WAC 388-76-10000   Definitions.  "Abandonment" means action or inaction by a person or entity with a duty of care for a frail elder or vulnerable adult that leaves the vulnerable person without the means or ability to obtain necessary food, clothing, shelter, or health care.

     "Abuse" means the willful action or inaction that inflects injury, unreasonable confinement, intimidation, or punishment on a vulnerable adult:

     (1) In instances of abuse of a vulnerable adult who is unable to express or demonstrate physical harm, pain, or mental anguish, the abuse is presumed to cause physical harm, pain or mental anguish; and

     (2) Abuse includes sexual abuse, mental abuse, physical abuse, and exploitation of a vulnerable adult, which have the following meanings:

     (a) "Sexual abuse" means any form of nonconsensual sexual contact, including but not limited to unwanted or inappropriate touching, rape, sodomy, sexual coercion, sexually explicit photographing, and sexual harassment. Sexual abuse includes any sexual contact between a staff person, who is not also a resident or client, of a facility or a staff person of a program authorized under chapter 71A.12 RCW, and a vulnerable adult living in that facility or receiving service from a program authorized under chapter 71A.12 RCW, whether or not consensual.

     (b) "Physical abuse" means a willful action of inflicting bodily injury or physical mistreatment. Physical abuse includes, but is not limited to, striking with or without an object, slapping, pinching, choking, kicking, shoving, prodding, or chemical restraints unless the restraints are consistent with licensing requirements, and includes restraints that are otherwise being used inappropriately.

     (c) "Mental abuse" means any willful action or inaction of mental or verbal abuse. Mental abuse includes, but is not limited to, coercion, harassment, inappropriately isolating a vulnerable adult from family, friends, or regular activity, and verbal assault that includes ridiculing, intimidating, yelling, or swearing.

     (d) "Exploitation" means an act of forcing, compelling, or exerting undue influence over a vulnerable adult causing the vulnerable adult to act in a way that is inconsistent with relevant past behavior, or causing the vulnerable adult to perform services for the benefit of another.

     "Adult family home" means:

     (1) A residential home in which a person or entity are licensed to provide personal care, special care, room, and board to more than one but not more than six adults who are not related by blood or marriage to the person or persons providing the services; and

     (2) For the purposes of this chapter, any person or entity who has been granted a license to operate an adult family home.

     "Affiliated with an applicant" means any person listed on the application as a partner, officer, director, resident manager, or majority owner of the applying entity, or is the spouse or domestic partner of the applicant.

     "Applicant" means an individual, partnership, corporation, or other entity seeking a license to operate an adult family home.

     "Capacity" means the maximum number of persons in need of personal or special care permitted in an adult family home at a given time and includes related children or adults in the home who receive personal or special care and services.

     "Caregiver" for purposes other than training, means any person eighteen years of age or older responsible for providing direct personal or special care to a resident and who is not the provider, entity representative, a student or volunteer.

     "Dementia" is defined as a condition documented through the assessment process required by WAC 388-76-10335.

     "Department" means the Washington state department of social and health services.

     "Department case manager" means the department authorized staff person or designee assigned to negotiate, monitor, and facilitate a care and services plan for residents receiving services paid for by the department.

     "Developmental disability" means:

     (1) A person who meets the eligibility criteria defined by the division of developmental disabilities under WAC 388-823-0040; or

     (2) A person with a severe, chronic disability which is attributable to cerebral palsy or epilepsy, or any other condition, other than mental illness, found to be closely related to mental retardation which results in impairment of general intellectual functioning or adaptive behavior similar to that of a person with mental retardation, and requires treatment or services similar to those required for these persons (i.e., autism); and

     (a) The condition was manifested before the person reached age eighteen;

     (b) The condition is likely to continue indefinitely; and

     (c) The condition results in substantial functional limitations in three or more of the following areas of major life activities:

     (i) Self-care;

     (ii) Understanding and use of language;

     (iii) Learning;

     (iv) Mobility;

     (v) Self-direction; and

     (vi) Capacity for independent living.

     "Direct supervision" means oversight by a person who has demonstrated competency in the basic training and specialty training if required, or who has been exempted from the basic training requirements and is:

     (1) On the premises; and

     (2) Quickly and easily available to the caregiver.

     "Domestic partners" means two adults who meet the requirements for a valid state registered domestic partnership as established by RCW 26.60.030 and who have been issued a certificate of state registered domestic partnership.

     "Entity provider" means any corporation, partnership, association, or limited liability company that is licensed under this chapter to operate an adult family home.

     "Financial exploitation" means the illegal or improper use of the property, income, resources, or trust funds of the vulnerable adult by any person for any person's profit or advantage other than for the vulnerable adult's profit or advantage.

     "Entity representative" means the individual designated by an entity provider who is responsible for the daily operation of the adult family home.

     "Home" means adult family home.

     "Indirect supervision" means oversight by a person who:

     (1) Has demonstrated competency in the basic training and specialty training if required; or

     (2) Has been exempted from the basic training requirements; and

     (3) Is quickly and easily available to the care giver, but not necessarily on-site.

     "Inspection" means a review by department personnel to determine the adult family home's compliance with this chapter and chapters 70.128, 70.129, 74.34 RCW, and other applicable rules and regulations. The department's review may include an on-site visit.

     "Mandated reporter" means an employee of the department, law enforcement, officer, social worker, professional school personnel, individual provider, an employee of a facility, an employee of a social service, welfare, mental health, adult day health, adult day care, or hospice agency, county coroner or medical examiner, Christian Science practitioner, or health care provider subject to chapter 18.130 RCW. For the purpose of the definition of a mandated reporter, "Facility" means a residence licensed or required to be licensed under chapter 18.20 RCW (boarding homes), chapter 18.51 RCW (nursing homes), chapter 70.128 RCW (adult family homes), chapter 72.36 RCW (soldiers' homes), chapter 71A.20 RCW (residential habilitation centers), or any other facility licensed by the department.

     "Medical device" as used in this chapter, means any piece of medical equipment used to treat a resident's assessed need.

     (1) A medical device is not always a restraint and should not be used as a restraint;

     (2) Some medical devices have considerable safety risks associated with use; and

     (3) Examples of medical devices with known safety risks when used are transfer poles, Posey or lap belts, and side rails.

     "Medication administration" means giving resident medications by a person legally authorized to do so, such as a physician, pharmacist or nurse.

     "Medication organizer" is a container with separate compartments for storing oral medications organized in daily doses.

     "Mental illness" is defined as an Axis I or II diagnosed mental illness as outlined in volume IV of the Diagnostic and Statistical Manual of Mental Disorders (a copy is available for review through the aging and disability services administration).

     "Multiple facility provider" means an individual or entity provider who is licensed to operate more than one adult family home.

     "Neglect" means:

     (1) A pattern of conduct or inaction by a person or entity with a duty of care that fails to provide the goods and services that maintain physical or mental health of a vulnerable adult, or that fails to avoid or prevent physical or mental harm or pain to a vulnerable adult; or

     (2) An act or omission that demonstrates a serious disregard of consequences of such a magnitude as to constitute a clear and present danger to the vulnerable adult's health, welfare, or safety, including but not limited to conduct prohibited under RCW 9A.41.100.

     "Nurse delegation" means a registered nurse transfers the performance of selected nursing tasks to competent nursing assistants in selected situations. The registered nurse delegating the task retains the responsibility and accountability for the nursing care of the resident.

     "Over-the-counter medication" is any medication that can be purchased without a prescriptive order, including but not limited to vitamin, mineral, or herbal preparations.

     "Personal care services" means both physical assistance and/or prompting and supervising the performance of direct personal care tasks as determined by the resident's needs and does not include assistance with tasks performed by a licensed health professional.

     "Physical restraint" means a manual method, obstacle, or physical or mechanical device, material, or equipment attached or adjacent to the resident's body that restricts freedom of movement or access to his or her body, is used for discipline or convenience, and is not required to treat the resident's medical symptoms.

     "Practitioner" includes a physician, osteopathic physician, podiatric physician, pharmacist, licensed practical nurse, registered nurse, advanced registered nurse practitioner, dentist, and physician assistant licensed in the state of Washington.

     "Prescribed medication" refers to any medication (legend drug, controlled substance, and over-the-counter) that is prescribed by an authorized practitioner.

     "Provider" means any person or entity that is licensed under this chapter to operate an adult family home.

     "Qualified staff" means a person who:

     (1) Is employed, directly or by contract, by an adult family home; and

     (2) Meets all of the requirements of a provider, entity representative, resident manager or caregiver.

     "Resident" means any adult unrelated to the provider who lives in the adult family home and who is in need of care. Except as specified elsewhere in this chapter, for decision-making purposes, the term "resident" includes the resident's surrogate decision maker acting under state law.

     "Resident manager" means a person employed or designated by the provider or entity representative to manage the adult family home.    

     "Significant change" means:

     (1) A lasting change, decline or improvement in the resident's baseline physical, mental or psychosocial status;

     (2) The change is significant enough so the current assessment and/or negotiated care plan do not reflect the resident's current status; and

     (3) A new assessment may be needed when the resident's condition does not return to baseline within a two week period of time.

     "Special care" means care beyond personal care services as defined in this section.

     "Staff" means any person who:

     (1) Is employed, directly or by contract, by an adult family home; and

     (2) Provides care and services to any resident.

     "Unsupervised" means not in the presence of:

     (1) Another employee or volunteer from the same business or organization; or

     (2) Any relative or guardian of any of the children or developmentally disabled persons or vulnerable adults to which the employee, student or volunteer has access during the course of his or her employment or involvement with the business or organization.

     "Usable floor space" means resident bedroom floor space exclusive of:

     (1) Toilet rooms;

     (2) Closets;

     (3) Lockers;

     (4) Wardrobes;

     (5) Vestibules, and

     (6) The space required for the door to swing if the bedroom door opens into the resident bedroom.

     "Water hazard" means any body of water over twenty-four inches in depth that can be accessed by a resident, and includes but not limited to:

     (1) In-ground, above-ground, and on-ground pools;

     (2) Hot tubs, spas;

     (3) Fixed-in-place wading pools;

     (4) Decorative water features;

     (5) Ponds; or

     (6) Natural bodies of water such as streams, lakes, rivers, and oceans.

     "Willful" means the deliberate or nonaccidental action or inaction by an alleged perpetrator that he/she knew or reasonably should have known could cause a negative outcome, including harm, injury, pain or anguish.

     "Vulnerable adult" includes a person:

     (1) Sixty years of age or older who has the functional, mental, or physical inability to care for himself or herself;

     (2) Found incapacitated under chapter 11.88 RCW;

     (3) Who has a developmental disability as defined under RCW 71A.10.020;

     (4) Admitted to any facility;

     (5) Receiving services from home health, hospice, or home care agencies licensed or required to be licensed under chapter 70.127 RCW;

     (6) Receiving services from an individual provider; or

     (7) With a functional disability who lives in his or her own home, who is directing and supervising a paid personal aide to perform a health care task as authorized by RCW 74.39.050.



[Statutory Authority: RCW 70.128.040. 09-03-029, § 388-76-10000, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. 07-21-080, § 388-76-10000, filed 10/16/07, effective 1/1/08.]