W. Va. Code R. § 64-2-3 - Definitions

3.1. Abuse. - The infliction or threat to inflict injury, unreasonable confinement, misuse of physical or chemical restraints, intimidation, or punishment with resulting physical harm, pain, or mental anguish, including the following:

3.1.a. Mental Abuse. - Includes, but is not limited to, humiliation, harassment, threats of punishment or deprivation;

3.1.b. Physical Abuse. - Includes, but is not limited to, hitting, slapping, pinching, kicking or, use of controlling behavior through corporal punishment;

3.1.c. Sexual Abuse. - Includes, but is not limited to, harassment, coercion, or assault of a sexual nature; and

3.1.d. Verbal Abuse. - Includes, but is not limited to, the use of oral, written or gestured language in communicating with a participant or used within the participant's hearing regardless of the participant's age, ability to comprehend or disability that contains disparaging and derogatory terms.

3.2. Activities of Daily Living. - The activities that an individual generally performs regularly in the course of maintaining his or her physical self, such as eating, dressing, oral hygiene, toileting, personal grooming, and moving himself or herself from one location to another.

3.3. Adult. - An individual eighteen years of age or older or who other-wise qualifies as an adult under West Virginia law.

3.4. Administration of Medication. - Assisting a person in the ingestion, application or inhalation of medications, including both prescription drugs and non-prescription drugs.

3.5. Ambulatory Health Care Facility. - Any facility which provides health care or mental health care to noninstitutionalized persons on an outpatient basis. This definition does not include the legally authorized practice of medicine by any one or more persons in the private office of any health care providers.

3.6. Center. - Medical adult day care center as defined in this rule.

3.7. Conservator. - A person appointed pursuant to the West Virginia Legal Guardianship and Conservatorship Act, W. Va. Code § 44A-1-1 et seq., within the limits set by the order, responsible for managing the estate and financial affairs of another individual who has been determined by the court to be incompetent and therefore no longer able to handle those affairs independently.

3.8. Committee. - A person who is bonded and given the responsibility of proper use of an incompetent person's money who was appointed prior to June 9, 1994, within the limits set by the appointing order and W. Va. Code § 44A-1-2(d).

3.9. Communicable Disease. - An illness caused by an infectious agent or its toxic product that is transmitted, directly or indirectly, to a susceptible host from an infected person or animal or through the agency of an intermediate host or a vector or through the inanimate environment.

3.10. Developmental Disorder. - A group of disorders in which the predominant disturbance is in the acquisition of cognitive, language, motor, or social skills. The disturbance may involve a general delay, as in mental retardation, or a delay or failure to progress in a specific area of skill acquisition or multiple areas in which there are qualitative distortions of normal development.

3.11. Disability. - Any limitation of physical, mental, or social activity of an individual as compared with other individuals of similar age, sex, and occupation. It frequently refers to limitation of the usual or major activities, most commonly vocational.

3.12. Deficiency. - A violation of this rule.

3.13. Director. - The owner or individual selected by the licensee to be responsible for the day-to-day operation of the medical adult day care program.

3.14. Durable Power of Attorney. - A person appointed by another person to make decisions on his or her behalf pursuant to W. Va. Code § 39-4-1, or a power of attorney under common law, within the limits of the appointment.

3.15. Exploitation. - The act or process of taking unjust advantage of another individual for one's own benefit that includes, but is not limited to, the deliberate misplacement or wrongful use of his or her belongings or money without the individual's consent.

3.16. Extensive Nursing Care. - The nursing care required when there is a major deviation from normal in a body system or multiple body systems of such magnitude that the deviations are life-threatening and the individual's condition is unstable and unpredictable.

3.17. Functional Needs Assessment. - Any measurement tool that identifies for the participant and the licensee those services that the licensee will need to obtain or provide for the participant in order to promote the participant's health, comfort, dignity and independence.

3.18. Governing Body. - The individual, agency, group or corporation appointed, elected or otherwise designated in which the ultimate responsibility and authority for the conduct of the center is vested.

3.19. Guardian. - A person appointed pursuant to the West Virginia Guardianship and Conservatorship Act, W. Va. Code § 44A-1-1 et seq., within the limits set by the order, responsible for the personal affairs of another individual who has been determined by the court to be incompetent and therefore no longer able to handle these affairs independently.

3.20. Health Care Surrogate. - A person appointed by a health care professional pursuant to the West Virginia Health Care Decisions Act, W. Va. Code § 16-30-1 et seq., within the limits set by the appointment, to make health care decisions for another individual who has been determined to lack the capacity to independently make those decisions.

3.21. Immediate and Serious Threat. - A situation that presents a high probability of serious harm or injury to one (1) or more program participants. An immediate or serious threat need not result in actual harm to any participant.

3.22. Legal Representative. - A person lawfully invested with the power and charged with the duty of taking care of another person or with managing the property or rights of another person, including a committee, conservator, guardian, health care surrogate, durable power of attorney, medical power of attorney, representative payee, trustee or other duly appointed person.

3.23. License. - The document issued by the Secretary of the Department of Health and Human Resources or his or her designee which constitutes the authority to perform services included within the scope of this rule.

3.24. Licensed Capacity. - The number of participants a medical adult day care program is licensed to serve at one time.

3.25. Licensed Health Care Professional. - A health care professional currently licensed in West Virginia including, but not limited to, a social worker, dentist, practical nurse, occupational therapist, pharmacist, physical therapist, physician, physician assistant, psychologist, registered professional nurse, or speech-language pathologist.

3.26. Major Incident. - An event or occurrence, the outcome of which places one or more participant's health and well-being in imminent danger, such as:

3.26.a. A fall, an accident or another event that results in fracture or serious injury or threatens the life of the participant;

3.26.b. A participant's death occurring from other than natural causes;

3.26.c. A missing participant who is likely to injure himself or herself or who needs medication or treatment on a regular basis, and who is likely to have difficulty returning to the medical adult day care program on his or her own;

3.26.d. Assault on a participant resulting in injury; or

3.26.e. Other suspected criminal activity or events that cause the disruption of normal medical adult day care program activity, including threats or occurrences of extreme violence, explosions, fire or natural disasters.

3.27. Medical Adult Day Care Center. - An ambulatory health care facility which provides an organized day program of therapeutic, social, and health maintenance and restorative services and whose general goal is to provide an alternative to twenty-four hour long term institutional care to elderly or disabled adults who are in need of such services by virtue of physical and mental impairment.

3.28. Medical Power of Attorney. - A document naming a person eighteen years of age or older to make health care decisions for another person pursuant to the West Virginia Health Care Decisions Act, W. Va. Code § 16-30-1 et seq., within the limits set by law and the appointment.

3.29. Mental Disorder. - An illness that affects the psychological well-being or behavior of an individual to the extent that the individual requires treatment for his or her own welfare or the welfare of others.

3.30. Multi-disciplinary Team. - A service planning team comprised of representation from at least the following: the center director, a registered nurse, the activity director, direct care staff, the participant and the participant's family. Representation from other disciplines such as nutrition, physical therapy, occupational therapy and speech therapy may be included as applicable.

3.31. Neglect. - Failure to provide for the necessities of daily living or the lack of care.

3.32. Nursing Care. - Those procedures commonly employed in providing for the physical, emotional and rehabilitational needs of the ill or otherwise incapacitated which require technical skills and knowledge beyond that which the untrained person possesses, including, but not limited to, procedures such as: irrigations; catheterization; application of dressings; supervision of special diets; objective observation of changes in a participant's condition as a means of analyzing and determining the nursing care required and the need for further medical diagnosis and treatment; special procedures contributing to rehabilitation; administration of medication by any route ordered by a physician, such as parenterally, rectally, or orally; and carrying out other treatments prescribed by a physician which involve a like level of complexity and skill in administration.

3.33. Participant. - An individual who has been accepted for participation in the services and activities offered by a licensed medical adult day care program.

3.34. Personal Care Services. - Personal services designed to assist an individual to achieve an optimum level of functioning and self-care., including, but not limited to, the following: help with activities of daily living or supervision required because of the age or physical or mental impairment of the participant.

3.35. Representative Payee. - A person or organization that receives Social Security and/or Supplemental Security Income (SSI) payments for someone who cannot manage or direct the management of his or/her money appointed under the U.S. Social Security Act, Title 42 US Code §301 et seq., within the limits of the payee's legal authority.

3.36. Restraint. - Any physical or chemical means used for the purpose of limiting or restricting a person's movement or mobility including:

3.36.a. Any manual method or physical or mechanical device, material or equipment that the participant cannot remove at will and that physically limits, restricts, or deprives the participant of movement or mobility including but not limited to lapbelts, vests, gates, or locked doors; or

3.36.b. Any drug used to limit movement or mental capacity of a participant beyond the requirements of therapeutic treatment.

3.37. Secretary - means the Secretary of the Department of Health and Human Resources or his or her designee.

3.38. Self-administration of Medications. - The act of a participant, who is independently capable of reading and understanding the labels of prescribed medication, in opening and accessing a prepackaged container of medication, accurately identifying and taking the correct dosage of the medication, at the correct time and under the correct circumstances as prescribed by a licensed health care professional with prescriptive authority.

3.39. Substantial compliance -- The Medical Adult Day Care Center has no violation of which, as the secretary determines, would present an imminent danger to the health, safety or welfare of any resident or a probability that death or serious physical harm could result, and has no ongoing violation of a regulation where there is a direct or immediate relationship to the health, safety or welfare of the resident(s).

3.40. Supervision of self administration of medication. - a personal service which includes reminding participants to take medications, opening medication containers for participants, reading the medication label to participants, observing participants while they take medications, checking the self-administered dosage against the label on the container and reassuring participants that they have obtained and are taking the dosage as prescribed.

3.41. Service Plan. - A written description of the services that need to be provided to a participant to meet all of the needs identified in his or her functional needs assessment.

3.42. Specialty services. - Specialized services offered to participants in addition to regular medical adult day care services including physical therapy, occupational therapy, speech therapy and services specifically targeted to special populations such as individuals with Alzheimer's disease, developmental disabilities, traumatic brain injury, mental illness and HIV/AIDS.

3.43. Supervision. - The assumption of varying degrees of responsibility for the safety and well-being of participants including, but not limited to:

3.43.a. Being aware of the participant's whereabouts, to the extent identified as a need by the participant's assessment or service plan;

3.43.b. Monitoring the activities of a participant while on the premises of the medical adult day care program to ensure the participant's health, safety and well-being; and,

3.43.c. Reminding the participant of any important activities of daily living.

3.44. Volunteer. - A person who offers his or her time to provide services to the center without pay.

3.45. Waiver. - An exemption from compliance with a requirement set forth in this rule.

Notes

W. Va. Code R. § 64-2-3