HAR §11-800-2. Definitions

As used in this chapter: "Abuse" means actual or imminent physical injury, psychological abuse, or neglect, sexual abuse, financial exploitation, negligent treatment, or maltreatment, as further defined in section 346-222, Hawaii Revised Statutes (HRS). "Administrator" means the person who is responsible for the daily management and operation of a case management agency and its compliance with professional and licensing requirements. "Adult abuse perpetrator check" means a search to determine whether an individual is 800-3 B325 11-800-2 known to the department as a perpetrator of abuse as defined in section 346-222, HRS, by means of a search of the individual's name and birth date in the department's adult protective service file. "Adverse event" means any incident or event that may have quality of care implications for clients, including but not limited to: (1) All bodily injuries sustained by the client, regardless of cause or severity; (2) All medication errors; (3) Major and unresolved conflicts between the client and the primary caregiver, substitute caregivers, contracted personnel, or other household members, as applicable; (4) The whereabouts of the client are unknown; or (5) Any protective service reports or investigation involving the client or the facility in which the client is residing. "Assisted living facility" means an assisted living facility as defined in section 321-15.1, HRS. "Authorized agent" means a person, institution, organization, or agency authorized by the department of health to issue licenses to home and community-based case management agencies and to monitor these agencies for license compliance and quality assurance. The authorized agent shall perform these functions for the department of health and shall not at the same time function as a home and community- based case management agency or as the owner or operator of a residential care facility as defined in this section. "Case management" means the process of continuous assessment of the service needs of the client in a community care foster family home, expanded adult residential care home, or assisted living facility, the development, review, and updating, as necessary, of the client's service plan, and the locating, coordinating, and monitoring of an integrated and comprehensive combination of services 800-4 B325 1-4 11-800-2 necessary to cost effectively maintain and support, and ensure the welfare of the client in the community, on a twenty-four hour basis. Case management is intended to assist the client to access needed care and services on a timely basis and to prevent inappropriate institutionalization through a thorough consideration of community-based alternatives. "Case manager" means an individual other than and not related to the caregiver that locates, coordinates, and monitors comprehensive services to meet a client's needs. "Certificate of approval" or "certificate" means the certificate issued by the department which authorizes a person, agency, or organization to operate a community care foster family home. "Client" means an individual who receives home and community-based case management services to reside in a community care foster family home, expanded adult residential care home, or assisted living facility. "Community care foster family home" or "home" means a home as defined in section 321- 481, HRS. "Department" means the department of health, its designee when the context of the rule refers to community care foster family homes, or its authorized agent when the context of the rule refers to home and community-based case management agencies. "Designee" means a person, institution, organization, or agency authorized by the department of health to issue certificates of approval to community care foster family homes and to monitor these homes for certificate compliance and quality assurance. The designee shall perform these functions for the department of health and shall not at the same time function as a home and community-based case management agency or as the owner or operator of a residential care facility as defined in this section. "Expanded adult residential care home" means any facility providing twenty-four hour living accommodations, for a fee, to adults unrelated to the family, who require at least minimal assistance in the activities of daily 800-5 3325 11-800-2 living, personal care services, protection, and health care services, and who may need the professional health services provided in an intermediate care facility or skilled nursing facility. "Home and community-based case management agency" or "case management agency" means a person, agency, or organization that is licensed by the department to locate, coordinate, and monitor comprehensive services to meet the needs of clients whom the case management agency serves in community care foster family homes or medicaid waiver service recipients in expanded adult residential care homes, or assisted living facilities. "Homemaker services" means those tasks performed by the caregiver that healthy individuals would do for themselves, including but not limited to laundry, shopping, meal preparation, and keeping the client's room safe and sanitary. Housekeeping activities that do not directly pertain to the client, such as household maintenance and overall house cleaning, are not homemaker services. "License" means an approval issued by the department or its authorized agents for a person, agency, or organization to operate as a home and community-based case management agency. "Licensed practical nurse" or "LPN" means an individual licensed as a practical nurse by the State of Hawaii, pursuant to chapter 457, HRS. "Nurse aide" or "NA" means an individual who has successfully completed an approved nurse aide course, or has passed an approved equivalency test, or an individual who has one year of full-time employment as a nurse aide under the supervision of a registered nurse in a hospital, skilled nursing facility, intermediate care facility, or home health agency. "Nursing facility level of care" means the level of care provided at skilled nursing facilities where the resident would require daily skilled nursing services on more than one shift per day or daily restorative skilled 800-6 3325 11-800-2 rehabilitative services or a combination of skilled nursing and rehabilitative services; or at intermediate care facilities where the resident would require intermittent skilled nursing, a daily skilled nursing assessment, and twenty-four hour supervision. "Personal care" means assisting with activities of daily living such as ambulating, mobility, transfer and lifting, positioning and turning, bowel and bladder care, toileting, bathing, dressing, grooming, feeding, exercise, medication assistance, range of motion, and maintenance of health records. "Physician" means a person who is licensed to practice medicine or osteopathy under chapter 453 or 460, HRS. "Primary caregiver" or "caregiver" means the individual who is directly responsible for the supervision and care of the client. "Reassessment" means the formal review of a client's status to determine if the client's situation and functioning have changed since the initial or most recent assessment. The reassessment measures the progress toward the goals established in a service plan and ensures the client's continued appropriateness for services through a community care foster family home, expanded adult residential care home, or assisted living facility. "Registered nurse" or "RN" means an individual who is licensed as a registered nurse in the State of Hawaii, pursuant to chapter 457, HRS. "Residential care facility" means a community care foster family home, an expanded adult residential care home, or an assisted living facility. "Respite services" means temporary care in a residential care facility or other facility licensed by the State to care for individuals with nursing facility level care needs, to allow the primary caregiver relief from the care giving duties. "Service plan" means a written plan that is based upon a comprehensive assessment of the client, including a review of the client's 800-7 3325 11-800-5 health, functional, psychosocial, and financial situations, which specifies the type, provider, amount, duration and frequency of services necessary to maintain the client in the community as a cost-effective alternative to institutionalization. "Substitute caregiver" means an individual who is trained and identified in the service plan to provide daily personal care to clients in the absence of the primary caregiver. [Eff NOV 13 2018] (Auth: HRS §§321-9, 321-11, 321-15.1, 321-15.62, 321-481 to 321-483, 346-14, 346-222) (Imp: HRS §§321-481 to 321-483)