Current through Register Vol. 46, No. 52, December 24, 2024
(a) The operator shall:
(1) select and admit to and retain in the
adult day health care program only those persons for whom adequate care and
needed services can be provided and who, according to the comprehensive
assessment, can benefit from the services provided on the basis of at least one
visit per week to the program;
(2)
assess each applicant, unless the assessment was conducted by a managed care
organization or care coordination model that referred the applicant to the
adult day health care program, utilizing an assessment instrument provided by
the Department as part of the admission review process, which assessment shall
include at a minimum the following:
(i)
medical needs, including the determination that the applicant is expected to
need continued service for a period of 30 or more days from the date of the
completion of the comprehensive assessment;
(ii) use of medication and required
treatment;
(iii) nursing care
needs;
(iv) functional
status;
(v) mental/behavioral
health status;
(vi) sensory
impairments;
(vii) rehabilitation
therapy needs, including a determination regarding the specific need for
physical therapy, occupational therapy, and speech language pathology
services;
(viii) family and other
informal supports;
(ix) home
environment;
(x) psycho-social
needs;
(xi) financial
status;
(xii) nutritional
status;
(xiii) ability to tolerate
the duration and method of transportation to the program;
(xiv) evidence of any substance abuse
problem; and
(xv) need for HIV risk
reduction counseling.
(3) register each applicant only upon
recommendation from the applicant's physician and after completion of a
personal interview by qualified personnel with the applicant, next of kin
and/or sponsor;
(4) register each
applicant only after determining that the applicant is not receiving the same
services from any other facility or agency;
(5) determine whether the applicant is
receiving primary medical care and, if so, where the care is
provided;
(6) admit an applicant to
the service only after execution of a written agreement which shall include but
not be limited to a requirement that:
(i) the
applicant agrees to a medical examination at a physician's office, the facility
or other appropriate site, within six weeks prior to or seven days after
admission ; and
(ii) the operator
provides to the applicant, next of kin and/or sponsor a written list of basic
services furnished by the facility to registrants and paid for as part of the
registrant visit at daily, weekly or monthly rates;
(7) record all financial arrangements with
the applicant or designated representative, with copies executed by and
furnished to each party;
(8) make
no arrangement for prepayment for basic services exceeding one month;
and
(9) comply with the provision
of financial policies as set forth in the applicable section of this
Title.
(b) An individual
may be registered in an adult day health care program only if his or her
comprehensive assessment indicates that the program can adequately and
appropriately care for the physical and emotional health needs of the
individual.
(c) No applicant
suffering from a communicable disease that constitutes a danger to other
registrants or staff may be registered or retained for services on the premises
unless a physician certifies that the registrant presents no significant risk
to any person.
(d) The operator may
admit, on any given day, up to 10% over the approved capacity for that program.
The average annual capacity, however, may not exceed the approved capacity of
the operator's program.