Current through Reg. 50, No. 187; September 24, 2024
In addition to the minimum Basic Services, the Center may
choose to provide Supportive and Optional Services. If provided, such services
must be administered by Staff qualified to provide such services and within the
criteria established by relevant Florida Statutes. The following are examples
of such services:
(1) Health or social
services such as assessment, counseling, treatment and referral.
(2) Speech therapy provided by or under the
supervision of an individual licensed under chapter 468, part I, F.S., who has
a certification of clinical competence from the American Speech and Hearing
Association, and who has completed the equivalent education requirements and
work experience necessary for certification, or who has completed the academic
program and is acquiring supervised work experience to qualify for the
certificate. Progress notes shall be maintained and must be written in the
Participant's File and signed by the speech therapist as services are
provided.
(3) Physical therapy must
be provided by, or under the supervision of, an individual who is a graduate of
a program of physical therapy approved by both the Council on Medical Education
of the American Medical Association and the American Therapy Association, or
the equivalent, and licensed by the State. Progress notes shall be maintained
and must be written in the Participant's File and signed by the physical
therapist as services are provided.
(4) Occupational therapy as an adjunct to
treatment of persons with physical and mental limitations must be provided by,
or under the supervision of, an individual who is registered by the American
Occupational Therapy Association; or a graduate of a program approved by the
Council on Medical Education of the American Medical Association and engaged in
the supplemental clinical experience required before registration by the
American Occupational Therapy Association. Progress notes shall be written in
the Participant's File and signed by the occupational therapist as services are
provided.
(5) Modified diets or
diets based on the normal diet and designed to meet the requirements of a given
situation such as altering individual nutrients, caloric values, consistency,
flavor, techniques of service or preparation, content of specific foods, or a
combination of these factors, may be provided as an optional service. When
modified diets are provided, a physician's written or documented oral order for
each Participant receiving a modified diet shall be on file. A menu including
types and amounts of food to serve will be on file in the food service area.
Diets shall be prepared and served as ordered by the physician.
(6) Adult day health care services for
disabled adults or aged persons, provided the Center complies with the
following:
(a) Make services available for a
minimum of five hours per day five days per week, excluding legal holidays as
posted by the facility. For purposes of this subsection, legal holiday shall
mean any day which, by the laws of this state or the United States, is
designated or recognized as a legal or public holiday or any day on which
businesses or institutions are customarily closed.
(b) Provide or coordinate, in addition to the
Basic Services specified in rule
59A-16.105, F.A.C., and
Supportive and Optional Services, pursuant to subsections (1), (2), (3), (4)
and (5), the following adult day health care services:
1. Medical screening emphasizing prevention
and continuity of care which includes routine blood pressure checks or blood
glucose diabetic maintenance checks,
2. Nursing services including a configuration
of services at different levels of intensity as determined by the nursing
assessment, Participant Care Plan, and physician's orders. Services shall
include:
a. Health education and counseling
including nutritional advice, liaison with the Participant's personal
physician, and notification of the Participant's physician, as well as the
caregiver or family of any changes in the Participant's health status,
b. Coordination of the provision
of other health services provided outside the Center,
c. Supervision of health services provided by
program aides.
3. Social
services including: counseling for Participants' families and caregivers;
compilation of a social history and psychosocial assessment of formal and
informal support systems; mental and emotional status; caregiver data;
information on planning for discharge; and referral for persons not appropriate
for adult day care.
4. Additional
medical services such as dental, ophthalmological, optometric, hearing aid, or
laboratory services.
5.
Transportation Services to and from the adult day health care
services.
(c) In addition
to the minimum staffing required in chapter 59A-16, F.A.C., provide the
following Staff:
1. The Operator shall: have
a minimum of a Bachelor's degree in a health or social services or related
field, with one year of supervisory experience in a social or health service
setting; hold a registered nurse license with one year of supervisory
experience; or have 5 years of supervisory experience in a social or health
service setting.
2. A registered
nurse (RN) or licensed practical nurse (LPN) shall be on-site during the
primary hours of program operation and on-call during all hours the Center is
open. Arrangements shall be formalized for obtaining the services of an LPN or
RN in anticipation of potential absences, planned and unplanned, of the regular
nursing Staff.
3. A social worker
with a minimum of a Bachelor's degree in social work or a case worker with a
minimum of a Bachelor's degree in sociology, psychology, nursing, or
gerontology, or a Bachelor's degree with at least two years of experience in a
human service field. Services provided by program aides in this service area
must be provided under the direct supervision of a social worker or case
manager who meets or exceeds these standards (e.g., a Master's degree in a
related field).
4. An activity
director or Recreational Therapist with a Bachelor's degree in a social or
health service field or an Associate's degree in a related field plus 2 years
of experience. All services provided by program aides must be provided under
the direct supervision of the activity director or recreation therapist. The
recreation therapist may be retained as a consultant.
(d) Documentation of services provided under
this section must be in the Participant Care Plan and stored in the Participant
File. Participant Care Plans must be reviewed at least quarterly by a
multidisciplinary team. At a minimum, narrative nursing, social work, and
activity notes must be entered in the participant's record quarterly,
indicating the Participant's progress toward achieving health goals. More
frequent notes are required if indicated by the Participant's
condition.
Rulemaking Authority 429.929 FS. Law Implemented 429.929
FS.
New 7-8-81, Formerly 10A-6.10, 10A-6.010,
59A-16.010, Amended 11-9-95,
3-29-98, 8-3-15, Formerly
58A-6.010,
7-1-19.
