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Title: Section 492.6 - Program planning and implementation.

492.6 Program planning and implementation. (a) The operator must assure that each participant in a nonresident services program has an individualized written plan for services prepared by the program director.

(b) In developing the plan, the program director must involve the participant, caregiver, other professionals and the local department of social services, as appropriate. The service plan must describe:

(1) the needs of the participant;

(2) the service goals for the participant while in the nonresident services program and the manner in which they will integrate with other care being rendered by other service providers;

(3) the services to be provided;

(4) the name of the staff member responsible for implementing the service plan; and

(5) the time limit for the plan, with provision for review and renewal.

(c) The operator must have a program plan which meets the following criteria:

(1) Overall planning of services and activities must reflect the individual service plans.

(2) The primary program mode must be group activities with provision for individual activities and services.

(3) Staff will encourage participants to engage in the planning and operation of the program.

(4) Staff will encourage participants and residents to attend meals and activities together.

(5) Staff will explore and utilize other available community resources as a regular part of the program activities.

(6) The operator will supply adequate and appropriate equipment and supplies.

(7) Physical activity will be encouraged within the participant's limitations, as determined by information furnished by the participant's physician.

(8) Activities designed to improve the capacity of the participants for selfcare and personal hygiene will be provided.

(9) Participants will be afforded the opportunity to rest; there will be a sufficient number of lounge chairs available for participants' needs.

(10) Participants may refuse to participate in any activity of the nonresident services program.

(d) A schedule of activities must be prepared and must:

(1) be in writing;

(2) be planned for a two-week period, one week in advance of its implementation;

(3) specify each activity to be provided, the days of the week each activity will be conducted, and the approximate duration of each activity; and

(4) be posted in a conspicuous place in the area where the nonresident services program will be conducted.

(e) If activities for participants and residents are jointly planned and conducted, one schedule of activities provided in accordance with applicable provisions of section 487.7 of this Title may be used.

(f) There will be a minimum of four hours of planned activities for each program day.

(g) Personal care services will be provided in accordance with applicable provisions of sections 487.7 and 488.7 of this Title.

(h) Supervision services will be provided in accordance with applicable provisions of sections 487.7 and 488.7 of this Title.

(i) The program director will encourage caregivers to transport the participants to and from the facility.

(j) The program director will coordinate the utilization of volunteers and other resources in the community for the purpose of transporting participants to the facility.

(k) The operator may transport participants to and from the program.

(l) If a participant wants or needs to leave the program before the scheduled departure time, the participant's caregiver must be notified before the participant leaves the facility. Such notification must be documented in the participant's case record.

(m) If a participant does not arrive as scheduled and the facility has not been contacted about the delay, the program director will immediately attempt to contact the participant, caregiver or representative to determine the reason for the absence.

(n) Any abrupt or progressive changes in a participant's behavior or appearance which suggests the need for additional help or services will be reported as follows:

(1) A report will be made immediately to the participant's caregiver and local department of social services caseworker if the participant is a social services client.

(2) The report will be made to the caregiver or representative if the participant is not a social services client.

(3) The report will be made to the local department of social services if the participant has no caregiver or representative.

(4) Any action taken by the operator or program director as a result of changes in the participant's behavior or appearance will be noted in the participant's case record.

(o) The operator will offer referral services to participants and caregivers when such persons are in need of services not otherwise provided by the facility.



VOLUME B-1 (Title 18)