455 IAC 3-1-2 - Definitions
Authority: IC 12-9.1-2-3
Affected: IC 12-9-1-1; IC 12-10-13-4.5; IC 12-15; IC 16-28; IC 16-36-1-5
Sec. 2.
The following definitions apply throughout this rule:
(1) "Activities of daily living" means those
personal functional activities required by a recipient for continued well-being
including:
(A) mobility;
(B) dressing;
(C) bathing;
(D) eating;
(E) toileting; and
(F) transferring.
(2) "Aging in place" means being in a care
environment that will provide the recipient with a range of care options as the
needs of the recipient change. Aging in place does not preclude assisting a
recipient in relocating to a new care environment if necessary.
(3) "Applicant" means a natural person or
entity that applies to provide assisted living Medicaid waiver
services.
(4) "Area agency on
aging" means the agency designated by the BAIHS services in each planning and
service area under IC 12-10-1-4(18).
(5) "Assessed impairment level" means the
level of service needed by a recipient as determined using the level of service
assessment form.
(6) "Assisted
living Medicaid waiver services" means the array of services provided to a
recipient residing in a facility, including any or all of the following:
(A) Personal care services.
(B) Homemaker services.
(C) Chore services.
(D) Attendant care services.
(E) Companion services.
(F) Medication oversight (to the extent
permitted under state law). and
(G)
Therapeutic social and recreational programming.
(7) "Assisted living Medicaid waiver services
provider" means an entity approved to provided [sic., provide]
assisted living Medicaid waiver services.
(8) "Attendant care" means hands-on care, of
both a supportive and health-related nature, specific to the needs of a
medically stable, physically disabled individual.
(9) "BAIHS" means the bureau of aging and
in-home services as created under IC 12-10-1-1.
(10) "Case manager" means the individual or
agency enrolled by the office of Medicaid policy and planning chosen by the
recipient to provide case management services.
(11) "Choice" means a recipient has viable
options that enable him or her to exercise greater control over his or her
life. Choice is supported by the provision of sufficient private and common
space within the facility to provide opportunities for recipients to select
where and how to spend time and receive personal assistance.
(12) "Chore services" means services needed
to maintain the recipient's residential unit in a clean, sanitary, and safe
environment.
(13) "Companion
services" means nonmedical care, supervision, and socialization services. It
does not include assisting or supervising the recipient with meal preparation,
laundry, or shopping.
(14)
"Complaint" means an allegation that an assisted living Medicaid waiver
services provider has violated this article or a dissatisfaction relating to
the condition of the facility or the recipient(s).
(15) "Dignity" means providing support in
such a way as to validate the self-worth of the recipient. Dignity is supported
by designing a structure that allows personal assistance to be provided in
privacy and delivering services in a manner that shows courtesy and
respect.
(16) "Division" means the
division of disability, aging, and rehabilitative services created under IC
12-9-1-1.
(17) "Facility" a means
facility licensed under IC 16-28 and
410 IAC 16.2-5.
(18) "Homelike" means an environment that has
the qualities of a home, including privacy, comfortable surroundings, and the
opportunity to modify one's living area to suit one's individual preferences,
which promotes the dignity, security, and comfort of recipients through the
provision of personalized care and services to encourage independence, choice,
and decision making by the recipients. A homelike environment also provides
recipients with an opportunity for self-expression and encourages interaction
with the community, family, and friends.
(19) "Homemaker services" means services
consisting of general household activities, including meal preparation and
routine household care.
(20)
"Independence" means being free from the control of others and being able to
assert one's own will, personality, and preferences within the parameters of
the house rules or residency agreement.
(21) "Interdisciplinary team" means a group
of individuals, which must include the recipient, and which may be composed of,
but is not limited to:
(A) the recipient's
family and/or legal representative;
(B) the recipient's case manager;
(C) a licensed nurse; and
(D) the provider(s) of service; who work
together to develop the recipient's individual plan of care.
(22) "Legal representative" means
a person who is:
(A) a guardian;
(B) a health care representative;
(C) an attorney in fact; or
(D) a person authorized by IC 16-36-1-5 to
give health care consent.
(23) "Level of service" means the specific
level of service that an assisted living Medicaid waiver services provider is
authorized to provide to a recipient in accordance with the recipient's plan of
care and that is based on the assessed impairment level of the
recipient.
(24) "Medication
oversight services" means personnel operating within the scope of applicable
licenses and/or certifications providing reminders or cues to recipients to
take medication, open preset medication containers, and handle and/or dispense
medication.
(25) "Office of
Medicaid policy and planning" means the office of Medicaid policy and planning
created by IC 12-8-6-1
[IC 12-8-6 expired
under IC 12-8-6-10
. See IC
12-8-6.5.].
(26)
"Ombudsman" means a representative of the office of the state long term care
ombudsman as provided in IC 12-10-13 4.5.
(27) "Personal care services" means
assistance with:
(A) eating;
(B) bathing;
(C) dressing;
(D) personal hygiene; and
(E) activities of daily living.
(28) "Plan of care" means the
written plan developed by the interdisciplinary team, on which the recipient's
case manager documents the proposed Medicaid waiver services, the Medicaid
state plan services, as well as other medical services and social services and
informal community supports that are needed by the recipient to ensure the
health and welfare of the recipient.
(29) "Provider" means an entity approved
under this article to provider [sic., provide] assisted living
Medicaid waiver services.
(30)
"Recipient" means an individual who is receiving assisted living Medicaid
waiver services.
(31) "Room and
board" means the provision of:
(A)
meals;
(B) a place to
sleep;
(C) laundry; and
(D) housekeeping.
(32) "Service plan" means a written plan for
services to be provided by the provider, developed by the provider, the
recipient, and others, if appropriate, on behalf of the recipient, consistent
with the services needed to ensure the health and welfare of the recipient. It
is a detailed description of the capabilities, needs, choices, measurable
goals, and if applicable the measurable goals and managed risk issues, and
documents the specific duties to be performed for the recipient, including who
will perform the task, when, and the frequency of each task based on the
individual's assessed needs and preferences.
(33) "Services" means activities which help a
recipient develop skills to increase or maintain level of functioning or which
assist the recipient in performing personal care or activities of daily living
or individual social activities.
(34) "Supportive services" means services
which substitute for the:
(A)
absence;
(B) loss;
(C) diminution; or
(D) impairment; of a physical or cognitive
function.
Notes
Transferred from the Division of Disability and
Rehabilitative Services (460 IAC 8-1-2) to the Division of Aging (455 IAC 3-1-2) by P.L.
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