La. Admin. Code tit. 48 § I-8703
Abuse-the willful infliction of physical or mental injury on an individual by other parties, including but not limited to such means as sexual abuse, exploitation, or extortion of funds or other things of value, unreasonable confinement and/or intimidation to such an extent that his/her health, self-determination or emotional well-being is endangered.
Acquired Brain Injury-an injury to the brain that has occurred after birth and is not hereditary, congenital, or degenerative. The injury commonly results in a change in neuronal activity, which affects the physical integrity, the metabolic activity or the functional ability of the cell. It can also result in the disturbance of behavioral or emotional functioning. These impairments may be either temporary or permanent and cause partial or total functional disability or psychosocial maladjustments. The term does not refer to brain injuries induced by birth trauma.
Activities of Daily Living (ADLs)-activities considered the basic, vital, daily activities for persons and are identified as bathing, grooming, dressing, dining, toileting and ambulation/transfer.
Adult-an individual 18 years of age or older.
Adult Brain Injury (ABI) Facility-any of the following:
1. residential level of care-a facility publicly or privately owned, located at one or more geographic addresses, providing a rehabilitative treatment environment which serves four or more adults who suffer from brain injury and at least one of whom is not related to the operator. Services shall include personal assistance or supervision for a period of 24 hours continuously per day preparing them for community integration. Such services shall be provided by adult brain injury facilities licensed to provide residential level of care services;
2. community living level of care-a home or apartment publicly or privately owned, providing a rehabilitative treatment environment which serves one to six adults who suffer from brain injury and at least one of whom is not related to the operator. Services may include personal assistance or supervision for a period of up to 24 hours continuously per day in a home or apartment setting preparing them for community integration:
a. the apartment or home shall contain, at a minimum, a living/dining/bedroom area, kitchen/kitchenette, bathroom and storage space;
b. there shall be no more than three bedrooms in an apartment and no more than six beds per home;
c. such treatment environment shall be provided by adult brain injury facilities licensed to provide community living level of care services;
3. outpatient level of care-a facility publicly or privately owned providing an outpatient rehabilitative treatment environment which serves adults who suffer from brain injury, at least one of whom is not related to the operator, in an outpatient day treatment setting in order to advance the individuals independence for higher level of community or transition to a greater level of independence in community or vocational function. Such services shall be provided by adult brain injury facilities licensed to provide outpatient level of care services.
Assistance with Activities of Daily Living-services that provide assistance with activities of daily living. Such assistance may be the actual performance of the task for the individual, providing hands-on assistance with the performance of the tasks, or supervision and prompting to allow the individual to self-perform such tasks.
Behavioral Services-services that identify maladaptive behaviors which interfere with the persons safe integration into the community and the formulation of an inclusive behavior management program to decrease identified maladaptive behaviors.
Brain Injury-an acquired or traumatic injury to the brain. Such term does not include brain dysfunction caused by congenital disorders, degenerative disorders or birth trauma but may include brain injuries caused by anoxia due to trauma.
Cessation of Business-the ABI facility is non-operational and/or has stopped offering or providing services to the community.
Client-an individual receiving care from an ABI facility who is medically stable and does not require an I V, a functioning feeding tube, or other artificial or mechanical supports for life sustaining processes.
Cognitive Rehabilitation-a systematic, functionally oriented service of therapeutic cognitive activities based on an assessment and an understanding of the behavior of a client. Services are directed to achieve functional improvement by either:
1. reinforcing, strengthening or re-establishing previously learned patterns of behavior; or
2. establishing new patterns of cognitive activity or mechanisms to compensate for impaired neurological systems.
Community Integration-the participation in the mainstream of community life and maintaining social relationships with family members, peers and others in the community who do not have brain injuries. Integration also means that clients have equal access to and full participation in community resources and activities available to the general public at the maximum amount of safety and independence as possible.
Department (LDH)-the Louisiana Department of Health, formerly known as Department of Health and Hospitals or DHH.
Direct Care Staff-an employee of the facility, either contracted or directly employed, who provides personal care services to the clients. Such services may include, but are not limited to, assistance with ADLs and IADLs.
Director-the person designated by the owner or governing body as responsible for carrying out the day-today management, administration, supervision and operation of the facility.
Employed-performance of a job or task for compensation, such as wages or a salary. An employed person may be one who is contracted or one who is hired directly.
Functional Limitations-actual behaviors or mental or physical disabilities exhibited by adults with brain injuries or conditions presented by their environment, or both, that shall be modified or minimized in order for clients to fulfill their potential or maximize their functioning.
Head Injury-a traumatic or acquired brain injury.
Health Standards Section (HSS)-the agency or office within the Louisiana Department of Health with the responsibility for the inspection and licensure of adult brain injury facilities.
Impairment-any loss or abnormality of psychological, cognitive, physiological, or anatomical structure or functioning.
Instrumental Activities of Daily Living (IADLs)-activities considered to be instrumental, essential activities for persons, but are not usually considered as basic or vital activities of daily living, and may not be daily activities. Such activities include, but are not limited to:
1. socialization;
2. managing personal affairs;
3 financial management;
4 shopping;
5. housekeeping; and
6. appropriate transportation, correspondence, behavior and health management, etc.
Medication Management Program-a systematic, functionally, oriented program formulated in consultation with the clients primary provider and implemented by staff, either contracted or directly employed, and trained by a nursing director. The program shall be based upon an assessment and understanding of the behaviors of the client and recognition of the unique medical and pharmacological needs of the client. It shall also mean an incorporation of the most appropriate level of assistance necessary to advance towards independence.
Neglect-the failure to provide food, shelter, clothing, medical or other health services, appropriate security and supervision or other personal services necessary for a clients well-being.
Non-Ope rational-the ABI facility is not open and available for business operation as stated on the licensing application and business location signage.
Nursing Director-a person who meets the legal requirement of a registered nurse (RN) in the state of Louisiana.
Personal Care-services and supports including but not limited to:
1. bathing, hair care, skin care, shaving, nail care, oral hygiene, overall hygiene and activities of daily living;
2. interventions to assist with eating and bowel and bladder management;
3. positioning;
4. care of adaptive personal care devices; and
5. an appropriate level of supervision.
Primary Provider-a provider, board-certified in his/her specialty, who currently holds a valid license in Louisiana and is responsible for overseeing the decision making process for admission and continued stay of clients.
Rehabilitation-the process of providing those comprehensive services deemed appropriate to the needs of a client in a coordinated manner in a program designed to achieve functional objectives of improved health, welfare, maximum physical, cognitive, social, psychological and community functioning.
Rehabilitative Treatment Environment-a rehabilitation setting that provides for all of the following:
1. a provision of a range of choices, with personal preference, self-determination and dignity of risks receiving full respect and consideration;
2. a variety of social interactions that promote community integration;
3. an environment of peer support and mentorship;
4. professional team involvement;
5. a physical environment conducive to enhancing the functional abilities of the client;
6 necessary therapeutic services which may include social work, behavioral services, speech therapy, physical therapy, occupational therapy, vocational services and therapeutic recreational services;
NOTE: All therapeutic providers shall be licensed under state and, if applicable, national boards.
7. a medication management program;
8. cognitive rehabilitation activities; and
9. the identification of functional limitations.
Representative-a person who voluntarily, with the clients written authorization, may act upon the clients direction regarding matters concerning the health and welfare of the client, including having access to personal records contained in the clients file and receiving information and notices about the clients overall care and condition.
1. No member of the governing body, administration or staff, either contracted or directly employed, of an ABI facility or any member of their family may serve as the representative for a client unless they are related to the client by blood or marriage.
2. In the case of an individual that has been interdicted, the representative is the court-appointed curator or his/her designee.
Support-activities, materials, equipment, or other services designed and implemented to assist the client with a brain injury. Examples include, but are not limited to:
1. instruction;
2. training;
3. assistive technology; or
4. removal of architectural barriers.
Therapeutic Recreational Services-services that identify leisure activities and assistance in modifying and adapting identified leisure activities to allow safe participation by the client as a means to improve quality of life and aid in integration into the community.
Traumatic Brain Injury-an insult to the brain, not of a degenerative or congenital nature, caused by an external physical force that may produce a diminished or altered state of consciousness, which results in an impairment of cognitive abilities or physical functioning. It can also result in the disturbance of behavioral or emotional functioning. These impairments may be either temporary or permanent and cause partial or total functioning disability, or psychosocial maladjustment.
Vocational Services-services provided directly or through cooperating agencies to a client in accordance with his individualized plan and designed to improve or enhance skills and behaviors necessary for successful placement in a volunteer or work setting.
La. Admin. Code tit. 48, § I-8703