Definitions

When used in 651 CMR 12.00, unless the context otherwise requires, the following terms shall have the following meanings: Abuse. Consistent with the Elder Protective Services regulations, 651 CMR 5.00: Elder Abuse Reporting and Protective Services Program, an act or omission, including but not limited to emotional abuse, financial exploitation, neglect, physical abuse, sexual abuse, and/or self-neglect. Activities of Daily Living (ADL). Tasks related to bathing, dressing, grooming, ambulation, eating, toileting and other similar tasks related to personal care needs. Administrative Fee. Any charge billed to and payable by a Resident as a condition of admission, excluding room, board, and services. Alteration. Any of the following changes made after the date of the Residence's last Certification: (a) a change in the number of Units; (b) a substantial change in the configuration of Units; (c) a substantial change in the premises; (d) a substantial change in the operating plan; (e) a new management company; and (f) a name change of the Residence or the Residence's Sponsor. Applicant. A person or legal entity applying to EOAI for Certification as a Sponsor of an Assisted Living Residence. Assisted Living Residence or Residence. Any entity, however organized, whether conducted for profit or not for profit, which meets all of the following criteria: (a) provides room and board; (b) provides, directly by its employees or through arrangements with another organization which the entity may or may not control or own, Personal Care Services for three or more adults who are not related by consanguinity or affinity to their care provider; and (a) collects payments or third-party reimbursements from or on behalf of Residents to pay for the provision of assistance with the Activities of Daily Living, or arranges for the same. Basic Health Services. Certain services provided at an Assisted Living Residence certified to provide such services by employees of the Residence that are qualified to administer such services or a qualified third-party in accordance with a Medical Order issued by an Licensed Independent Provider; provided, however, that such services shall include all of the following: (i) injections; (ii) the application or replacement of simple non-sterile dressings; (iii) the management of oxygen on a regular and continuing basis; (iv) specimen collection and the completion of a home diagnostic test, including, but not limited to, COVID-19 testing, influenza testing, warfarin, prothrombin or international normalized ratio testing, and glucose testing; provided, that such home diagnostic test or monitoring is approved by the United States Food and Drug Administration for home use; and (v) application of ointments or drops. Bathing Facility. A room equipped with a showerhead or a bathtub to enable one person to take a shower or a bath. Certification. EOAI's initial approval, or subsequent renewal of that approval, of the qualifications of an Applicant or Sponsor to operate and maintain an Assisted Living Residence subject to the requirements of M.G.L. c. 19D and 651 CMR 12.00. Certified Provider of Ancillary Health Services. A person or legal entity certified to provide home health care services or hospice care services under Title XVIII of the Social Security Act 49, Stat. 620 (1935) or an entity licensed under M.G.L. c. 111 that provides physician services, pharmacyservices, restorative therapies, podiatry, hospice services, and/or home health aide services. Clinical Professional. A licensed health care provider who provides health services, including Basic Health Services, within their scope of practice to Residents of an Assisted Living Residence. Computation of Time. In computing any period of time under 651 CMR 12.00, the day of the act which initiates the running of the time period shall not be counted. The last day of the time period shall be included, unless it is a Saturday, Sunday or legal holiday or any other day on which EOAI is closed, in which case the period shall run until the end of the next business day. When the time period is less than seven days, any days when EOAI is closed shall be excluded from the computation. Controlled Substances. For the purposes of 651 CMR 12.00, controlled substances shall include all Class II controlled substances identified by 21 U.S.C. c. 13, and any Class I controlled substances identified by 21 U.S.C. c. 13, that may be legally prescribed according to the laws of the Commonwealth. EOAI. The Executive Office of Aging & Independence, formerly known as the Executive Office of Elder Affairs, a department within the Executive Office of Health and Human Services established pursuant to M.G.L. c. 6A, § 16. EOHHS. The Executive Office of Health and Human Services established pursuant to M.G.L. c. 6A, § 2. EOHHS Agency. Any department, agency, commission, office, board, division, or other body within and subject to EOHHS under M.G.L. c. 6A, § 16, including EOAI. Evidence Informed Falls Prevention Program. The use of the best available knowledge and research to guide the design and implementation of a program to assess Resident risk for falls and establish preventive measures and situational procedures. Floater. A staff member of the Residence who is available on an ad hoc basis to assist in times of unusually heavy workload or emergency situations and is not specifically assigned to a group of Residents or unit. Health Care Agent. An adult to whom authorityto make health care decisions is delegated under a Health Care Proxy. Health Care Proxy. A document delegating to an agent the authority to make health care decisions, executed in accordance with the requirements of M.G.L. c. 201D. Instrumental Activities of Daily Living (IADL). Tasks related to meal preparation, housekeeping, clothes laundering, shopping for food and other items, telephoning, use of transportation, and other similar tasks related to environmental needs. Legal Representative. Guardian, Conservator, or attorney in-fact under a Power of Attorney, as appropriate. No entity or individual can be a legal representative unless they meet all requirements under applicable state law. Licensed Independent Provider. Licensed Independent Provider shall have the same meaning as the term "authorized medical professional" as defined in M.G.L. c. 19D, § 1. Lift Device. A device designed to assist in transferring a Resident between positions or locations, including, but not limited to, ceiling-based lifts, floor-based lifts, and sit-to-stand lifts. Limited Medication Administration (LMA). The administration of medication to a Resident which is not otherwise prohibited by M.G.L. c. 19D or 651 CMR 12.00. LMA may only be provided in a Residence by a practitioner as defined in M.G.L. c. 94C, or a nurse licensed under the provisions of M.G.L. c. 112, § 74 or § 74A to the extent allowed by laws, regulations and standards governing nursing practice in Massachusetts, but which may not include a nurse delegate under M.G.L. c. 112, § 80B. This definition is not intended to address or prohibit the administration of medication conducted by a familymember, an individual designated in writing by the Resident, or the Resident's Legal Representative, the conducting of which is not governed by 651 CMR 12.00. Lodging. The provision of a single or a double living Unit. Manager. The individual who has general administrative charge of an Assisted Living Residence. A Manager may also be known as an Executive Director. Medical Order. A care order as defined in St. 2024, c. 197, § 2 as a written order for Basic Health Services issued by an authorized medical professional. Medication Diversion. The transfer of any legally prescribed medication from the individual for whom it was prescribed to another person for any illicit use. Medication Error. A failure to administer a medication as prescribed, including the failure to administer the correct medication or the failure to administer the medication: (1) Within appropriate time frames; (2) In the correct dosage; (3) In accordance with accepted practice; (4) To the correct participant; or (5) In the correct route. Mobility Assistive Device. Any portable or fixed mechanical, electronic, or manual device (e.g., a cane, walker, wheelchair, etc.) specificallydesigned, approved, and maintained for the purpose of facilitating the safe movement or ambulation of a Resident with limited mobility. The Mobility Assistive Device must conform to applicable national and local safety and quality standards. Modification of Certification. A change to or limitation on the scope of a Sponsor's authority to operate an Assisted Living Residence. Mutual Aid. A coordinated and collaborative effort between local Assisted Living Residences to provide support and assist with the management of evacuations and resource/asset needs, including the identification of substitute housing for use during an extended evacuation of Residents. Newly Constructed. A building or buildings for which a person or entity received a building permit on or after June 1, 1995 and seeks Certification as an Assisted Living Residence; provided that a building or buildings for which a person or entity at any time is or was providing facilities or services other than those of an Assisted Living Residence shall not be considered newly constructed for the purpose of the physical requirements for an Assisted Living Residence under M.G.L. c. 19D, § 16 or 651 CMR 12.04(1). Personal Care Service. Assistance with one or more of the Activities of Daily Living and Self-administered Medication Management, either through physical support or supervision. Supervision includes reminding or observing Residents while they perform activities. Personal Care Staff. Any individual who provides Personal Care Services to a Resident. Residency Agreement. The written contract between an Assisted Living Residence and a Resident or prospective Resident on either a temporary (e.g., for respite care) or more permanent basis. Resident. An individual who resides in an Assisted Living Residence and who receives housing and Resident Services and, when the context requires or permits, such individual's Legal Representative. An individual who resides in an Assisted Living Residence or Special Care Residence for any period of time shall be entitled to all the rights and privileges accorded under 651 CMR 12.00 regardless of the anticipated length of the residency. Resident Care Director. The individual(s) responsible for ensuring and overseeing the process for coordination of Resident Services, including the preparation and periodic review and revision of each Resident's Service Plan. A Resident Care Director may also be known as a Service Coordinator. Resident Representative. An individual who is authorized by the Resident to help them fully participate in planning services or paying fees. The Resident Representative shall not be employed by the Residence, nor affiliated with the Sponsor unless related to the Resident by kinship or marriage. The Resident Representative shall not act on behalf of a Resident in circumstances warranting a Legal Representative. The Residence shall not treat the Resident Representative as personally liable for payment of Resident fees without having first obtained the Resident Representative's written agreement to act as a guarantor or surety. Resident Services. Services to assist Residents with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Self-administered Medication Management (SAMM), or other similar services, but does not include optional services such as concierge services, recreational or leisure services. Resident Services are provided either through physical assistance or staff supervision. Restraint. For the purposes of 651 CMR 12.00, any action taken by the Assisted Living Residence for the purpose or punishing or penalizing a Resident, or to control or manage a Resident's behavior with lesser effort by the Assisted Living Residence that is not in the Resident's best interest by means of: (a) manual method or physical or mechanical device, material, or equipment attached or adjacent to the Resident's body that the individual cannot remove easily which restricts the Resident's freedom of movement or normal access to their body; or (b) any drug not required to treat medical symptoms and not requested by the Resident. Secretary. The Secretary of the Executive Office of Aging & Independence of the Commonwealth of Massachusetts. Self-administered Medication Management (SAMM). A process which includes reminding Residents to take medication, opening containers for Residents, opening prepackaged medication for Residents, reading the medication label to Residents, and observing Residents while theytake the medication. Serious Incident. Any sudden or progressive development or event that requires immediate attention and decisive action to prevent or minimize any negative impact on the health, safety, or welfare of one or more Residents. Service Plan. The individualized plan for each Resident developed and implemented in accordance with 651 CMR 12.04(8) and 12.04(9). Skilled Nursing Care. Skilled services described in 130 CMR 456.409: Clinical Eligibility Criteria or any successor regulation. Special Care Residence (SCR). The Residence in its entirety or any separate and distinct section or sections within the Residence that provide(s) an enhanced level of supports and services for one or more Residents to address their specialized needs due to cognitive or other impairments. Special Care Unit. A portion of a Special Care Residence designed for and occupied pursuant to a Residency Agreement by one or two individuals as the private living quarters of such individuals. Sponsor. The person or legal entity named in the Certification of an Assisted Living Residence. A Sponsor may be the owner of the Assisted Living Residence. Transfer Assistive Device. Any portable or fixed mechanical, electronic, or manual device (e.g., a Lift Device, a bed rail that is less than half the length of the bed, etc.) specifically designed, approved, and maintained for the purpose of transferring a Resident with limited mobility. The Transfer Assistive Device must conform to applicable national and local safety and quality standards. Transfer of Ownership. Transfer of a majority interest in the ownership of an Assisted Living Residence. In the case of an individual, transfer of ownership; in the case of a corporation, transfer of a majority of the stock thereof; in the case of a partnership, transfer of a majority of the partnership interest; in the case of a trust, change of the trustee, or majority of trustees shall constitute transfer of ownership. A transfer of ownership shall also be deemed to have occurred where foreclosure proceedings have been instituted and consummated by a mortgagee in possession of the premises, or when bankruptcy proceedings have been initiated. Unanticipated Death. The death of a Resident resulting from any cause not directly related to an existing diagnosis or prognosis. Unit. A portion of an Assisted Living Residence designed for and occupied pursuant to a ResidencyAgreement byone or two individuals as the private living quartersof such individuals.