RCFE Title 22 Definitions Glossary

"Administrator" means the individual designated by the licensee to act in behalf of the licensee in the overall management of the facility. The licensee, if an individual, and the administrator may be one and the same person.Part 1, Page 7

"Admission Agreement" includes all documents that a resident or resident's representative must sign at the time of, or as a condition of, admission.Part 1, Page 7

"Adult" means a person who is eighteen (18) years of age or older.Part 1, Page 7

"Adult protective services agency" means a county welfare department, as defined in Welfare and Institutions Code section 15610.13.Part 1, Page 7

"Advance Health Care Directive" means a written instruction that relates to the provision of health care when the individual is incapacitated. Advance directives include, but are not limited to, a Durable Power of Attorney for Health Care, an Individual Health Care Instruction, a Request to Forego Resuscitative Measures, or a Do Not Resuscitate Form.Part 1, Page 8

"Allowable Health Condition" means any health condition that the licensee is allowed to care for either in accordance with a specific regulation, or with an exception approved by the licensing agency. This includes restricted health conditions as specified in Section 87612, Restricted Health Conditions.Part 1, Page 8

"Ambulatory Person" means a person who is capable of demonstrating the mental competence and physical ability to leave a building without assistance of any other person or without the use of any mechanical aid in case of an emergency.Part 1, Page 8

"Applicant" means any individual, firm, partnership, association, corporation, county, city, public agency or other government entity that has made application for a residential care facility for the elderly license, administrator certificate, or special permit.Part 1, Page 8

"Appropriately Skilled Professional" means an individual that has training and is licensed to perform the necessary medical procedures prescribed by a physician. This includes but is not limited to the following: Registered Nurse (RN), Licensed Vocational Nurse (LVN), Physical Therapist (PT), Occupational Therapist (OT) and Respiratory Therapist (RT).Part 1, Page 8

"Basic Rate" means the SSI/SSP established rate, which does not include that amount allocated for the recipient's personal and incidental needs.Part 1, Page 8

"Basic Services," as defined in Health and Safety Code section 1569.312, means those services required to be provided by the facility in order to obtain and maintain a license and include ... safe and healthful living accommodations; personal assistance and care; observation and supervision; planned activities; food service; and arrangements for obtaining incidental medical and dental care.Part 1, Page 8

"Behavioral expression" means behavior or behaviors displayed by a resident that may result in harm to self or others including, but not limited to, unsafe wandering ... or elopement ..., expressions of frustration, disorientation, hallucinations, or lacking in hazard awareness or impulse control. Behavioral expression may be due to boredom, fear, overstimulation, perceived threat, fatigue, physical discomfort, pain, "Major Neurocognitive Disorder (major NCD)" ..., or other causes including, but not limited to, medication interactions and/or illnesses such as urinary tract infections.Part 1, Page 8.1

"California Clearance" means an individual has no felony or misdemeanor convictions reported by the California Department of Justice. However, the individual may have been arrested with no criminal conviction, convicted of a minor traffic offense or adjudicated as a juvenile.Part 1, Page 8.1

"Capacity" means that maximum number of persons authorized to be provided services at any one time in any licensed facility.Part 1, Page 8.1

"Care and Supervision" means those activities which if provided shall require the facility to be licensed. It involves assistance as needed with activities of daily living and the assumption of varying degrees of responsibility for the safety and well-being of residents.Part 1, Page 9

"Certificate holder" means a person who has a current administrator's certificate issued by the Department regardless of whether the person is employed as an administrator in a residential care facility for the elderly.Part 1, Page 9

"Certified administrator" means an administrator who has been issued a residential care facility for the elderly administrator certificate by the Department and whose certificate is current.Part 1, Page 9

"Close friend" means a person who is attached to another by feelings of personal regard as indicated by both parties involved.Part 1, Page 9

"Community Care Facility" means any facility, place or building providing nonmedical care and supervision, as defined in Section 87101(c)(3).Part 1, Page 10

"Complete request" means the vendor applicant has submitted, and the Department has received, all required information and materials necessary to approve or deny the request for certification program and/or course approval.Part 1, Page 10

"Conservator" means a person appointed by the Superior Court pursuant to Probate Code section 1800 et. seq. or Welfare and Institutions Code section 5350, to care for the person, or estate, or person and estate, of an adult.Part 1, Page 10

"Contagious disease" means an illness capable of being transmitted from one human to another human via direct or indirect contact.Part 1, Page 10

"Control of Property" means the right to enter, occupy, and maintain the operation of the facility property within regulatory requirements. Evidence of control of property shall include, but is not limited to ... A Grant Deed showing ownership; or ... Lease Agreement or Rental Agreement; or ... A court order or similar document ...Part 1, Page 11

"Criminal Record Clearance" means an individual has a California clearance and a FBI clearance.Part 1, Page 11

"Day" means calendar day unless otherwise specified.Part 1, Page 11

"Deficiency" means any failure to comply with any provision of the Residential Care Facilities Act for the Elderly and regulations adopted by the Department pursuant to the Act.Part 1, Page 11

"Delayed Egress Device" means a special egress-control device of the time delay type as specified in Health and Safety Code section 1569.699(a).Part 1, Page 11

"Dementia" means an overall term for diseases and conditions characterized by a progressive decline in memory, language, problem-solving, and other thinking skills that are severe enough to interfere with a person's ability to perform activities of daily life. Dementia is a general term referring to "Major Neurocognitive Disorder (major NCD)" ...Part 1, Page 13

"Department" ... "'Department' means the State Department of Social Services."Part 1, Page 13

"Direct care staff" means the licensee, or those individuals employed by the licensee, who provide direct care to the residents, including, but not limited to, assistance with activities of daily living.Part 1, Page 13

"Director" ... "'Director' means the Director of the State Department of Social Services."Part 1, Page 13/14

"Do-Not-Resuscitate (DNR) Form" means the pre-hospital do-not-resuscitate forms developed by the California Emergency Medical Services Authority and by other local emergency medical services agencies. These forms ... alert pre-hospital emergency medical services personnel to the resident's wish to forego resuscitative measures in the event of the resident's cardiac or respiratory arrest.Part 1, Page 14

"Documentation" means written supportive information including but not limited to the Licensing Report (Form LIC 809).Part 1, Page 14

"Egress Alert Device" means a wrist band or other device which may be worn by a resident or carried on a resident's person, which triggers a visual or auditory alarm when the resident leaves the facility building or grounds.Part 1, Page 14

"Elderly Person" means, for purposes of admission into a residential care facility for the elderly, a person who is sixty (60) years of age or older.Part 1, Page 14

"Elopement" occurs when a resident who is at risk of harm due to their cognitive condition leaves the facility unsupervised, or while in the licensee's care, leaves another safe location unsupervised.Part 1, Page 14

"Emergency Approval to Operate" (EAO) means a temporary approval to operate a facility for no more than 60 days pending the issuance or denial of a license by the licensing agency.Part 1, Page 14

"Evidence of Licensee's Death" shall include, but is not limited to, a copy of the death certificate, obituary notice, certification of death from the decedent's mortuary, or a letter from the attending physician or coroner's office verifying the death of the licensee.Part 1, Page 14

"Exception" means a variance to a specific regulation based on the unique needs or circumstances of a specific resident or staff person. Requests for exceptions are made to the licensing agency by an applicant or licensee. They may be granted for a particular facility, resident or staff person, but cannot be transferred or applied to other individuals.Part 1, Page 14

"Existing Facility" means any facility operating under a valid license on the date of application for a new license.Part 1, Page 15

"Facility Hospice Care Waiver" means a waiver from the limitation on retention of residents who require more care and supervision than other residents and residents who are bedridden other than for a temporary illness. The Hospice Care Waiver granted by the Department will permit the retention in a facility of a designated maximum number of terminally ill residents who are receiving hospice services from a hospice agency.Part 1, Page 15

"Federal Bureau of Investigation (FBI) Clearance" means an individual has no felony or misdemeanor convictions reported by the FBI. The individual may also have been arrested with no criminal conviction, convicted of a minor traffic offense or adjudicated as a juvenile.Part 1, Page 15

"Gender Expression" means a person's appearance and behavior, whether or not these are stereotypically associated with the person's sex assigned at birth.Part 1, Page 15

"Gender Identity" means a person's stated identification with a sex, regardless of whether the stated sex is consistent with the person's physical appearance, surgical history, genitalia, legal sex, sex assigned at birth, or name and sex, as they appear in medical records ...Part 1, Page 15

"Healing wounds" include cuts, stage one and two pressure injuries and incisions with the affected area returning to its normal state. They may involve breaking or laceration of the skin and usually damage to the underlying tissues.Part 1, Page 15

"Health Care Surrogate Decision Maker" means an individual who participates in health care decision making on behalf of an incapacitated resident ... The licensee or any staff member of the facility shall not be appointed health care surrogate decision maker.Part 1, Page 15

"Health Condition Relocation Order" means written notice by the Department to a licensee requiring the relocation of a resident from a residential care facility for the elderly because the resident has a health condition which cannot be cared for within the limits of the license, requires inpatient care in a health facility or has a prohibited health condition ...Part 1, Page 16

"Hospice Care Plan" means the hospice agency's written plan of care for a terminally ill resident. The hospice shall retain overall responsibility for the development and maintenance of the plan and quality of hospice services delivered.Part 1, Page 16

"Hospice or Hospice Agency" means an entity which provides hospice services to terminally ill persons, is Medicare certified for hospice, and holds either a Hospice license or a Home Health Agency license from the California Department of Public Health.Part 1, Page 16

"Interdisciplinary Team" means a team that shall assist the Department in evaluating the need for relocating a resident ... This team shall consist of the Department's nurse consultant and a social worker, designated by the Department ... Persons selected for an interdisciplinary team review shall not have been involved in the initial decision ...Part 1, Page 17

"LGBT" means lesbian, gay, bisexual, or transgender.Part 1, Page 17

"License" means a basic permit to operate a residential care facility for the elderly.Part 1, Page 17

"Licensed Professional" means a person who is licensed in California to provide medical care or therapy. This includes physicians and surgeons, physician assistants, nurse practitioners, registered nurses, licensed vocational nurses, psychiatric technicians, physical therapists, occupational therapists and respiratory therapists ...Part 1, Page 17

"Licensee" means the individual, firm, partnership, corporation, association or county having the authority and responsibility for the operation of a licensed facility.Part 1, Page 17

"Licensing Agency" means a state, county or other public agency authorized by the Department to assume specified licensing, approval or consultation responsibilities pursuant to Health and Safety Code section 1569.13.Part 1, Page 17

"Major Neurocognitive Disorder" (major NCD) is a clinical term that describes substantially decreased cognitive or mental function due to a medical disease other than a psychiatric illness. Major NCD includes Alzheimer's disease and related disorders ... vascular dementia, Lewy body dementia, Parkinson's disease, and frontotemporal dementia.Part 1, Page 17

Welfare and Institutions Code Section 15630(a): "Any person who has assumed full or intermittent responsibility for the care or custody of an elder or dependent adult, whether or not he or she receives compensation ... is a mandated reporter."Part 1, Page 17/18

"Medical Professional" means an individual who is licensed or certified in California to perform the necessary medical procedures within his/her scope of practice. This includes, but is not limited to, Medical Doctor (MD), Registered Nurse (RN) and Licensed Vocational Nurse (LVN).Part 1, Page 18

"Mild cognitive impairment" (MCI) refers to people whose cognitive abilities are in a "conditional state" between normal aging and dementia ... MCI is characterized by short-term memory problems, but no other symptoms of dementia ... that affect a person's daily functioning.Part 1, Page 18

"New Facility" means any facility applying for an initial license whether newly constructed or previously existing for some other purpose.Part 1, Page 18

"Nonambulatory Person" means a person who is unable to leave a building unassisted under emergency conditions. It includes, but is not limited to, those persons who depend upon mechanical aids such as crutches, walkers, and wheelchairs.Part 1, Page 18

Health and Safety Code section 1569.655(b): "'nonrecurring lump-sum assessments' mean rate increases due to unavoidable and unexpected costs that financially obligate the licensee..."Part 1, Page 18.1

"Placement Agency" ... means any county welfare department, county social services department, county mental health department, county public guardian, general acute care hospital discharge planner or coordinator, state-funded program or private agency providing placement or referral services, and regional center ... engaged in finding homes or other places for the placement of elderly persons ...Part 1, Page 18.1

"Preadmission Fee" ... an application fee, processing fee, admission fee, entrance fee, community fee or other fee, however designated, that is requested or accepted by a licensee ... prior to admission.Part 1, Page 18.1

"Pressure Injury" means localized damage to the skin and/or soft tissue under the skin that is usually over a bony part of the body or related to a medical or other device ... Based on appearance and severity, the damage to tissue is a Stage 1, 2, 3, or 4 pressure injury.Part 1, Page 18.2

"Privately Operated Facility" means a residential care facility for the elderly that is licensed to an individual, firm, partnership, association, or corporation.Part 1, Page 18.2

"PRN Medication" (pro re nata) means any nonprescription or prescription medication which is to be taken as needed.Part 1, Page 18.2

"Provisional License" means a temporary, nonrenewable license, issued for a period not to exceed twelve months which is issued in accordance with the criteria specified in Section 87162, Provisional License.Part 1, Page 18.2

"Publicly Operated Facility" means a residential care facility for the elderly that is licensed to a city, county, or other government entity.Part 1, Page 18.2

"Representative" means an individual who has authority to act on behalf of the resident; including but not limited to, a conservator, guardian, person authorized as the agent in the resident's valid advance health care directive, the resident's spouse, registered domestic partner, or family member, a person designated by the resident, or other surrogate decisionmaker ... Without other legal obligation to the contrary, acting as a resident representative does not mean that the individual assumes personal responsibility or liability for payment of any charges incurred by the resident.Part 1, Page 19

Probate Code section 4780: "'Request to forego resuscitative measures' means a written document, signed by (A) an individual, or a legally recognized surrogate health care decisionmaker, and (B) a physician that directs a health care provider to forgo resuscitative measures for the individual."Part 1, Page 19

"Residential Care Facility for the Elderly" means a housing arrangement chosen voluntarily by the resident, the resident's guardian, conservator or other responsible person; where 75 percent of the residents are sixty years of age or older and where varying levels of care and supervision are provided, as agreed to at time of admission or as determined necessary at subsequent times of reappraisal.Part 1, Page 20

"Responsible Person" means "Representative," as defined in Section 87101(r)(3), for purposes of these regulations and applicable statutes.Part 1, Page 20

"Room and Board" means a living arrangement where care and supervision is neither provided nor available.Part 1, Page 20

"Serious Deficiency" means any deficiency that presents an immediate or substantial threat to the physical health, mental health, or safety of the residents or clients of a community care facility.Part 1, Page 21

"Shall" means mandatory. "May" means permissive.Part 1, Page 21

"Significant Change in Condition" means a deterioration or improvement in a resident's physical, cognitive, behavioral, or functional condition that is significant enough to require an alteration of the services provided to the resident.Part 1, Page 21

"SSI/SSP" means the Supplemental Security Income/State Supplemental Program.Part 1, Page 21

"Substantial Compliance" means the absence of any deficiencies which would threaten the physical health, mental health, safety or welfare of the residents.Part 1, Page 21

"Transfer Trauma" means the consequences of the stress and emotional shock caused by an abrupt, involuntary relocation of a resident from one facility to another.Part 1, Page 21

Health and Safety Code section 1569.44(a): "A facility shall be deemed to be an 'unlicensed residential care facility for the elderly' ... if it is unlicensed and not exempt from licensure, and any one of the following conditions is satisfied: (1) The facility is providing care and supervision ... (2) The facility is held out as, or represented as, providing care and supervision ... (3) The facility accepts or retains residents who demonstrate the need for care and supervision ... (4) The facility represents itself as a licensed residential facility for the elderly."Part 1, Page 22

"Waiver" means a variance to a specific regulation based on a facility-wide need or circumstance which is not typically tied to a specific resident or staff person. Requests for waivers are made to the licensing agency, in advance, by an applicant or licensee.Part 1, Page 23