Code of Massachusetts Regulations
940 CMR - OFFICE OF THE ATTORNEY GENERAL
Title 940 CMR 4.00 - Long Term Care Facilities
Section 4.01 - Definitions

Additional Services: services provided by a long-term care facility that are not included in the basic per diem rate or are not included under Titles XVIII or XIX of the Social Security Act.

Administrator: the person charged with the general administration of a nursing home, rest home, or other long-term care facility, and his/her agents or employees, as further defined in 105 CMR 150.000: Licensing of Long Term Care Facilities.

Clear and Conspicuous Type: shall mean printed typeface no smaller than 12 point print.

Emergency: a situation in which the resident's medical or psychological condition requires immediate medical attention or treatment; the existence of an emergency shall be determined by a physician, except that if a physician is not readily available, the existence of an emergency may be determined by the person on the premises of the long-term care facility who is in charge of the facility's medical or nursing services at the time that the situation giving rise to the emergency occurs or is about to occur.

Facility: a long-term care facility as defined in 940 CMR 4.01(9).

Legal Representative: shall mean, for any resident adjudged incompetent under the laws of the Commonwealth, the person duly appointed by a court of competent jurisdiction to act on the resident's behalf, and, for any resident who has not been adjudged incompetent by a state court, any legal-surrogate designated in accordance with state law.

Licensee: any person, corporation, or other entity holding at least a 10% ownership interest in a facility that is licensed by the Department of Public Health as a long-term care facility and his/her or its agents or employees.

Long-Term Care Facility: any institution or distinct part of an institution, whether conducted for charity or profit, which is advertised, announced or maintained for the express or implied purpose of providing three or more individuals admitted thereto with long-term resident, nursing or convalescent care, supervision and care incident to old age for ambulatory persons, or retirement home care for elderly persons; the term long-term care facility shall include but not be limited to residential care facilities, convalescent or rest homes, infirmaries maintained in towns, and charitable homes for the aged; an institution licensed by the Department of Public Health to provide chronic disease or rehabilitative services under M.G.L. c. 111, § 51 is not a "long term care facility" hereunder except, however, if and when any such institution provides or has provided chronic disease or rehabilitative care and services to one or more individuals for a period of 60 days or longer, such institution shall be deemed a long term care facility hereunder with respect only to such individual or individuals residing in it for 60 days or longer and only for the purpose of affording such individual or individuals the protections set forth in 940 CMR 4.06(1), (3)(d), (4) through (6), (9), (10), (12) through (21); 4.07(1) through (3), (8), (9), (11), (12); 4.08(2) through (13), (15) through (17); and 4.09(6) through (8).

Private Facility: a long-term care facility that admits, or provides services to, only private or self paying residents and does not provide services pursuant to, or have any contract with Medicare, Medicaid, SSI, Veteran's Benefit or any other public benefit program.

Private Resident: a resident of a long-term care facility whose stay in the facility at any given time is not paid for, either in whole or in part, by public funds pursuant to the Social Security Act (Medicaid or Medicare), SSI, Veteran's Benefit, or any other public benefit program.

Resident: any individual or patient residing or receiving care in a long-term care facility; except, however, any individual or patient residing or receiving care in an institution licensed by the Department of Public Health under M.G.L. c. 111, § 51 to provide chronic disease or rehabilitative services for a period of 60 days or longer shall be deemed a "resident" and shall be entitled to the protections afforded by 940 CMR 4.06(1), (3)(d), (4) through (6), (9), (10), (12) though (21); 4.07(1) through (3), (8), (9), (11), (12); 4.08(2) through (13), (15) through (17); and 4.09(6) through (8).

Social Security Act: Titles XVIII and XIX of the Social Security Act.

Third Party: shall mean a licensee or administrator, employee or agent of the licensee or administrator, next of kin, son, daughter, granddaughter, grandson, niece, nephew, social/case worker, or duly designated agent of the Department of Public Health, the Department of Mental Retardation, or the State Long-Term Care Ombudsman.

Treatment: any medication, drug, test or procedure conducted or administered for the purpose of diagnosing or treating a physical or mental illness or condition.

Written Acknowledgment: a signed statement by a resident or his/her legal representative, preserved in the resident's personal file, stating that he/she has received a copy of the documents required to be tendered to him/her; if a resident is unable or unwilling to sign his/her name, the licensee or administrator may satisfy the requirement of written acknowledgement by placing a written and dated statement in the resident's personal records which indicates receipt of the documents and the resident's ability or unwillingness to sign his/her name; such statement must be signed by the person who tendered the required documents to the resident and by a witness thereto and must include a detailed explanation of the resident's inability or unwillingness to sign his/her name.

Written Authorization: a written statement, signed by the resident or his/her legal representative, in which the resident authorizes the licensee or administrator, the resident's legal representative or a third party to perform certain specified acts on behalf of the resident; the authorization shall be dated and shall include:

(a) the specific act or acts authorized by the resident;

(b) the period of time that the resident authorizes the particular act or acts, if applicable; and

(c) the name of the person to whom certain records or other information is authorized to be made available; if the resident is unable to sign his/her name, a licensee or administrator or a third party may satisfy the requirements of a written authorization by submitting a dated statement that contains the information required by 940 CMR 4.01(18)(a) through (c); the statement must also include the name and signature of the person to whom the resident made the oral authorization and the name and signature of a person who has witnessed the resident's oral authorization.

Written Request: a statement signed by the resident or his/her legal representative that states that the resident requests one or more specified services for a certain period of time; such a statement must include the charge for each such service; if a legal representative is not available to sign the statement and if the resident is unable to sign his/her name, a licensee or administrator may satisfy the requirements for a written request by placing in the resident's personal records a written and dated statement, signed by both the person receiving the request for the service or services and a witness to that request, that states:

(a) the service or services requested by the resident;

(b) the charge for such service or services, if any;

(c) the period of time for which the resident has requested such service or services; and

(d) that the resident was unable to sign his/her name to request such service or services and that his/her legal representative was not available to sign the written request.