Definitions

Activities of Daily Living (ADL) means personal care activities including but not limited to bathing, dressing, grooming, toileting, transfers, ambulation, personal hygiene, and eating. Adult Day Health Program (Program) means any entity, however organized, whether conducted for profit or not for profit that: (1) Is community-based and non-residential; (2) Provides nursing care, supervision, and health related support services in a structured group setting to persons 18 years of age or older who have physical, cognitive, or behavioral health impairments; and (3) Supports families and other caregivers thereby enabling the participant to live in the community. Adult Day Health Services (Services) means the services that a Program provides or performs for participants in accordance with 105 CMR 158.000. Applicant means any person who applies to the Department for a license to operate a Program. In the case of an applicant which is not a natural person, the term Applicant shall also mean any shareholder owning 5% or more; any officer and any director of any corporate applicant; any limited partner owning 5% or more and any general partner of any partnership applicant; any trustees of any trust applicant; any sole proprietor of any applicant which is a sole proprietorship; any mortgagee in possession; and any executor or administrator of any applicant which is an estate. Applicant also means a person filing a Notice of Intent form. Aversive Interventions means any intervention technique based upon behavior modification principles, which applies painful, seclusion or intrusive methods, stimuli, or punishments to a participant in order to correct, decrease, or eliminate any undesirable behaviors. Chemical Restraints means a drug that is used for discipline or convenience and not required to treat medical symptoms. Commissioner means the Commissioner of the Department of Public Health. Convenience means any action taken by a Program staff to control or manage a participant's behavior that requires a lesser amount of effort by Program personnel and is not in the participant's best interest. Department means the Department of Public Health of the Commonwealth of Massachusetts. Direct Care Staff include nurses, program aides, social workers and any individual(s) supervised by a social worker in accordance with 258 CMR 12.00: Scope of Practice, and activities directors. Discharge means the termination of enrollment at a Program without an intention or expectation that the participant will return to the Program. Discipline means any action taken by a Program for the purpose of punishing or penalizing a participant. Elopement means that a participant who requires supervision has left the Program premises or safe area without the necessary supervision to do so. Emergency means a situation or condition which presents imminent danger of death or serious physical harm to one or more individuals. Felony means a crime which is deemed a felony in the state in which the crime was committed or by the federal government. Health Record means the cumulative required documentation maintained at a Program regarding the delivery of care and services to a participant, as specified in 105 CMR 158.000. Influenza Vaccine or Vaccination means immunization by either influenza vaccine, inactivated or live; attenuated influenza vaccine including seasonal influenza vaccine, and/or other influenza vaccine pursuant to 105 CMR 158.030(L). Jeopardy means a situation or condition which the Commissioner or his or her designee has determined presents an imminent threat to the health or safety of participants. Legally Authorized Representative means the person or agency authorized to make health care decisions for a participant pursuant to an executed health care proxy or pursuant to an order of a Massachusetts court. License means any license to operate a Program, issued by the Department, including an original or a renewal license. Licensed Practical Nurse means a nurse who is currently licensed by the Massachusetts Board of Registration in Nursing, pursuant to M.G.L. c. 112, § 74A, to practice as a licensed practical nurse in Massachusetts. Licensed Prescriber means a health care provider who is legally authorized to prescribe medication pursuant to M.G.L c. 94C and other state and federal laws. Licensee means any person holding a license to operate a Program. In the case of a licensee which is not a natural person, the term Licensee shall also mean any shareholder owning 5% or more, any officer, and any director of any corporate licensee; any limited partner owning 5% or more and any general partner of a partnership licensee; any trustee of any trust licensee; any sole proprietor of any licensee which is a sole proprietorship; any mortgagee in possession and any executor or administrator of any licensee which is an estate. Massachusetts Medical Orders for Life Sustaining Treatments (MOLST) means the Department sponsored program to improve the communication and adherence to participants' expressed preferences regarding life sustaining treatments, by providing a standardized, easily recognized MOLST form documenting the care planning conversations between a participant or, if incapacitated, the participant's authorized representative for MOLST and the physician, nurse practitioner, or authorized physician assistant. Medical Symptom means an indication or characteristic of a physical or psychological condition. Medication Error means 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. Notice of Intent means a form supplied by the Department through which an applicant notifies the Department of his or her intent to acquire a Program and/or to apply for a license to operate a Program. Nurse Practitioner means a registered nurse authorized to practice as a nurse practitioner by the Board of Registration in Nursing pursuant to M.G.L. c. 112, § 80B and 244 CMR 4.00: The Practice of Nursing in the Expanded Role. Original License means the first license issued to a Program by the Department pursuant to 105 CMR 158.000. Participant means any individual enrolled in a Program licensed by the Department. Participant Area means the physical space within the Program used for provision of Services, therapeutic activities, and dining. The Participant Area does not include reception areas, storage areas, offices, restrooms, corridors, or services areas. Person means any natural person, corporation, society, association, partnership, or other entity. Personnel means an individual or individuals employed by or affiliated with a Program, whether directly, by contract with another entity, or as an independent contractor, paid or unpaid. Pharmacist means a person licensed by the Board of Registration in Pharmacy in accordance with M.G.L. c. 112, § 24. Physical Restraints means any manual method or physical or mechanical device, material, or equipment attached to or adjacent to a participant's body that the participant cannot remove, which restricts freedom of movement or normal access to one's body. Physician means a doctor of medicine or doctor of osteopathy who is registered to practice medicine in Massachusetts pursuant to M.G.L. c. 112, § 2. Physician Assistant means a physician assistant authorized to practice by the Board of Registration of Physician Assistants, pursuant to M.G.L. c. 112, § 9I. Primary Care Provider means a health care professional qualified to provide general medical care for common health care problems, who supervises, coordinates, prescribes or otherwise provides or proposes health care services, initiates referrals for specialist care and maintains continuity of care within the scope of practice. Program Aide means any individual who meets the following criteria: (1) Is 18 years of age or older and has at least a high school diploma or its equivalent; (2) Meets the requirements stated in 105 CMR 158.033(F); and (3) Provides delegated nursing or nursing related services to participants in a Program as described at 105 CMR 158.033(F). Program Capacity means the maximum number of participants that may be in the care of the Program at any one time based on the square footage specified in 105 CMR 158.026. Program Director means a person responsible for general administration of daily operations of a Program, as specified at 105 CMR 158.030(K). Qualified Cook means an individual who: (1) As described in 105 CMR 590.000: State Sanitary Code Chapter X – Minimum Sanitation Standards for Food Establishments, has passed a certified food protection manager test that is part of an accredited program recognized by the Department; (2) Has been issued a Massachusetts certificate of allergen awareness training by an allergen awareness training verification program recognized by the Department; and (3) Has a minimum of six months of supervisory experience in the planning, preparation, and service of food, including therapeutic diets. Registered Dietitian means a registered dietitian licensed under M.G.L. c. 112, §§ 201 through 210. Registered Nurse means a nurse who is currently registered pursuant to M.G.L. c. 112, § 74 to practice as a registered nurse in Massachusetts. Rehabilitation Services means services provided by physical therapists, occupational therapists, and speech, hearing and language therapists for the purpose of maximum reduction of physical or mental disability and restoration of the participant to maximum functional level. Renewal License means any license issued after an original license to a Program by the Department pursuant to 105 CMR 158.000. Restorative Nursing means the process of providing, in a coordinated manner, comprehensive services deemed appropriate to the needs of an individual with a disability, to achieve objectives of improved health and welfare with the realization of his or her maximum physical, psychological, and functional potential. Self-administration means a participant taking or applying his or her medication in the manner directed by the prescribing provider, with no more than minimal assistance or direction from nursing staff, in accordance with Program policies and procedures. Service Coordination means an interdisciplinary, collaborative process to assess, plan, implement, coordinate, monitor, and evaluate the services required to meet a participant's needs, including the medically-related physical, mental, behavioral, environmental, and other service needs of a participant at the time of enrollment, during treatment and care in the Program, or at the time of discharge. Significant Change means a major decline or improvement in the participant's health status that will not normally resolve itself without further intervention by staff or by implementing standard disease-related clinical interventions, that has an impact on more than one area of the participant's health status, and requires review or revision of the plan of care, or both. Social Worker means an individual who meets the qualifications set forth in M.G.L. c. 112, § 131, and 258 CMR 9.00: Licensure Requirements and Procedures and who is licensed by the Board of Social Workers to perform or provide social work services in accordance with 258 CMR 12.01: Scope of Professional Practice - Licensed Independent Clinical Social Worker (LICSW), 12.02: Scope of Professional Practice - Licensed Certified Social Worker (LCSW), or 12.03: Scope of Professional Practice - Licensed Social Worker (LSW). Transfer of Ownership means a transfer of a majority interest in the ownership of a Program. In the case of a corporation, transfer of ownership includes the transfer of a majority of the stock thereof. In the case of a partnership, transfer of ownership includes the transfer of a majority of the partnership interest. In the case of a trust, transfer of ownership includes change of the trustee, or majority of trustees. In the case of a non-profit corporation, such changes in the corporate membership or directors as the Department determines to constitute a shift of 5% or more in control of the Program. A transfer of ownership shall also be deemed to have occurred where foreclosure proceedings have been instituted by a mortgagee in possession.