(1) "Abuse" means the willful infliction of
injury, unreasonable confinement, intimidation or punishment with resulting
physical harm, pain or mental anguish.
(2) "Activities of Daily Living (ADLs)" means
those activities which indicate an individual's independence in eating,
dressing, personal hygiene, bathing, toileting, ambulating, and medication
evacuation" means the ability of the adult care home provider, resident
manager, or substitute caregiver, including such additional minimum staff as
may be required by the Board in regulation, to evacuate all residents from the
dwelling within five (5) minutes.
(4) "Administering medication" means the
direct application of a single dose of medication to the body of a resident by
injection, inhalation, ingestion, topical application or by any other means and
the placement of a single dose of medication into a container.
(5) "Adult" means a person 18 years of age or
(6) "Adult care home (ACH)"
means a single family residence licensed pursuant to this act in which
twenty-four (24) hour residential care, including assistance with activities of
daily living, is provided in a homelike environment to no more than five (5)
elderly or disabled adults.
"Adult care home provider" means a person who is twenty-one (21) years of age
or older that owns and operates an adult care home.
(8) "Adult care home resident" means an
individual residing at the adult care home who is ventilator dependent or who
suffers from a traumatic brain injury.
(9) "Assessment" means a procedure for
determining the nature and extent of the problem(s) and needs of a resident or
potential resident to ascertain if the ACH can adequately address those
problems, meet those needs, and secure information for use in the development
of the individual care plan.
"Assistance with self-administration of medication" means assistance in reading
labels, opening medication containers or packaging, reminding residents of
their medication, or observing the resident while taking medication in
accordance with the plan of care.
(11) "Board" means the Board for Licensing
Health Care Facilities.
"Cardiopulmonary resuscitation (CPR)" means the administering of any means or
device to restore or support cardiopulmonary functions in a resident, whether
by mechanical devices, chest compressions, mouth-to-mouth resuscitation,
cardiac massage, tracheal intubation, manual or mechanical ventilators or
respirators, defibrillation, the administration of drugs and/or chemical agents
intended to restore cardiac and/or respiratory functions in a resident where
cardiac or respiratory arrest has occurred or is believed to be
(13) "Disabled" means an
individual who is ventilator dependent or who has a traumatic brain
order (DNR)" means a written order, other than a POST, not to resuscitate a
patient in cardiac or respiratory arrest in accordance with accepted medical
(15) "Elderly" means an
individual who is fifty-five (55) years of age or older.
(16) "Emergency" means any situation or
condition which presents an imminent danger of death or serious physical or
mental harm to residents.
"Exploitation" shall have the same meaning as set forth in T.C.A. §
(18) "Health care" means any care, treatment,
service or procedure to maintain, diagnose, treat, or otherwise affect an
individual's physical or mental condition, and includes medical care as defined
in T.C.A. §
(19) "Health care decision" means an
individual's consent, refusal of consent or withdrawal of consent to health
(20) "Health care
decision-maker" means that in the case of a resident who lacks capacity, the
resident's health care decision-maker is one of the following: the resident's
health care agent as specified in an advance directive, the resident's
court-appointed guardian or conservator with health care decision-making
authority, the resident's surrogate as determined pursuant to T.C.A. §
68-11-1806, or the individual's
designated physician pursuant to T.C.A. §
(21) "Home like" means an environment that
promotes the dignity, security and comfort of residents through the provision
of personalized care and services and encourages independence, choice and
decision-making by the residents.
(22) "Infectious waste" means solid or liquid
wastes which contain pathogens with sufficient virulence and quantity such that
exposure could result in an infectious disease.
(23) "Level 2 home" means an adult care home
that provides services to residents who are ventilator dependent or who have a
traumatic brain injury.
"Licensed health care professional" means any health care professional
currently licensed by the State of Tennessee to practice within the scope of a
regulated profession, such as a nurse practitioner, registered nurse, licensed
practical nurse, (nurses may be licensed or hold multistate licensure pursuant
to Tennessee Code Annotated §§
63-7-101 et seq.), dietitian,
dentist, occupational therapist, pharmacist, physical therapist, physician,
physician assistant, psychologist, clinical social worker, respiratory
therapist, speech-language pathologist, and emergency service
(25) "Licensee" means
the person, association, partnership, corporation, company or public agency to
which the license is issued. For the purposes of these rules, the term
"licensee" is synonymous to "adult care home provider."
(26) "Medical record" means documentation of
medical histories, nursing and treatment records, care needs summaries,
physician orders, and records of treatment and medication ordered and given
which must be maintained by the ACH, regardless of whether such services are
rendered by ACH staff or by arrangement with an outside source.
(27) "Misappropriation of patient/resident
property" means the deliberate misplacement, exploitation or wrongful,
temporary or permanent use of an individual's belongings or money without the
"Neglect" means the failure to provide goods and services necessary to avoid
physical harm, mental anguish or mental illness; however, the withholding of
authorization for or provision of medical care to any terminally ill person who
has executed an irrevocable living will in accordance with the Tennessee Right
to Natural Death Law, or other applicable state law, if the provision of such
medical care would conflict with the terms of the living will, shall not be
deemed "neglect" for purposes of these rules.
(29) "NFPA" means the National Fire
"Occupant" means anyone residing in or using the facility of the adult care
home including residents, the adult care home provider, resident manager,
substitute caregiver, staff, and an adult care home provider's family members
or a resident manager's family members.
(31) "Person" means an individual,
association, estate, trust, corporation, partnership, joint venture,
government, governmental subdivision, agency, or instrumentality, or any other
legal or commercial entity.
"Personal services" means those services rendered to residents who need
supervision or assistance in activities of daily living. Personal services do
not include nursing or medical care.
(33) "Physician assistant" means a person who
has graduated from a physician assistant educational program accredited by the
Accreditation Review Commission on Education for the Physician Assistant, has
passed the Physician Assistant National Certifying Examination, and is
currently licensed in Tennessee as a physician assistant under title 63,
for scope of treatment" or "POST" means written orders that:
(a) Are on a form approved by the Board for
Licensing Health Care Facilities;
(b) Apply regardless of the treatment setting
and that are signed as required herein by the patient's physician, physician
assistant, nurse practitioner, or clinical nurse specialist; and
Specify whether, in the event the patient suffers cardiac or respiratory
arrest, cardiopulmonary resuscitation should or should not be
2. Specify other medical
interventions that are to be provided or withheld; or
3. Specify both 1 and 2.
(35) "Power of Attorney for Health
Care" means the legal designation of an agent to make health care decisions for
the individual granting such power under T.C.A. §§
34-6-201, et seq.
(36) "Resident manager" means a person
twenty-one (21) years of age or older who lives in an adult care home and
oversees the day-to-day operation of the adult care home on behalf of the adult
care home provider.
"Retaliation" means increasing charges, decreasing services, rights or
privileges; taking or threatening to take any action to coerce or compel the
resident to leave the facility; or abusing or threatening to harass or abuse a
resident in any manner.
"Self-administration of medication" means assistance in reading labels, opening
dosage packaging, reminding residents of their medication, and observing the
resident while taking medication in accordance with the plan of care.
(39) "Specialized services" means services
provided to ventilator dependent residents and residents with a traumatic brain
(40) "Substitute caregiver"
means any person twenty-one (21) years of age or older who temporarily oversees
care and services in an adult care home during the short-term absence of the
adult care home provider or resident manager.
(41) "Supervising health care provider" means
the health care provider who has undertaken primary responsibility for an
individual's health care.
"Surrogate" means an individual, other than a resident's agent or guardian,
authorized to make a health care decision for the resident pursuant to T.C.A.
(43) "Traumatic brain injury" means an
acquired injury to the brain caused by an external physical force resulting in
total or partial disability or impairment. Traumatic brain injury includes open
and closed head injuries and may result in seizures, and/or mild, moderate, or
severe impairment in one (1) or more areas including cognition, language,
memory, attention, reasoning, abstract thinking, judgment, problem-solving,
sensory perceptual and motor abilities, psychosocial behavior, physical
functions, information processing, and speech. Such term does not include brain
injuries induced by birth trauma, but may include brain injuries caused by
anoxia and other related causes, infectious disease not of a degenerative
nature, brain tumor, toxic chemical or drug reaction.
(44) "Treating health care provider" means a
health care provider directly or indirectly involved in providing health care
to a resident at the time such care is needed by the resident.
(45) "Ventilator dependent" means using an
apparatus designed to control air that is breathed through it to either
intermittently or continuously assist or control pulmonary ventilation, without
which, the patient would not be able to breathe independently.