105 CMR, § 158.032 - Adult Day Health Staffing Requirements
(A) A
Program shall ensure adequate staff are on duty at all times so that the
health, safety, and care needs of each participant are met.
(B)
Licensed Nursing
Staff.
(1) All Programs shall
provide sufficient, licensed nursing staff to ensure that preventive measures,
treatments, medications, nutritional care, rehabilitation services, therapeutic
activities, and related services are carried out, recorded, and reviewed, in
accordance with participant assessments and plans of care.
(a) A Program must ensure licensed nursing
staff are on-site for a minimum of eight hours per day, four of which must be
provided by a registered nurse. The balance of the coverage may be provided by
a licensed practical nurse.
(b)
When the census reaches 35 members or more, the Program must provide nursing
coverage on-site for a minimum of 12 hours per day, four hours of which must be
provided by a registered nurse.
(c)
When the census reaches 50 members or more, the Program must provide nursing
coverage on-site for a minimum of 16 hours per day, eight hours of which must
be provided by a registered nurse.
(d) When the census reaches over 75 members,
the Program must increase the nursing coverage in proportion to the
requirements listed in 105 CMR 158.032(B)(1)(a) through (d).
(2) When a registered nurse is
absent from the Program due to vacation or other temporary circumstances, the
Program shall designate a licensed nurse to fulfill the nursing duties within
the designee's scope of practice to act as a relief nurse in accordance with
Department guidance.
(C)
Program Aide Staff.
(1) A Program shall provide at least one
qualified Program Aide per 12 participants attending the Program.
(2) A Program shall ensure a sufficient
number of qualified Program Aide staff are available at all times to provide
necessary supervision and assistance for each participant in accordance with
participant needs and plans of care, written policies and procedures, and 105
CMR 158.000.
(3) Licensed nursing
staff shall supervise Program Aides.
(D)
Service Coordination
Staff. A Program with a licensed program capacity of 24 or more
participants shall provide a social worker or other staff person who is
appropriately licensed or supervised pursuant to 258 CMR 12.00: Scope
of Practice for at least 20 hours per week.
(E)
Therapeutic Activity
Director. A Program shall provide a therapeutic activity director
who is on-site at least four hours per day.
(F)
Dietary Staff.
(1)
Registered
Dietitian. A Program shall provide a registered dietitian to
monitor dietary services. A registered dietitian shall be on-site for a minimum
of four hours every six months.
(2)
Qualified Cook. A Program that prepares meals on-site
shall employ a qualified cook. A Program shall ensure the qualified cook is
available on-site for a sufficient number of hours to effectively manage all
aspects of the meal service and kitchen functions.
(3) A Program shall provide sufficient
numbers of adequately trained personnel to plan, prepare, and serve the proper
diets to participants. All dietary staff shall be 18 years of age or
older.
(G)
Direct Care Staff.
(1) A Program shall provide at least one
direct care staff person per six participants attending the Program.
(2) A Program shall ensure a sufficient
number of qualified direct care staff are available at all times to provide
necessary care, supervision, and assistance for each participant in accordance
with participant assessed needs, plans of care, written policies and
procedures, and 105 CMR 158.000.
Notes
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