Haw. Code R. § 11-100.1-2
As used in this chapter:
"Abuse" means the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm or pain or mental anguish, or deprivation by an individual, including a caregiver, of goods or services that are necessary to attain or maintain physical, mental and psychosocial well-being. This presumes that instances of abuse of all residents, even those in a coma, cause physical harm, or pain or mental anguish.
"Activities of daily living", or "ADL" means basic services required to be provided by the facility for benefit of residents in order to obtain and maintain a license and shall include, but not be limited to, the following: personal care, shelter, protection, supervision, assistance, guidance or training, planned activities, food service, laundering of personal clothing, recognition of and provision for changes in health status, and arrangement for and transportation to medical and dental offices.
"Adult residential care home", or "ARCH" means any facility providing twenty four hour living accommodations, for a fee, to adults unrelated to the family, who require at least minimal assistance in the activities of daily living, personal care services, protection, and health care services, but who do not need the professional health services of an intermediate, skilled nursing, or acute care facility. It does not include facilities operated by the federal government. There shall be two types of ARCHs:
(1) Type I home for five or less residents; and
(2) Type II home for six or more residents.
"Advanced directive" means a written or oral declaration made by a competent adult, instructing his or her physician to provide, withhold, or withdraw life-sustaining procedures under certain conditions such as a terminal condition or where the resident has a permanent loss of ability to communicate with others due to irreversible brain injury or coma. (An advanced directive is often referred to as a living will.)
"Advanced practice registered nurse", or "APRN" means a registered nurse who is licensed pursuant to chapter 457, HRS.
"Ambulatory" means the ability to move on foot from place to place without human assistance.
"ARCH resident" means a person unrelated to the primary care giver and licensee who resides in an ARCH. Individuals residing in an ARCH require minimal assistance in the activities of daily living, and do not need assistance from skilled, professional personnel on a regular long-term basis.
"Assistive devices" means a physical or mechanical apparatus or equipment required by an individual for ambulation or mobility.
"Cardiopulmonary resuscitation certification", or "CPR certification" means verification that an individual has satisfactorily completed a course provided by a nationally approved source that contains instruction and required participation in an emergency first aid procedure that consists of opening and maintaining a resident's airway, providing 'artificial ventilation by means of rescue breathing, and providing artificial circulation by means of external cardiac compression.
"Care plan" means a written plan developed by the resident, resident's family, legal guardian or surrogate, case manager, staff of the ARCH or expanded ARCH, and resident's physician or APRN that articulates the overall plan of care to be provided to the resident by the ARCH or expanded ARCH with the purpose of achieving the optimal level of function of the resident.
"Case manager" (as it applies to an expanded ARCH) means an individual other than the licensee or staff of the expanded ARCH who is licensed in the state as a registered nurse or social worker and possesses the skills and knowledge required to deal with the long term care needs of the geriatric population. This individual shall have the ability to plan, locate, coordinate, and monitor comprehensive services to meet the individual resident's needs based on a comprehensive assessment of the resident.
"Category 3 adult residential care home" means an ARCH which was established and licensed prior to 1986, and was providing only room and board services to individuals that did not require twenty four hour supervision and personal care services, and whose licensee does not meet requirements as set forth in section 11-100.1-8.
"Chemical restraint" means a psychopharmacologic drug that is used for discipline or convenience and not required to treat medical symptoms.
"Comprehensive assessment" means an evaluation which includes, but is not limited to, medically defined conditions and prior medical history, medical status measurement, physical and mental functional status, sensory and physical impairments, nutritional status and requirements, special treatments or procedures, mental psychosocial status, discharge potential, dental condition, activities potential, cognitive status and drug therapy.
"Convenience" means any action taken by the licensee or care giver to control resident behavior or maintain residents with a lesser amount of effort by the licensee or care giver and not in the resident's best interest.
"Day care client" means any person who does not reside in the ARCH or expanded ARCH and requires temporary supervision during the hours that the 'person's care giver, outside of the ARCH or expanded ARCH, is unavailable. This person requires minimal assistance in the activities of daily living and does not need the professional health services of an intermediate, skilled nursing, or acute care facility. This person does not stay overnight in the ARCH or expanded ARCH but shall be characterized as a resident for purposes of an ARCH'S or expanded ARCH'S licensed capacity.
"Department" means the department of health, State of Hawaii.
"DHS" means the department of human services, State of Hawaii.
"Dietitian" means a person who is registered by the Commission on Dietetics Registration of the American Dietetic Association or is eligible for such registration. "Director" means the director of health, State of Hawaii or designee.
"Discipline" means any action taken by the licensee or care giver for the purpose of punishing or penalizing residents.
"Emergency" means an event or incident occurring while an ARCH or expanded ARCH resident is under the care of a primary care giver or ARCH or expanded ARCH licensee, whereby a resident experiences physical or mental changes which necessitate care or services which cannot be provided by the ARCH or expanded ARCH.
"Expanded ARCH" means any facility providing twenty four hour living accommodations, for a fee, to adults unrelated to the family, who require at least minimal assistance in the activities of daily living, personal care services, protection, and health care services, and who may need the professional health services provided in an intermediate care facility or skilled nursing facility. There shall be two types of expanded ARCHs:
(1) Type I home shall consist of five or less residents with no more than two nursing facility level residents; provided that more nursing facility level residents may be allowed at the discretion of the department; and
(2) Type II home shall consist of six or more residents with no more than twenty per cent of the home's licensed capacity as nursing facility level residents, provided that more nursing facility level residents may be allowed at the discretion of the department; provided further that the department shall exercise its discretion for a resident presently residing in a Type I or Type II home to allow the resident to remain as an additional nursing facility resident based upon the best interest of the resident. The best interest of the resident shall be determined by the department after consultation with the resident, the resident's family, primary physician, case manager, primary care giver and home operator.
"Expanded ARCH resident" means a person that meets the requirements of section 321-15.61(a).
"Fire Safety Evaluation System rating", or "FSES" means an assessment conducted by a Life Safety Consultant to ensure compliance with the prescriptive code requirements of the National Fire Protection Association (NFPA) 101 life safety codes.
"First aid certification" means verification that an individual has successfully completed a course that provides instruction on basic first aid principles, including but not limited to rescue breathing procedures.
"Fully ambulatory" means the ability to move on foot from place to place without the use of any mechanical device and/or human assistance.
"Home health agency" means a licensed public or proprietary agency, a private nonprofit organization, or a subdivision of such agency or organization which is primarily engaged in providing direct or indirect skilled nursing services and other therapeutic services under a physician's direction to homebound patients on a part-time or intermittent basis (in a place used as the individual's home). A homebound patient is a person who, because of a condition due to illness or injury, has a restricted ability to leave the place of residence except with the aid of supportive devices including but not limited to, crutches, canes, wheelchairs, walkers, special transportation, or with the assistance of another person; or a person who has a condition which is such that leaving home is medically contraindicated.
"Infection control" means procedures established for the identification, prevention and control of infections.
"Interim care plan" means a care plan developed by a registered nurse for an expanded ARCH resident within forty-eight hours of the expanded ARCH resident's admission to an expanded ARCH. The interim care plan shall identify the immediate needs of the expanded ARCH resident and shall be based on information, including but not limited to physician or APRN progress notes, the hospital discharge summary, and the emergency room discharge. The interim care plan shall provide sufficient information to the licensee or primary care giver and shall set forth a plan to meet the immediate needs of the resident until a comprehensive care plan can be developed within seven days of the expanded ARCH resident's admission to the expanded ARCH.
"Intermediate care facility", or "ICF" means a facility which provides appropriate care to persons:
(1) Referred by a physician;
(2) Who need twenty four hour a day assistance with the activities of daily living;
(3) Who need care provided by licensed nursing and paramedical personnel on a regular, long-term basis; and
(4) Who do not need twenty four hour a day skilled nursing care.
"Licensee" means the person, group of persons, or entity that holds the license to operate an ARCH or expanded ARCH and who is responsible for the supervision of the ARCH or expanded ARCH and the residents therein.
"Licensed capacity" means the number of residents and the type of residents permitted by the director, pursuant to these rules and chapter 321, HRS, in a particular ARCH or expanded ARCH, and so stated on the particular ARCH's or expanded ARCH'S license.
"Licensed nurse" means a person who is either a licensed practical nurse or a registered professional nurse.
"Licensed practical nurse", or "LPN" means a person who is licensed as a practical nurse pursuant to chapter 457, HRS.
"Life safety consultant" means an individual who has experience in conducting fire or life safety inspections of facilities utilizing county and national fire codes and standards.
-"Minimal assistance in activities of daily living" means the provision of services including but not limited to, stand-by assistance, set up, verbal cues or prompting, and visual supervision.
"National Fire Protection Association", or "NFPA" means the association that publishes the national fire codes.
"Neglect" means failure to provide goods and services necessary to avoid physical harm, mental anguish or mental illness, with complete disregard for negative consequences or negative resident outcome which may arise.
"Nurse aide" means a person who performs a variety of duties relating to patients and patient care under the supervision of a nurse, including but not limited to assisting patients in all activities of daily living. A nurse aide may also assist a nurse by changing bed linens, delivering messages, and sterilizing instruments, serving and collecting food trays, and helping patients get out of bed, bathe, and dress.
"Nursing facility level of care" means the level of care provided at skilled nursing facilities or at intermediate care facilities.
"Occupational therapist" means a person who is currently registered or eligible for registration by the American Occupational Therapy Association, and who meets the qualifications under chapter 457G, HRS.
"Personal care services" means daily personal attention and care, including but not limited to skin, nails, hair, teeth, and oral hygiene in addition to any therapeutic regimen ordered by the resident's physician or APRN.
"Physical restraint" means any 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 freedom of movement or normal access to one's body.
"Physical therapist" means a person who is licensed as a physical therapist under chapter 461J, HRS.
"Physician" means a person who is licensed to practice medicine or osteopathy under chapters 453 or 460, HRS.
"Plan of correction" means a plan developed by the licensee to address deficiencies in the operation of an ARCH or expanded ARCH as detected by the department pursuant to an inspection and/or complaint investigation that shall include preventive measures to ensure compliance with this chapter and chapter 321, HRS, and the time frame in which these corrections shall take place.
"Primary care giver" means the licensee or the individual designated as the primary care giver by the licensee pursuant to section 11-100.1-8.
"Provisional licensure" means a temporary license issued by the department that allows the licensee additional time to correct deficiencies without putting the immediate health, welfare and safety of residents at risk.
"Registered professional nurse" means a person who is licensed as a registered nurse under chapter 457, HRS.
"Regular business hours" means the hours between 7:45 a.m and 4:30 p.m., Monday to Friday, inclusive, except for state holidays.
"Representative payee" means an individual who meets the requirements of the Social Security Administration to receive a Social Security payment on behalf of a resident of an ARCH or expanded ARCH pursuant to 42 U.S.C. §1605.
"Resident of a category 3 ARCH" means a person unrelated to the primary care giver who resides in the category 3 ARCH, for a fee, and requires room and board which includes a place to sleep, the preparation of meals and laundering of personal clothing. These residents do not require assistance with activities of daily living, and when such care is required, the resident shall be transferred to an appropriate facility.
"Responsible agency" means any public or private agency that has responsibility for the health, welfare, or financial support of the resident.
"Self preservation" means the ability of an ARCH or expanded ARCH resident to ambulate without physical assistance, and the ability of the resident to follow directions and take appropriate action in exiting an ARCH or expanded ARCH in the, event of an emergency.
"Skilled nursing" means care and services provided by a licensed nurse.
"Skilled nursing facility", or "SNF" means a health facility which provides skilled nursing and related services to residents who require medical or nursing care, or rehabilitation services, including but not limited to physical therapy, occupational therapy and speech therapy services.
"Social model of care" means the provision of care that promotes the individuality, dignity, choice, independence, and privacy of an ARCH or expanded ARCH resident in a home-like atmosphere and that provides 'for the inclusion of the resident, the resident's family, and resident's surrogate in the development of the resident's schedule of activities and/or care plan and in all decision-making affecting the resident.
"Social worker" means a person licensed as a social worker pursuant to chapter 467E, HRS.
"Special diet" means a diet ordered by a physician or APRN that is prescribed as part of the medical nutrition therapy of an ARCH or expanded ARCH resident.
"Specialized care" means any care that is identified in the care plan that requires training and monitoring by a registered nurse.
"Staff" means a nurse aide[,] who works in a Type II ARCH, and performs a variety of duties for residents under the supervision of a registered nurse.
"Standard precautions" means guidelines developed by the Center for Disease Control (CDC) which are designed to reduce the risk of transmission of blood borne and other pathogens from both recognized and unrecognized sources of infection, including recommendations to prevent cross contamination between residents.
"Substitute care giver" means an adult who is authorized by the licensee or primary care giver to temporarily take charge of an ARCH or expanded ARCH while the licensee or primary care giver is absent and who possesses the requirements as specified in section 11-100.1-9(a) through (e) as applicable.
"Surrogate" means an individual, other than an ARCH or expanded ARCH resident's agent or guardian, authorized under chapter 327E, HRS, to make a healthcare decision for the resident.
"Type I ARCH" means a facility which is licensed for a capacity not to exceed five residents.
"Type II ARCH" means a facility which is licensed for a capacity of six or more residents.
"Tuberculosis clearance" means a negative tuberculin skin test or chest x-ray, which indicates freedom from any infectious or communicable disease.
"Waiver" means an exemption to a rule.
Whenever the singular is used in this chapter it can include the plural.
Haw. Code R. § 11-100.1-2