§ 11.3. Definitions.
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:
ADL—Activities of Daily Living—The term includes bathing, dressing and undressing, grooming, eating, transferring in and out of bed or chair, toileting, bladder management, bowel management and additional personal care activities such as nail care.
Abuse—The occurrence of one or more of the following acts:(i) The infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain or mental anguish.
(ii) The willful deprivation by a caretaker of goods or services which are necessary to maintain physical or mental health.
(iii) Sexual harassment, rape or abuse as it is defined in the Protection From Abuse Act (35 P. S. § § 10181—10190).
Act—The Older Adult Daily Living Centers Licensing Act (62 P. S. § § 1511.1—1511.22).
Area agency on aging—The single local agency designated within a planning and service area by the Department to develop and administer the delivery of a comprehensive and coordinated plan of social service activities for older persons.
Aversive conditioning—The application, contingent upon the exhibition of maladaptive behavior, of startling, painful or noxious stimuli.
CRNP—Certified Registered Nurse Practitioner—A registered nurse licensed in this Commonwealth who is certified by the State Board of Nursing and the State Board of Medicine in a particular clinical specialty area and who, while functioning in the expanded role as a professional nurse, performs acts of medical diagnosis and prescription of medical, therapeutic or corrective measures in collaboration with and under the direction of a physician licensed to practice medicine in this Commonwealth, as authorized by section 15 of the Medical Practice Act (63 P. S. § 422.15) and implementing regulations at 49 Pa. Code Chapter 21, Subchapter C (relating to certified registered nurse practitioners).
Caregiver—A person who has assumed the primary responsibility for the care of a person with a functional impairment who is 60 years of age or older, or who is 18 years of age or older and has post-stroke dementia, Parkinsonism or a dementia-related disease such as Alzheimer’s or other organic brain syndrome.
Caretaker—The operator and staff persons of the older adult daily living center who have assumed responsibility for the provision of older adult daily living services in the older adult daily living center.
Center or older adult daily living center—A premises operated for profit or not-for-profit in which older adult daily living services are simultaneously provided for four or more clients who are not relatives of the operator for part of a 24-hour day.
Client—A resident of this Commonwealth with functional impairment who meets the following criteria:(i) The person is categorically eligible because the person is one of the following:
(A) Sixty years of age or older.
(B) Eighteen years of age or older and has post-stroke dementia, or Parkinsonism or a dementia-related disease such as Alzheimer’s or other organic brain syndrome.
(ii) The person receives services in an older adult daily living center.
(iii) The person requires assistance to meet personal needs and perform basic daily activities as determined by an intake screening process.
Communicable disease—An illness due to a specific infectious agent or its toxic products which arises through transmission of that agent or its products from an infected person to a susceptible host, either directly or indirectly through an intermediate plant, animal host or the environment.
Department—The Department of Aging of the Commonwealth.
Exploitation—An act or course of conduct by a caretaker or other person against a client or a client’s resources, without the informed consent of the client or with consent obtained through misrepresentation, coercion or threats of force, that results in monetary, personal or other benefit, gain or profit for the perpetrator or monetary or personal loss to the client.
Fire safe area—An area which is accessible from the facility by two different routes and which is separated from other areas of the building by a minimum of 1-hour rated wall and door assemblies.
Fire safety authority—A local fire department, fire protection engineer, State-certified fire protection instructor, college instructor in fire science, county or State fire school, volunteer fire person trained by a county or State fire school, or an insurance company loss control representative.
Functional impairment—A professionally determinable state or condition attributable to a range of physical, mental, developmental, psychosocial, neurological or other conditions, in which the capacity for independence is limited and the ability to perform or carry out activities of daily living is impeded.
IADL—Instrumental Activities of Daily Living—The term includes preparing meals, doing housework, doing laundry, shopping, using transportation, managing money, using a telephone, and doing home maintenance—that is chores and repairs.
Long-term care ombudsman—An agent of the Department who investigates and seeks to resolve complaints made by or on behalf of older individuals who are consumers of long-term care services. These complaints may relate to action, inaction or decisions of providers of long-term care services, of public agencies, of social service agencies, or their representatives, which may adversely affect the health, safety, welfare or rights of these consumers.
Neglect—The failure of a caretaker to provide goods or services essential to avoid a clear and serious threat to physical or mental health.
Older adult daily living services—Services provided or arranged to assist in meeting the needs, including personal care, social, nutritional, health and educational needs, of clients. These are provided, as appropriate for each client, through a planned program of social, educational, recreational, therapeutic, rehabilitative, habilitative and developmental activities. The term does not include services provided for persons whose needs are such that they can only be met in a long-term care facility on an inpatient basis receiving professionally supervised nursing care and related medical and other health services.
Program staff—An employe of the center who directly assists clients with activities of daily living or provides older adult daily living services, or both. The term does not include a person whose totality or majority of time involves providing housekeeping, maintenance, accounting/bookkeeping or clerical services. The term also does not include a nurse or social worker retained by the center as a consultant; that is, retained as an independent contractor to give advice, guidance or other assistance in accordance with the standards of the nursing or social work profession.
Provider or operator—The individual, agency, partnership, association, organization or corporate entity which owns or operates, or both, the older adult daily living center and provides the program of services provided in the center.
Relative—A spouse, parent, child, stepparent, stepchild, grandparent, grandchild, brother, sister, half brother, half sister, aunt, uncle, niece or nephew.
Responsible party—A person who is responsible for making decisions on behalf of the client.
Restraint—A chemical or mechanical device used to restrict movement or normal function of an individual or a portion of the individual’s body.(i) Mechanical devices used to restrain include geriatric chairs; posey; chest; waist; wrist or ankle restraints; locked restraints; and locked doors to prevent egress. The term does not include devices used to provide support for the achievement of functional body position or proper balance as long as the device can easily be removed by the client.
(ii) Chemical restraint includes drugs or chemicals administered for the specific and exclusive purpose of controlling acute or episodic aggressive behavior. The term does not include drugs administered on a regular basis, as prescribed by a physician, for the purposes of treating the symptoms of mental, emotional or behavioral disorders and for assisting the client in gaining self-control over impulses.
Seclusion—Locking an individual in a room by means of a door locking device, such as a key lock, spring lock, bolt lock, or foot pressure lock, or by means of a technique such as physically holding the door shut.
Unusual incident—An occurrence which seriously threatens the health and safety of a client. The term includes:(i) Criminal infractions.
(ii) Injury, trauma or illness of a client requiring treatment at a medical facility.
(iii) Abuse or suspected abuse of a client.
(iv) Violation or suspected violation of a client’s rights.
(v) A client who is missing and presumed to be at risk.
(vi) Misuse or suspected misuse of client funds or property.
(vii) Outbreak of a communicable disease, as defined in 28 Pa. Code § 27.2 (relating to specific identified reportable diseases, infections and conditions) to the extent that confidentiality laws permit reporting.
(viii) An incident involving a fire department or circumstances requiring police action.
(ix) A condition, except for snow or ice conditions, that results in closure of the facility for more than 1 scheduled day of operation.
(x) Neglect or suspected neglect of a client.
Volunteer—A person who, of the person’s own free will, and without monetary compensation, provides service for center clients.
Notes of Decisions Long-Term Care Ombudsman
Inmate, who was resident of specialized correctional institution designed to provide long-term care to elderly and seriously ill inmates, did not fall within statutorily defined class of persons that long-term care ombudsman was designed to serve; he was not a ‘‘resident’’ of a skilled nursing facility, nursing facility, board and care facility, and as an inmate of a State correctional institution, he is not the intended beneficiary of the services designed to serve older persons in the community. Silo v. Commonwealth, 886 A.2d 1193, 1195 (Pa. Cmwlth. 2005).
Cross References This section cited in 6 Pa. Code § 11.2 (relating to applicability); and 6 Pa. Code § 11.212 (relating to applicability).
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