Current through Reg. 49, No. 38; September 20, 2024
(a) This section
establishes the requirements for adult day services, a service provided under
the Older Americans Act and funded, in whole or in part, by DADS.
(b) Eligibility. A AAA must ensure that a
program participant who receives adult day services:
(1) is:
(A)
60 years of age or older; and
(B)
at least moderately impaired in the ability to perform instrumental or ordinary
activities of daily living; or
(2) is qualified to receive services under
Title III, Part E, of the Older Americans Act.
(c) Requirement for licensed vendor to
provide services. A AAA must enter into a vendor agreement for the provision of
adult day services with an adult day care facility licensed in accordance with
§ 98.11 of this title (relating to Criteria for Licensing).
(d) Service authorization. Before adult day
services are provided by a vendor to a program participant, a AAA must ensure
that the vendor obtains authorization for the services from the AAA in
accordance with § 83.3(o)(2)(B) of this title (relating to System of
Access and Assistance).
(e)
Description of adult day services. Adult day services consist of nursing
services, physical rehabilitative services, nutrition services, socialization
activities, and transportation services.
(1)
Nursing services. Nursing services must include:
(A) assessing, observing, evaluating, and
documenting a program participant's health condition, and instituting
appropriate nursing interventions to stabilize or improve a program
participant's condition or prevent complications;
(B) assisting a program participant with
self-administered medications including, but not limited to, ordering,
maintaining, or administering the medications as directed by a physician or
other health care practitioner acting within the scope of the practitioner's
authority and license;
(C)
assisting a program participant with medical treatments, as directed by a
physician or other health care practitioner acting within the scope of the
practitioner's authority and license;
(D) counseling a program participant on the
program participant's health needs and involving family members and caregivers
in the discussions regarding immediate and long-term health goals;
and
(E) providing or supervising
personal day services to enable a program participant to restore, maintain, or
improve the ability to perform activities of daily living and instrumental
activities of daily living as defined in DADS Program Instruction AAA-PI-310
Activities of Daily Living/Instrumental Activities of Daily Living NAPIS
Mapping Requirements.
(2)
Physical rehabilitative services. Physical rehabilitative services must
include:
(A) restorative nursing;
and
(B) group and individual
exercises, including range of motion exercises.
(3) Nutrition services. Nutrition services
must include:
(A) one hot meal served between
the hours of 10:30 a.m. and 1:30 p.m. that:
(i) is suitable in quantity and adequacy to
attain and maintain nutritional requirements, including those of a special
needs program participant; and
(ii)
consists of at least two ounces of meat, one-half cup of fruit or vegetables,
one cup of milk, and two servings of bread;
(B) special diets as required by a program
participant's plan of care;
(C) a
supplementary mid-morning and mid-afternoon snack;
(D) dietary counseling and nutrition
education for a program participant and family member; and
(E) assisting with meals, if necessary, for
program participants with hand deformities, paralysis, hand tremors, or trouble
chewing, including:
(i) grinding meats and
mashing vegetables; and
(ii) spoon
feeding, bread buttering, and opening containers such as milk or
juice.
(4)
Socialization activities. Socialization activities are community interaction,
cultural enrichment, educational, recreational, or other social activities held
in the vendor's facility or in the community in a planned program to meet the
social needs and interests of a program participant. A AAA must ensure that a
service provider:
(A) provides at least three
social activities each day; and
(B)
posts a monthly activity calendar in a visible location at least one week in
advance of the activities listed.
(5) Transportation services.
(A) Transportation services must include:
(i) round trip transportation to a vendor's
facility from a program participant's residence; and
(ii) round trip transportation from a
vendor's facility to medical appointments ordered by a physician or other
health care practitioner acting within the scope of the practitioner's
authority and license if it is necessary for a program participant to attend
such therapies or appointments while at the facility.
(B) If a vendor does not provide
transportation directly, it must arrange for transportation from another person
or organization.
(C) A vehicle used
for transportation services must be properly operated and maintained and have
proper heating and cooling systems to maintain reasonable temperature levels
inside the vehicle.
(f) Staff qualifications. A AAA must ensure
that staff persons of a service provider meet the qualifications described in
§ 98.62(a) of this title (relating to Program Requirements).
