Ariz. Admin. Code § R9-10-1107 - Enrollment

A. An administrator shall ensure that a participant provides evidence of freedom from infectious tuberculosis:

1. Before or within seven calendar days after the participant's enrollment, and

2. As specified in R9-10-113.

B. Before or at the time of enrollment, an administrator shall ensure that a participant or the participant's representative signs a written agreement with the adult day health care facility that includes:

1. The participant's name and date of birth,

2. Enrollment requirements,

3. A list of the customary services that the adult day health care facility provides,

4. A list of services that are available at an additional cost,

5. A list of fees and charges,

6. Procedures for termination of the agreement,

7. A copy of participant rights,

8. 7. The requirements of the adult day health care facility,

9. 8. The names and telephone numbers of individuals designated by the participant to be notified in the event of an emergency, and

10. 9. A copy of the adult day health care facility's procedure on health care directives.

C. An administrator shall give a copy of the agreement in subsection (B) to the participant or the participant's representative and keep the original in the participant's medical record.

D. An administrator shall ensure that a participant has a signed written medical assessment that:

1. Was completed by the participant's medical practitioner within 60 calendar days before enrollment; and

2. Includes:

a. Information that addresses the participant's:

i. Physical health;

ii. Cognitive awareness of self, location, and time; and

iii. Deficits in cognitive awareness;

b. Physical, mental, and emotional problems experienced by the participant;

c. A schedule of the participant's medications;

d. A list of treatments the participant is receiving;

e. The participant's special dietary needs; and

f. The participant's known allergies.

E. At the time of enrollment, an administrator shall ensure that the participant or participant's representative:

1. Documents whether the participant may sign in and out of the adult day health care facility; and

2. Provides the following:

a. The name and telephone number of the:

i. Participant's representative;

ii. Family member to be contacted in an emergency;

iii. Participant's medical practitioner; and

iv. Adult who provides the participant with supervision and assistance in the preparation of meals, housework, and personal grooming, if applicable; and

b. If applicable, a copy of the participant's health care directive.

F. An administrator shall ensure that a comprehensive assessment of the participant:

1. Is completed by a registered nurse before the participant's tenth visit or within 30 calendar days after enrollment, whichever comes first;

2. Documents the participant's:

a. Physical health,

b. Mental and emotional status, and

c. Social history; and

3. Includes:

a. Medical practitioner orders,

b. Adult day health care services recommended for the participant's care plan, and

c. The signature of the registered nurse conducting the comprehensive assessment and date signed.

Notes

Ariz. Admin. Code § R9-10-1107

Adopted effective July 22, 1994 (Supp. 94-3). Section repealed; new Section made by exempt rulemaking at 19 A.A.R. 2015, effective October 1, 2013 (Supp. 13-2). Amended by exempt rulemaking at 20 A.A.R. 1409, effective 7/1/2014.