care needs as described in §
										63.2-1805 of the Code of
					 Virginia. An ALF shall not admit or allow the continued residence of an
					 individual with a prohibited condition. Prohibited conditions include an
					 individual who requires maximum physical assistance as documented on the
					 uniform assessment instrument and meets nursing facility level of care criteria
					 as defined in the State Plan for Medical Assistance. Unless the individual's
					 independent physician determines otherwise, an individual who requires maximum
					 physical assistance and meets nursing facility level of care criteria as
					 defined on the State Plan for Medical Assistance shall not be admitted to or
					 continue to reside in an ALF.
"Public human services agency" means an agency established
					 or authorized by the General Assembly under Chapters 2 and 3 (§§
										63.2-200 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 22 (§
										23.1-2200 et seq.) and 23
					 (§
										23.1-2300 et seq.) of Title 23.1
					 of the Code of Virginia and supported wholly or principally by public funds,
					 including funds provided expressly for the purposes of case management.
"Public pay" means that an individual residing in an ALF is
					 eligible for the Auxiliary Grants Program.
"Qualified assessor" means a person who is authorized to
					 perform an assessment, reassessment, or change in level of care for an
					 individual who is seeking admission to an ALF or who resides in an ALF. For
					 public pay individuals, a qualified assessor is an employee of a public human
					 services agency who is trained in the completion of the uniform assessment
					 instrument and is authorized to approve placement for an individual who is
					 seeking admission to or residing in an ALF. For private pay individuals, a
					 qualified assessor is staff of the ALF trained in the completion of the uniform
					 assessment instrument or an independent physician or a qualified assessor for
					 public pay individuals.
"Reassessment" means an update of information on the UAI
					 after the initial assessment. In addition to an annual reassessment, a
					 reassessment shall be completed whenever there is a significant change in the
					 individual's condition.
"Residential living care" means a level of service provided
					 by an ALF for individuals who may have physical or mental impairments and
					 require only minimal assistance. The definition of residential living care
					 includes the services provided by the ALF to individuals who are assessed as
					 capable of maintaining themselves in an independent living status.
"Significant change" means a change in an individual'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 individual
					 who is receiving an auxiliary grant in an ALF 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 ADL.
"Uniform assessment instrument" or "UAI" means the
					 department-designated assessment form. There is an alternate version of the
					 uniform assessment instrument that may be used for individuals paying privately
					 to reside in the ALF.
"Virginia Department of Medical Assistance Services" or
					 "DMAS" means the single state agency designated to administer the Medical
					 Assistance Services Program in Virginia.
Statutory Authority: §§
												51.5-131 and
						51.5-160 of the Code of
						Virginia.