Compilation of Rules and Regulations of the State of Georgia
Department 111 - RULES OF DEPARTMENT OF COMMUNITY HEALTH
Chapter 111-8 - HEALTHCARE FACILITY REGULATION
Subject 111-8-1 - RULES AND REGULATIONS FOR ADULT DAY CENTERS
Rule 111-8-1-.04 - Definitions

(a) "Abuse" means any intentional or grossly negligent act or series of acts or intentional or grossly negligent omission to act which causes injury to a participant, including but not limited to assault or battery, failure to provide treatment or care, or sexual harassment.

(b) "Activities of daily living" means bathing, shaving, brushing teeth, combing hair, toileting, dressing, eating, grooming, taking medications, and transfers and/or ambulation.

(c) "Adult" means a person 18 years or older or an emancipated minor.

(d) "Adult day care (ADC)" means the provision of a comprehensive plan of services that meets the needs of aging adults as defined in paragraph (g) of these definitions under a social model, as defined in paragraph (ll) of these definitions. This term shall not include programs which provide day habilitation and treatment services exclusively for individuals with developmental disabilities.

(e) "Adult day center" or "center" means a facility serving aging adults that provides adult day care or adult day health services, as defined in paragraphs (d) and (f) of these definitions, for compensation to three or more persons. Adult day centers may operate in more than one location if classified and approved by the Department as a mobile adult day center. This term shall not include a respite care services program.

(f) "Adult day health services (ADHS)" means the provision of a comprehensive plan of services that meets the needs of aging adults under a medical model as defined in paragraph (v) of these definitions. This term shall not include programs which provide day habilitation and treatment services exclusively for individuals with developmental disabilities.

(g) "Aging adults" means persons 60 years of age or older or mature adults below the age of 60 whose needs and interests are substantially similar to persons 60 years of age or older who have physical or mental limitations that restrict their abilities to perform the normal activities of daily living and impede independent living.

(h) "Assistance with self-administration" means staff can provide assistance as outlined in Rule 111-8-1-.19.

(i) "Capacity" means the number of participants for which a center has been licensed to provide care and services at any given time.

(j) "Days" means calendar days, not workdays, unless otherwise noted in the text.

(k) "Department" means the Georgia Department of Community Health.

(l) "Dietitian" means a registered dietitian, with current registration by the Commission on Dietetic Registration of the American Dietetic Association; and a licensed dietitian, with current licensure by the Georgia Board of Examiners of Licensed Dietitians.

(m) "Direct care staff" means any individual who provides direct services to participants, including, but not limited to the Director, a licensed nurse, the activities director, aides, and volunteers.

(n) "Director" means the person designated by the governing body as responsible for the overall operation of a center.

(o) "Disaster preparedness plan" means a written document which identifies potential hazards or events, that should they occur, would cause an emergency situation at the center; and proposes, for each identified emergency situation, a course of action so as to minimize the threat to health and safety of the participants.

(p) "Exploitation" means an unjust or improper use of another person or the person's property through undue influence, coercion, harassment, duress, deception, false representation, false pretense, or other similar means for one's own personal advantage.

(q) "Facility" means an adult day center, unless otherwise specified.

(r) "Governing body" means the Board of Trustees, the partnership, the corporation, the association, or the person or group of persons who maintain and control the center and who are legally responsible for the operation of the center.

(s) "Individual plan of care" means a document describing the participant's needs, services to be provided by the adult day center and, for adult day health services, identification of the therapeutic service provider who will deliver the required services, the expected outcomes and frequency of re-evaluation of the plan.

(t) "Licensed practical nurse (LPN)" means a person who provides care relating to the maintenance of health and prevention of illness under the supervision of a physician, dentist, podiatrist or registered nurse (RN).

(u) "Long-term care facility" means any skilled nursing home, intermediate care home, personal care home or assisted living community licensed by the Department.

(v) "Medical model" means a comprehensive program that provides adults with the basic social, rehabilitative, health and personal care services needed to sustain the essential activities of daily living and to restore or maintain optimal capacity for self-care. Such program of care shall be based on individual plans of care and shall be provided for less than 24 hours per day.

(w) "Mobile adult day center" means a program of services offered by an adult day center which utilizes a designated staff that travels from one central location to off-site locations to provide adult day services as described in these rules. The mobile adult day center transports the necessary staff and/or volunteers, participant records, supplies and program materials to each off-site location for the provision of services. The services offered by a mobile adult day center may either be adult day care services or adult day health services, or both, and are offered four days per week or less at any one location.

(x) "Neglect" means a failure to act or omission to act that caused or may cause physical harm, emotional injury or death.

(y) "Nurse" means a registered nurse (RN) or licensed practical nurse (LPN) licensed in the state of Georgia.

(z) "Nursing services" means services provided by licensed nursing personnel and may include therapy services. Nursing services may also include observation, promotion and maintenance of health, dressing changes, prevention of illness and disability, management of health care during acute and chronic phases of illness, guidance and counseling of individuals and participants' representatives, administration of medications and referral to physicians, other health care providers, and community resources when appropriate.

(aa) "Participant" means an adult receiving services in the adult day center.

(bb) "Physician's orders" means an order that is signed and dated by a medical doctor (MD), doctor of osteopathy (DO) or other person(s) authorized by law who is licensed to practice medicine in the state of Georgia.

(cc) "Primary caregiver" means the one identified relative or other person in a relationship of responsibility, such as an agent under a valid durable power of attorney for health care or health care agent under a valid advance directive for health care, who has assumed the primary responsibility for the provision of care needed to maintain the physical or mental health of an aging adult, who lives in the same residence with such individual, and who does not receive financial compensation for the care provided.

(dd) "Proxy caregiver" means an unlicensed person who has been determined to have the necessary knowledge and skills acquired through training by a licensed healthcare professional to perform documented health maintenance activities, including specialized procedures, for an individual with a disability who has delegated to the designated proxy caregiver the performance of such health maintenance activities through execution of a written informed consent by the individual with a disability or a person legally authorized to act on behalf of such individual with a disability.

(ee) "Registered nurse (RN)" means a person currently licensed by the Georgia Board of Nursing or successor entity to practice professional nursing.

(ff) "Representative" means anyone that the participant identifies as having authority to make decisions on his or her behalf.

(gg) "Resident" means any person receiving treatment or care in a long-term care facility.

(hh) "Respite care services program" means a program for aging adults who can function in a group setting and who can feed and toilet themselves with or without the assistance of a personal aide accompanying them and which:

(ii) "Restraint" means any manual or physical device, material, or equipment attached or adjacent to the participant's body that the individual cannot remove easily which restricts freedom or normal access to one's body or a drug or medication when it is used as a restriction to manage the participant's behavior or restrict the participant's freedom of movement and is not standard treatment or dosage for the participant's condition.

(jj) "Serious injury" means an injury requiring emergency medical intervention or treatment by medical personnel, either at an urgent care facility, at an emergency room or a medical office.

(kk) "Social activities" means therapeutic, educational, cultural enrichment, recreational, and other activities on site or in the community in a planned program to meet the social needs and interests of the participant.

(ll) "Social model" means a program that addresses primarily the basic social and recreational activities needed to be provided to aging adults, but also provides, as required, limited personal care assistance, supervision, or assistance essential for sustaining the activities of daily living. Such programs of care shall be based on individual plans of care and shall be provided for less than 24 hours per day.

(mm) "Staff" means, as appropriate to their roles and responsibilities, all people who provide supervision, care, treatment, and services in the center including permanent, temporary, and part-time employees, as well as contracted individuals and health profession students. The definition of staff does not include licensed independent practitioners who are not paid employees, contract employees or volunteers.

(nn) "Standard Precautions" means a system of precautions or set of guidelines designed to reduce exposure to and transmission of microorganisms from both recognized and unrecognized sources of potential infections.

(oo) "Volunteer" means an individual who performs or offers to perform a service for the center out of his/her own free will and without payment.