Current through Register Vol. 46, No. 39, September 25, 2024
The operator must provide or arrange for services
appropriate to each registrant in accordance with the comprehensive assessment
conducted and comprehensive care plan developed by the adult day health care
program or by the managed care organization or care coordination model that
referred the registrant to the adult day health care program. The following
registrant services shall be provided on-site, as appropriate, to each
registrant in accordance with the individual's multidisciplinary assessment of
needs and comprehensive care plan:
(a)
medical services provided by the operator, which, without limiting its
responsibility for the operation and management of the program, must:
(1) assign to the operator's medical board,
medical advisory committee, medical director or consulting practitioner the
following responsibilities regarding registrants of the program:
(i) developing and amending clinical
policies;
(ii) supervising medical
services;
(iii) advising the
operator regarding medical and medically related problems;
(iv) establishing procedures for emergency
practitioner coverage, records and consultants; and
(v) establishing professional relationships
with other institutions and agencies, such as general hospitals, rehabilitation
centers, residential health care facilities, home health agencies, hospital
outpatient departments, clinics and laboratories;
(2) ensure that medical services, including
arranging for necessary consultation services, are provided to registrants of
the program in accordance with the registrant's managed care organization or
care coordination model;
(3)
provide or arrange for the personnel, staff or other designated practitioner to
obtain a medical history and a physical examination of each registrant,
including diagnostic laboratory and x-ray services, as medically indicated,
within six weeks before or seven days after admission to the program;
(4) ensure that the practitioner record, date
and authenticate significant findings of the medical history, physical
examination, diagnostic services, diagnoses and orders for treatment in the
registrant's clinical records;
(5)
ensure that orders for treatment include orders for medication, diet, permitted
level of physical activity and, when indicated, special orders or
recommendations for rehabilitative therapy services and other adult day health
care services;
(b) case
management services;
(c) food and
nutrition services provided by the operator, which must:
(1) provide meals and nutritional
supplements, including modified diets when medically prescribed, to registrants
who are on the premises at scheduled meal times and, where appropriate, to
registrants in their homes in accordance with the identified needs included in
registrant comprehensive care plans;
(2) ensure that nutrition services are under
the direction of a qualified dietitian;
(i) A
qualified dietician is one who is qualified based on:
(a) registration by the Commission on
Dietetic Registration of the American Diabetes Association;
(b) education, training, and experience in
identification of dietary needs, planning, and implementation of dietary
program; or
(c) certification as a
certified dietician or certified nutritionist in accordance with Article 157 of
the Education Law;
(3) ensure that dietary service records for
the adult day health care service are maintained;
(d) social services provided by the operator
must:
(1) be under the supervision and
direction of a licensed clinical social worker;
(2) be provided through the use of a full or
part-time licensed mental health professional in conformance with the approved
application for operation and regular access may be directly with a master's
prepared or licensed mental health professional;
(3) either directly or through the managed
care organization or care coordination model that referred the registrant to
the adult day health care program, ensure that psychosocial needs are assessed,
evaluated and recorded, and that services are provided to meet the identified
needs of the registrant as part of the comprehensive care plan; and
(4) ensure that staff members arrange for the
use of and/or access to other community resources as needed and coordinate the
needs of the registrants with services provided by the adult day health care
program and other health care providers, community social agencies and other
resources; provided, however, with respect to registrants referred to the adult
day health care program by a managed care organization or care coordination
model, this shall be the responsibility of the managed care organization or
care coordination model.
(e) assistance and/or supervision with
activities of daily living, such as toileting, feeding, ambulation, bathing
including routine skin care, care of hair and nails, and oral hygiene, and
supervision and monitoring of personal safety, restorative rehabilitative and
maintenance therapy services, and instrumental activities of daily
living;
(f) rehabilitation therapy
services provided or arranged by the operator, either directly or through the
managed care organization or care coordination model that referred the
registrant to the adult day health care program, in conformance with the
registrant's needs identified during the comprehensive assessment;
(g) an activities program, provided by the
operator either directly or through the managed care organization or care
coordination model that referred the registrant to the adult day health care
program, which must involve community, interpersonal and self-care functions
appropriate and sufficient in scope to the needs and interests of each
registrant to sustain physical and psychosocial functioning and must:
(1) ensure that activities are an integral
part of the program and reflect the registrants' individual interests and
cultural backgrounds;
(2) ensure
that activities are designed to enhance registrant participation in the
program, home life and the community;
(3) involve appropriate volunteers and
volunteer groups in the program, unless prohibited by law;
(4) provide sufficient equipment and supplies
for the operation of the activity program;
(5) provide or arrange for transportation to
and from community events and outings; and
(6) ensure that activities are included as
part of each registrant's comprehensive care plan;
(h) nursing services, provided by the
operator, directly or through the managed care organization or care
coordination model that referred the registrant to the adult day health care
program, must be based on the care needs of the registrant as specified in the
comprehensive care plan and be provided by a registered professional nurse. A
licensed practical nurse, acting within his or her lawful scope of practice
under Title VIII of the Education Law, may provide the on-site services when a
registered professional nurse is available at the sponsoring licensed facility
to provide immediate direction or consultation;
(1) in addition to providing nursing services
as specified in the registrant comprehensive care plan, the operator must
ensure that a registered professional nurse is available to conduct sick call
triage assessments to registrants presenting with new problems or symptoms that
result in consultation with the registrant's primary care physician or the
managed care organization in which the registrant is enrolled or, as necessary,
immediate transfer to an emergency department;
(i) pastoral counseling, either provided
directly or arranged for by the operator;
(j) counseling for HIV risk
reduction;
(k) pharmaceutical
services;
(l) substance abuse
services;
(m) mental health and
psychiatric services;
(n) ancillary
services commensurate with the level of care delivered on-site; and
(o) referrals for dental services and
sub-specialty care that are in conformance with the needs identified during the
comprehensive assessment.
