Title: Section 759.5 - Admission, continued stay, and registrant assessment

Effective Date

06/14/2017

759.5 Admission, continued stay, and registrant assessment.

(a) The operator shall:

(1) select and admit to and retain in the adult day health care program only those persons for whom adequate care and needed services can be provided and who, according to the comprehensive assessment, can benefit from the services provided on the basis of at least one (1) visit per week to the program;

(2) assess each applicant, unless the assessment was conducted by a managed care organization or care coordination model that referred the applicant to the adult day health care program, utilizing an assessment instrument provided by the department as part of the admission review process, which assessment shall include, at a minimum, the following:

(i) medical needs, including the determination that the applicant is expected to need continued service for a period of 30 or more days from the date of the completion of the comprehensive assessment;

(ii) use of medication and required treatment;

(iii) nursing care needs;

(iv) functional status;

(v) mental/behavioral health status;

(vi) sensory impairments;

(vii) rehabilitation therapy needs, including a determination regarding the specific need for physical therapy, occupational therapy, and speech language pathology services;

(viii) family and other informal supports;

(ix) home environment;

(x) psycho-social needs;

(xi) financial status;

(xii) nutritional status

(xiii) ability to tolerate the duration and method of transportation to the program;

(xiv) evidence of any substance abuse problem; and

(xv) need for HIV risk reduction counseling.

(3) register each applicant only upon recommendation from the applicant's physician and after completion of a personal interview by qualified personnel with the applicant, next of kin and/or sponsor;

(4) register each applicant only after determining that the applicant is not receiving the same services from any other facility or agency;

(5) determine whether the applicant is receiving primary medical care and, if so, where the care is provided;

(6) admit an applicant to the service only after execution of a written agreement which shall include but not be limited to a requirement that:

(i) the applicant agrees to a medical examination at a physician's office, the facility or other appropriate site, within six weeks prior to or seven days after admission; and

(ii) the operator provides to the applicant, next of kin and/or sponsor a written list of basic services furnished by the facility to registrants and paid for as part of the registrant visit at daily, weekly or monthly rates;

(7) record all financial arrangements with the applicant or designated representative, with copies executed by and furnished to each party;

(8) make no arrangement for prepayment for basic services exceeding one month; and

(9) comply with the provision of financial policies as set forth in the applicable section of this Title;

(b) An individual may be registered in an adult day health care program only if his or her comprehensive assessment indicates that the program can adequately and appropriately care for the physical and emotional health needs of the individual.

(c) No applicant suffering from a communicable disease that constitutes a danger to other registrants or staff may be registered or retained for services on the premises unless a physician certifies that the registrant presents no significant risk to any person.

(d)  The operator may admit, on any given day, up to 10% over the approved capacity for that program.  The average annual capacity, however, may not exceed the approved capacity of the operator’s program.

 

Volume

VOLUME E (Title 10)

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