§ 2800.4. Definitions.

 The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:

   ADL—Activities of daily living—The term includes eating, drinking, ambulating, transferring in and out of a bed or chair, toileting, bladder and bowel management, personal hygiene, securing health care, managing health care, self-administering medication and proper turning and positioning in a bed or chair.

   Abuse—The occurrence of one or more of the following acts:

     (i)   The infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain or mental anguish.

     (ii)   The willful deprivation by the assisted living residence or its staff persons of goods or services which are necessary to maintain physical or mental health.

     (iii)   Sexual harassment, rape or abuse, as defined in 23 Pa.C.S. Chapter 61 (relating to protection from abuse).

     (iv)   Exploitation by an act or a course of conduct, including misrepresentation or failure to obtain informed consent which results in monetary, personal or other benefit, gain or profit for the perpetrator, or monetary or personal loss to the resident.

     (v)   Neglect of the resident, which results in physical harm, pain or mental anguish.

     (vi)   Abandonment or desertion by the assisted living residence or its staff persons.

   Adult—An individual who is 18 years of age or older.

   Age in place or aging in place—Receiving care and services at a licensed assisted living residence to accommodate changing needs and preferences in order to remain in the assisted living residence.

   Agent—An individual authorized by the Department to enter, visit, inspect or conduct an investigation of an assisted living residence.

   Ancillary staff person—An individual who provides services for the residents other than direct assistance with activities of daily living. Ancillary staff may include staff who do not provide direct care but who conduct assessment, care planning or care management activities, and who meet the direct care staff qualifications and training requirements. Ancillary staff may also include RNs, LPNs, dieticians, or skilled professionals who meet the requirements of their professional licensure and the direct care staff requirements, if they also provide direct assistance with activities of daily living. Other ancillary staff may include activities planners, housekeepers, cooking staff or facilities staff.

   Appropriate assessment agency—An organization serving adults who are older or adults with disabilities, such as a county mental health/intellectual disability agency, a drug and alcohol agency, an area agency on aging or another human service agency, or an individual in an occupation maintaining contact with adults who are older and adults with disabilities, such as medicine, nursing or rehabilitative therapies.

   Area agency on aging—The local agency designated by the Department of Aging as defined in section 2202-A of The Administrative Code of 1929 (71 P.S. §  581-2).

   Assessment—An instrument that includes screening of a resident or potential resident to determine whether the resident or potential resident requires the services of an assisted living residence.

   Assisted living residence administrator—An individual who is charged with the general administration of an assisted living residence, whether or not the individual has an ownership interest in the residence or his function and duties are shared with other individuals.

   Assisted living residence or residence—Any premises in which food, shelter, assisted living services, assistance or supervision and supplemental health care services are provided for a period exceeding 24-hours for four or more adults who are not relatives of the operator, who require assistance or supervision in matters such as dressing, bathing, diet, financial management, evacuation from the residence in the event of an emergency or medication prescribed for self-administration.

   Assisted living services—Services as defined in §  2800.220(b) (relating to service provision).

   Basic cognitive support services—These services include the following:

     (i)   Intermittent cueing.

     (ii)   Redirecting.

     (iii)   Environmental cues.

     (iv)   Measures to address wandering.

     (v)   Dementia-specific activity programming.

     (vi)   Specialized communication techniques.

   CAM—Complementary and alternative medications—Practices, substances and ideas used to prevent or treat illness or promote health and well-being outside the realm of modern conventional medicine. Alternative medicine is used alone or instead of conventional medicine. Complementary medicine is used along with or in addition to conventional medicine.

   CPB—Cognitive, physical, behavioral.

   CPR—Cardiopulmonary resuscitation.

   Cognitive support services

     (i)   Services provided to an individual who has memory impairments and other cognitive problems which significantly interfere with his ability to carry out ADLs without assistance and who requires that supervision, monitoring and programming be available 24 hours per day, 7 days per week, in order to reside safely in the setting of his choice.

     (ii)   The term includes assessment, health support services and a full range of dementia-capable activity programming and crisis management.

   Commercial boarding home—A type of residential living facility providing only food and shelter, or other services normally provided by a hotel, for payment, for individuals who require no services beyond food, shelter and other services usually found in hotel or apartment rental.

   Common living area—Includes any of the following:

     (i)   Dining room.

     (ii)   Indoor activity space.

     (iii)   Recreational space.

     (iv)   Swimming area, if located in the residence.

   Complaint—A written or oral criticism, dispute or objection presented by or on behalf of a resident to the Department regarding the care, operations or management of an assisted living residence.

   Day—Calendar day.

   Dementia—A clinical syndrome characterized by a decline of long duration in mental function in an alert individual. Symptoms of dementia may include memory loss, personality change, chronic wandering and the loss or diminishing of other cognitive abilities, such as learning ability, judgment, comprehension, attention and orientation to time and place and to oneself.

   Department—The Department of Human Services of the Commonwealth.

   Designated person—An individual who may be chosen by the resident and documented in the resident’s record, to be notified in case of an emergency, termination of service, assisted living residence closure or other situations as indicated by the resident or as required by this chapter. A designated person may be the resident’s legal representative or an advocate.

   Designee—A staff person authorized in writing to act in the administrator’s absence.

   Direct care staff person—A staff person who directly assists residents with activities of daily living, and instrumental activities of daily living and provides services or is otherwise responsible for the health, safety and well-being of the residents.

   Discharge—Termination of an individual’s residency in an assisted living residence.

   Distinct part—A portion of a building that is visually separated such as a wing or floor, or sections or parts of floors.

   Emergency medical plan—A plan that ensures immediate and direct access to medical care and treatment for serious injury or illness, or both.

   Financial management

     (i)   An assisted living service requested or required by the resident in accordance with his support plan, which includes taking responsibility for or assisting with paying bills, budgeting, maintaining accurate records of income and disbursements, safekeeping funds and making funds available to the resident upon request.

     (ii)   The term does not include solely storing funds in a safe place as a convenience for a resident.

   Fire safety expert—A member of a local fire department, fire protection engineer, Commonwealth-certified fire protection instructor, college instructor in fire science, county or Commonwealth fire school, volunteer trained and certified by a county or Commonwealth fire school, an insurance company loss control representative, Department of Labor and Industry building code inspector or construction code official.

   Health care or human services field—Includes the following:

     (i)   Child welfare services.

     (ii)   Adult services.

     (iii)   Older adult services.

     (iv)   Mental health/intellectual disability services.

     (v)   Drug and alcohol services.

     (vi)   Services for individuals with disabilities.

     (vii)   Medicine.

     (viii)   Nursing.

     (ix)   Rehabilitative services.

     (x)   Any other human service or occupation that maintains contact with adults who are older or adults and children with disabilities.

   Housekeeping—The cleaning of the living unit and common living areas. Cleaning of the living unit includes at least weekly dusting, sweeping, vacuuming, mopping, emptying trash, and cleaning of bathroom, counters, refrigerator and microwave oven, if these appliances are in the resident’s living area. Housekeeping for common living areas means keeping them in clean sanitary condition.

   IADL—Instrumental activities of daily living—The term includes the following activities when done on behalf of a resident:

     (i)   Doing laundry.

     (ii)   Shopping.

     (iii)   Securing and using transportation.

     (iv)   Financial management.

     (v)   Using a telephone.

     (vi)   Making and keeping appointments.

     (vii)   Caring for personal possessions.

     (viii)   Writing correspondence.

     (ix)   Engaging in social and leisure activities.

     (x)   Using a prosthetic device.

     (xi)   Obtaining and keeping clean, seasonal clothing.

   INRBI—Intense neurobehavioral rehabilitation after brain injury.

   Informed consent agreement—A formal, mutually agreed upon, written understanding which:

     (i)   Results after thorough discussion among the assisted living residence staff, the resident and any individuals the resident wants to be involved.

     (ii)   Identifies how to balance the assisted living residence’s responsibilities to the individuals it serves with a resident’s choices and capabilities with the possibility that those choices will place the resident or other residents at risk of harm.

   LPN—Licensed practical nurse.

   Legal entity—A person, society, corporation, governing authority or partnership legally responsible for the administration and operation of an assisted living residence.

   Legal representative—An individual who holds a power of attorney, a court-appointed guardian or other person legally authorized to act for the resident.

   License—A certificate of compliance issued by the Department permitting the operation of an assisted living residence, at a given location, for a specific period of time, for a specified capacity, according to Chapter 20 (relating to licensure or approval of facilities and agencies).

   Licensee—A person legally responsible for the operations of an assisted living residence licensed in accordance with this chapter.

   Long-term care ombudsman—A representative of the Office of the State Long-Term Care Ombudsman in the Department of Aging who investigates and seeks to resolve complaints made by or on behalf of individuals who are 60 years of age or older who are consumers of long-term care services. These complaints may relate to action, inaction or decisions of providers of long-term care services, of public agencies, of social service agencies or their representatives, which may adversely affect the health, safety, well-being or rights of these consumers.

   Mobile resident

     (i)   A resident who is physically and mentally capable of vacating the assisted living residence on the resident’s own power or with limited physical or oral assistance in the case of an emergency, including the capability to ascend or descend stairs if present on the exit path.

       (A)   Physical assistance means assistance in getting to one’s feet or into a wheelchair, walker or prosthetic device.

       (B)   Oral assistance means giving instructions to assist the resident in vacating the assisted living residence.

     (ii)   The term includes an individual who is able to effectively operate an ambulation device required for moving from one place to another, and able to understand and carry out instructions for vacating the assisted living residence.

   Neglect—The failure of an assisted living residence or its staff persons to provide goods or services essential to avoid a clear and serious threat to the physical or mental health of a resident. The failure or omission to provide the care, supervision and services that the assisted living residence has voluntarily, or by contract, agreed to provide and that are necessary to maintain the resident’s health, safety and well-being, including assisted living services, food, clothing, medicine, shelter, supervision and medical services. Neglect may be repeated conduct or a single incident.

   OTC—Over-the-counter or nonprescription.

   Premises—The grounds and buildings on the same grounds, used for providing services required by residents.

   Protective services unit—The local area agency on aging unit designated by the Department of Aging to investigate allegations of abuse of adults who are 60 years of age or older and assess the need for protective interventions.

   RN—Registered nurse.

   Referral agent—An agency or individual who arranges for or assists, or both, with placement of a resident into an assisted living residence.

   Relative—A spouse, parent, child, stepparent, stepchild, grandparent, grandchild, brother, sister, half-brother, half-sister, aunt, uncle, niece or nephew.

   Resident—An adult, unrelated to the legal entity, who resides in an assisted living residence, and who may require assisted living services or supplemental health care services, or both.

   Resident with mobility needs—An adult who is unable to move from one location to another, has difficulty in understanding and carrying out instructions without the continued full assistance of other individuals or is incapable of independently operating an ambulation device, such as a wheelchair, prosthesis, walker or cane to exit a building.

   Restraint—A manual, chemical or mechanical device used to limit or restrict the movement or normal function of an individual or a portion of the individual’s body.

   SSI—Supplemental Security Income.

   Secretary—The Secretary of the Department.

   Special care designation—A licensed assisted living residence or a distinct part of the residence which is specifically designated by the Department as capable of providing cognitive support services to residents with severe cognitive impairments, including dementia or Alzheimer’s disease, in the least restrictive manner to ensure the safety of the resident and others in the residence while maintaining the resident’s ability to age in place.

   Specialized cognitive support services—These services include the following:

     (i)   Nonpharmacological interventions.

     (ii)   Dining with dignity.

     (iii)   Routines and roles.

     (iv)   Close of day programming.

     (v)   Pain management and person-centered care planning.

     (vi)   Implementation and management.

   Staff person—An individual who works for the assisted living residence for compensation either on payroll or under contract.

   Supplemental health care services—The provision by an assisted living residence of any type of health care service, either directly or through contractors, subcontractors, agents or designated providers, except for any service that is required by law to be provided by a health care facility under the Health Care Facilities Act (35 P.S. § §  448.101—448.901).

   Support plan—A written document that describes for each resident the resident’s care, service or treatment needs based on the assessment of the resident, and when the care, service or treatment will be provided, and by whom.

   Third-party provider—Any contractor, subcontractor, agents or designated providers under contract with the resident or residence to provide services to any resident.

   Transfer—Movement of a resident within the assisted living residence or to a temporary placement outside the assisted living residence.


     (i)   An individual who, of his own free will, and without monetary compensation, provides direct care services for residents in the assisted living residence.

     (ii)   The term does not include visitors or individuals who provide nondirect services or entertainment on an occasional basis.


   The provisions of this §  2800.4 amended under sections 211 and 213 and Articles IX and X of the Human Services Code (62 P.S. § §  211, 213, 901—922 and 1001—1088).


   The provisions of this §  2800.4 amended June 17, 2016, effective June 18, 2016, 46 Pa.B. 3177. Immediately preceding text appears at serial pages (351479) to (351480), (375643) to (375444) and (351483) to (351486).

Cross References

   This section cited in 55 Pa. Code §  2800.220 (relating to service provision).

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