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.
