North Carolina Administrative Code
Title 10A - HEALTH AND HUMAN SERVICES
Chapter 06 - AGING - PROGRAMS OPERATIONS
Subchapter R - ADULT DAY CARE STANDARDS FOR CERTIFICATION
Section .0500 - PROGRAM OPERATION
Section 06R .0501 - PLANNING PROGRAM ACTIVITIES
Universal Citation: 10A NC Admin Code 06R .0501
Current through Register Vol. 39, No. 6, September 16, 2024
(a) Enrollment Policies and Procedures
(1) Each
adult day care program shall have written program policies including enrollment
policies that define the population served. These policies shall serve as the
basis for determining who shall be accepted into the program and for planning
activities for the participants. The planned activities shall be created to
meet the needs of the participant to satisfy their service plan. The enrollment
policies shall outline the criteria for people whose needs cannot be met by the
planned activities. The enrollment policies shall provide for discharge of
participants whose needs can no longer be met by the adult day care program. If
a day care program serves semi-ambulatory or non-ambulatory persons, it shall
be stated in the enrollment policies.
(2) Prior to enrollment, the applicant,
family members or caregiver shall have a minimum of one personal interview with
a program staff member. During the interview, the staff shall complete initial
documentation identifying support networks, activities enjoyed by the
participant, medical care needs, any spiritual, religious or cultural needs,
and a determination of whether the program can meet the individual's expressed
needs. The staff person doing the interviewing shall sign the determination of
needs and the applicant, family member or caregiver shall sign the application
for enrollment. These signed documents shall be obtained before the
individual's first day of attendance as a participant in the program.
(3) A medical examination report signed by a
physician, nurse practitioner or physician's assistant, completed within the
prior three months, shall be obtained by the program within 30 days of
enrollment. This report must be updated annually no later than the anniversary
date of the initial report. The requirements for the medical examination report
shall be found in Rule.0508 of this Section.
(4) At enrollment, or in the initial
interview, the program policies shall be discussed with the applicant, family
member or caregiver and a copy of the program policies shall be
provided.
(5) Documentation of
receipt of and agreement to abide by the program policies by the applicant,
family member or caregiver shall be obtained by the program and kept in the
participant's file.
(6) The program
policies shall contain:
(A) a discharge policy
outlining the criteria for discharge and notification procedures for discharge,
the timeframe and procedures for notifying the applicant, family member or
other caregiver of discharge, and referral or follow-up procedures;
(B) a medication policy as specified in Rule
.0505 of this Section;
(C) a
description of participant's rights while enrolled in the adult day care
program;
(D) the grievance policies
and procedures for families;
(E)
the advance directives policy;
(F)
the non-discrimination policies;
(G) the procedure to maintain
confidentiality;
(H) the policy on
reporting suspected abuse or neglect;
(I) the description of the geographical area
served by the program; and
(J) the
inclement weather policies.
(b) Planning Services for Individual Participants
(1) Within 30 days of enrollment
of a new participant, the program shall perform a comprehensive assessment and
written service plan for each individual. The comprehensive assessment shall
address the individual's ability to perform activities of daily living and
instrumental activities of daily living while in the program. The mental,
social, living environment, economic and physical health of the individual
shall also be assessed. The service plan shall be signed and dated by the
program director or the director's designee. For adult day health participants
the health component of the service plan shall be written and signed by a
registered nurse.
(2) In developing
the written service plan, the program shall include input from the participant,
family members, or caregiver and other agency professionals with knowledge of
the individual's needs. The service plan shall be based on strengths, needs and
abilities identified in the assessment. The assessment and service plan shall
be reviewed at regular intervals, and no less than once every six months. The
service plan shall include:
(A) the needs and
strengths of the participant;
(B)
the interests of the participant;
(C) the measurable service goals and
objectives of care for the participant while in the adult day care
program;
(D) the type of
interventions to be provided by the program in order to reach desired
outcomes;
(E) the services to be
provided by the program to achieve the goals and objectives;
(F) the roles of participant, family,
caregiver, volunteers and program staff; and
(G) the time limit for the plan, with
provision for review and renewal.
(3) Progress notes in the participant's
record shall be updated at least every three months.
(4) The participant, caregiver, and other
service providers may contribute to the development, implementation and
evaluation of the service plan.
(5)
Any change in behavior, mood, or attitude or need for help or services shall be
reported by the program. If the participant is a department of social services
client, the report shall be made to the participant's family, caregiver, or
responsible party and the department of social services worker or the social
worker designated as consultant to the adult day care program by the
department. If the participant is not a social services client, the report
shall be made to the person's family, caregiver or responsible party. A note
shall be made in the participant's record of action taken.
(6) The participant or the responsible party
may choose the days and number of days the participant will attend, with the
program director's approval.
(7)
The reason for any unscheduled participant absence shall be determined by the
program staff and documented on the day it occurs. The program shall attempt to
contact the absent participant or the responsible party to determine why the
participant was absent on a scheduled day of attendance.
(8) The adult day care program is responsible
for the participant's safety when a participant is registered in attendance. A
participant leaving the program for part of a day shall sign out relieving the
program of further responsibility. If a participant has emotional or mental
impairment that requires supervision and that person needs or wants to leave
the program during the day, the social worker, family, caregiver, friend, or
responsible party shall sign the person out.
(c) Program Activities Plan
(1) The day care center or home shall have a
program activities plan that meets the following criteria:
(A) Overall planning of activities shall be
based on elements of the individual service plans.
(B) Program activities shall follow the group
process, both large and small groups, with provision for individual activities
and services as needed.
(C)
Activities shall be adaptable and modifiable to allow for greater participation
and to maintain participant's individual skill level.
(D) Activities shall be consistent with the
stated program goals.
(E)
Activities shall be planned jointly by staff and participants. Staff shall
encourage participants to participate in the planning and operation of the
program as much as the participant is able, and to use their skills, talent and
knowledge in program planning and operation.
(F) All program activities shall be
supervised by program staff.
(G)
Participants may refuse to participate in any given activity.
(2) The activities schedule shall
provide for the inclusion of cognitive activities to be available on a daily
basis, and be designed to:
(A) stimulate
thinking and creativity;
(B)
provide opportunities for learning new ideas and skills;
(C) help maintain existing reasoning skills
and knowledge base; and
(D) provide
opportunities to utilize previously learned skills.
(3) The activities schedule shall provide for
the inclusion of physical activities to be available on a daily basis, and be
designed to:
(A) improve or maintain mobility
and overall strength; and
(B)
increase or maintain joint range of motion.
(4) The activities schedule shall provide for
the inclusion of psychosocial activities, as determined by the client's service
plan, to be available on a daily basis, and be designed to:
(A) provide opportunities for social
interaction;
(B) develop a sense of
belonging;
(C) promote
goal-oriented use of time;
(D)
create feelings of accomplishment;
(E) foster dignity and self-esteem;
(F) prompt self-expression; and
(G) provide fun and enjoyment.
(5) The activities schedule shall:
(A) be in writing, specifying the name of
each activity to be provided, the days of the week each activity shall be
conducted, and the approximate length of time of each activity;
(B) indicate the length of time the schedule
is to be followed; and
(C) be
posted weekly or monthly in the facility and visible to anyone into the
facility.
Authority
G.S.
131D-6;
143B-153(2a);
143B-153(6);
Eff. July 1, 1978;
Amended Eff. February 1, 2008; July 1, 2007;
July 1, 1990; January 1, 1981;
Readopted Eff. September 1,
2019.
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