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STATE OF NEVADA SERVICE
SPECIFICATIONS Any
exceptions to these Service Specifications must be requested in advance in
writing and approved by the Administrator. SERVICE DEFINITION: This service provides planned care for dependent adults in
a supervised, protective; congregate setting during some portion of a day. SERVICE CATEGORIES AND UNIT
MEASURES: The following service categories and unit measures
established by the Administration on Aging (AoA) must be used to document the
amount of service provided: Adult Day
Care/Adult Day Health: Provision of personal care for dependent adults
in a supervised, protective, congregate setting during some portion of a
twenty-four hour day. Services offered in conjunction with adult day care/adult
day health typically include social and recreational activities, training,
counseling, meals for adult day care and services such as rehabilitation,
medications assistance, and home health aide services for adult day
health. Adult Day Care/Social Model: Provision of personal care for adults in a supervised, protective, congregate setting during some portion of a twenty-four hour day. Services offered in conjunction with adult day care typically include social and recreational activities, counseling, nutrition, memory retention, music therapy, pet therapy, and arts and crafts for an adult day care center. Pursuant to NAC 449.4081, participants of social adult day care programs must be able to administer their own medications. If the facility accepts a participant who is not able to administer his/her medication, a Licensed Practical Nurse may be allowed to provide this service under the supervision of a contracted Registered Nurse. For reporting purposes, one unit equals one hour of
service. For fiscal reimbursement purposes, one to four hours
of service equals a reimbursement of $6.67 per hour. Five or more hours of
service equals one day and a total reimbursement of $40.00. GENERAL REQUIREMENTS: A.
Pursuant to NRS 449.001 - 449.240 all facilities must meet the Licensure
requirements established by the State of Nevada, Health Division, Bureau of
Licensure and Certification. B. Maintain copies of all licenses, certifications and provider agreements with other agencies. Maintain copies of all evaluations and inspection reports conducted by licensing organizations and boards. C.
Report to DAS all arrests or complaints filed in criminal or civil court
involving the facility or the licensee within one working day. SPECIFICATIONS: 1.
Required Services: 1.1
Establish written admission and screening procedures to ensure that adult
day care is an appropriate setting for referred clients. 1.2
Participants must be furnished one mid-day meal meeting 1/3 of the
Recommended Dietary Allowances (RDA) established by the Food and Nutrition Board
of the National Research Council of the National Academy of Sciences. An
appropriate mid-morning and mid-afternoon snack must also be provided. 1.3
Provide daily activities as indicated in the patient care plan, which
includes: activities of daily
living, socialization, recreation, and physical and mental activities to
stimulate short-term memory. 2.
Optional Services: 2.1
Provide specialized services as indicated in patient care plan to include:
administering and monitoring medications; physical, occupational and speech
therapy; and group counseling. 2.2
Arrange for family counseling and support groups as necessary. 3. Service Prohibitions: 3.1
Participants must not be bedridden, unmanageable, contagious, or lacking in the
stamina to attend the program for five (5) hours per day. Persons that are HIV
positive or have AIDS are not considered contagious. 3.2
Physical and Chemical restraints are prohibited unless prescribed by a physician
and a protocol has been established for their use. 4.
Assessment/Certification: 4.1
An assessment of participants will be made in conjunction with the
caregiver or family before initiation of service. Assessment documentation will
include baseline data regarding the participant’s physical and mental health,
activities of daily living skills, nutritional needs, medications, interests,
and special needs. 4.2 Each participant will be reassessed, at a minimum, every twelve (12) months, in consultation with the caregiver or family members. 4.3
Develop an individualized care plan for each participant, based on the
assessment, which includes goals and objectives for participants with specific
time frames. Document the progress of participants in achieving the goals. The
care plan must be modified, as necessary, following each reassessment and signed
by the caregiver. The care plan must be maintained in the participant’s file
and available for review by the caregiver. 5.
Operating Procedures: 5.1
Provide for the safety of all participants. Develop and implement safeguards to
prevent participants from leaving the site without supervision. Assure the
physical surroundings are free of hazardous conditions. 5.2
Provide appropriate levels of client supervision. As per Nevada Administrative
Code (NAC) 449.40723 Supervision of clients; volunteers. A client must be
supervised by an employee of the facility at all times during the operational
hours of the facility. The employee shall report a change in any physical,
mental, emotional or social function of the client to the director of the
facility. These reports must be included in the client’s file. 5.3
For individuals in long-term or group care facilities, Adult Day Care may only
be provided when there is a discharge plan which indicates a definite time-line
for transition back into the community within one hundred twenty (120) calendar
days of initial service delivery. 5.4
A daily record of the time of arrival and departure of each participant must be
maintained. 5.5
A waiting list is to be established only after all other measures for improving
the efficiency of the service delivery system have been examined and, when
feasible, implemented. Grantees are required to establish a waiting list policy
that will be activated in the event that the demand for service exceeds the
program’s capacity. Waiting list documentation must include, at a
minimum: 5.5.a.
the client’s name, address, and telephone number; 5.5.b.
the date the client was placed on the waiting list; and 5.5.c.
the description of each client’s need for service. Clients with the greatest needs are to receive priority consideration. The program must establish a procedure for updating the continued service needs of clients placed on the waiting list. 6.
Training: 6.1
Staff and volunteers must be provided training in working with disabled
adults. Maintain training documentation indicating date of training, topics
covered, and staff members who received training. 7.
Quality Improvement: 7.1 Conduct at least one quality assurance review annually. The review must evaluate the quality of service provided by the program and the adequacy of documentation. The results of the review must document any program deficiencies and contain a plan of correction.
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