Current through Bulletin 2024-06, March 15, 2024
(1) A
licensed nursing care facility may provide adult day care without an additional
license from the department.
(2)
The licensee shall submit policies and procedures for adult day care to the
department for approval.
(3) The
governing body shall designate a qualified director to be responsible for the
day-to-day program operation.
(4)
The director shall maintain written records on-site for each client and staff
person, that includes the following:
(a)
demographic information;
(b) an
emergency contact with name, address, and telephone number;
(c) client health records, including the
following:
(i) record of medication including
dosage and administration;
(ii) a
current health assessment, signed by a licensed practitioner; and
(iii) level of care assessment;
(d) signed client agreement and
service plan; and
(e) employment
file for each staff person that includes:
(i)
health history;
(ii) background
clearance consent and release form;
(iii) orientation completion; and
(iv) in-service requirements.
(5) The licensee shall
have a written eligibility, admission, and discharge policy that includes the
following:
(a) intake process;
(b) notification of responsible
person;
(c) reasons for admission
refusal, including the director's written, signed statement;
(d) resident rights notification;
and
(e) reason for discharge or
dismissal.
(6) Before the
licensee admits a client to the facility, the licensee shall ensure the
following are addressed in writing to determine client eligibility for the
program:
(a) current health status;
(b) medical history;
(c) immunizations;
(d) legal status; and
(e) psychological factors.
(7) The licensee shall ensure that
the director or designee, the responsible person, and the client if competent
develops a written, signed client agreement that includes:
(a) rules of the program;
(b) services to be provided and cost of
service, including refund policy; and
(c) arrangements regarding the following:
(i) absenteeism;
(ii) visits;
(iii) vacations;
(iv) mail;
(v) gifts; and
(vi) telephone calls.
(8) The licensee shall ensure the
following:
(a) the director or designee
develops an individual client service plan that is implemented for the client
within three days of admission to the program;
(b) the director or designee ensures the
service plan includes the specification of daily activities and services;
and
(c) the director or designees
shall reevaluate, and change if necessary, the client's service plan at least
every six months.
(9) The
licensee shall maintain the following incident report documentation that
outlines the actions taken, including actions taken to avoid future incident or
injury following any:
(a) client
death;
(b) injuries;
(c) elopement;
(d) fights or physical
confrontations;
(e) situations that
require the use of passive physical restraints;
(f) suspected abuse or neglect; and
(g) other situations or circumstances
affecting the health, safety, or well-being of a client while in
care.
(10) The director
shall notify and review the incident report with the responsible person no
later than when the client is picked up at the end of the day.
(11) The licensee shall post and implement a
daily activity schedule.
(12) The
licensee shall:
(a) ensure clients are
directly supervised at all times and are encouraged to participate in
activities;
(b) provide at least 50
square feet of indoor floor space, excluding hallways, office, storage,
kitchens, and bathrooms, per client designated for adult day care during
program operational hours;
(c)
maintain any indoor and outdoor areas in a clean, secure, and safe
condition;
(d) provide at least one
bathroom designated for client use during business hours;
(e) provide separate male and female
bathrooms designed for client use if serving more than ten clients;
(f) ensure staff supervision is provided
continually when clients are present;
(g) ensure one staff member provides
continuous, direct supervision when eight or fewer clients are
present;
(h) provide continuous,
direct supervision at a ratio of one staff to every eight clients;
and
(i) if one-half or more of the
clients are diagnosed by a physician's assessment with Alzheimer's or other
dementia, the ratio is one staff for every six clients, or fraction
thereof.
