AAA-provider agreement for ADS that is paid, in whole or in part, with Older
Americans Act funds
(2) Service requirements:
(a) Transportation: The provider shall
transport each consumer to and from the center by performing
a transportation
service that complies with rule
173-3-06.6 of the Administrative
Code, unless the provider enters into a contract with another provider who
complies with rule
173-3-06.6 of the Administrative
Code, or unless the caregiver
provides
transports or designates another person or
non-provider, other than the center provider, to transport the consumer to and
from the center.
(b) Case manager's
assessment: If the consumer receives a case management service as part of care
coordination:
(i) The case manager shall
assess each consumer's needs and preferences then specify which service level
will be approved for each consumer; and,
(ii) The provider shall retain records to
show that it provides the service at the level that the case manager
authorized.
(c)
Provider's initial assessment:
(i) The
provider shall assess the consumer before the end of the consumer's second day
of attendance at the center. If the consumer is enrolled in care coordination,
the provider may substitute a copy of the case manager's assessment of the
consumer if the case manager assessed the consumer no more than thirty days
before the consumer's first day of attendance at the center.
(ii) The initial assessment shall include
both of the following components:
(a)
Functional and cognitive profiles that identify the ADLs and IADLs that require
attention or assistance of the provider's staff members.
(b) Social profile including social activity
patterns, major life events, community services, caregiver data, formal and
informal support systems, and behavior patterns.
(d) Health assessment: No later
than thirty days after the consumer's initial attendance at the center or
before the consumer receives the first ten units of service at the center,
whichever comes first, the provider shall either obtain a health assessment of
each consumer from a licensed healthcare professional whose scope of practice
includes health assessments or require a staff member who is such a licensed
healthcare professional to perform a health assessment of each consumer. The
health assessment shall include the consumer's psychosocial profile and
shall identify the consumer's risk factors,
diet, and medications. If the licensed healthcare professional who performs the
health assessment is not a staff member of the provider, the provider shall
retain a record of the professional's name and phone number.
(e) Activity plan: No later than thirty days
after the consumer's initial attendance at the center or before the consumer
receives the first ten units of service at the center, whichever comes first,
the provider shall either obtain the services of a licensed healthcare
professional whose scope of practice includes developing activity plans to
draft an activity plan for each consumer or
the
provider shall require a staff member who is such a licensed
healthcare professional to draft an activity plan for each consumer. The plan
shall
identify the consumer's strengths, needs,
problems or difficulties, goals, and objectives. The plan shall describe the
consumer's
do all of the following:
(i)
Identify the
consumer's strengths, needs, problems or difficulties, and
objectives.
(i)(ii)
Describe the consumer's
Interestsinterests, preferences, and social
rehabilitative needs.
(ii)(iii)
Describe the consumer's
Health
health
needs.
(iii)(iv)
Describe the consumer's
Specific
specific goals, objectives, and planned interventions
of ADS that meet the goals.
(iv)(v)
Describe the consumer's
Level
level
of involvement in the drafting of the plan, and, if the consumer has a caregiver, the caregiver's
level of involvement in the drafting of the plan.
(v)(vi)
Describe the consumer's
Ability
ability to provide a unique identifier to verify
receipt of service delivery.
(f) Plan of treatment: Before administering
medication or meals with a therapeutic diet, and before providing a nursing
service, nutrition counseling, physical therapy, or speech therapy, the
provider shall obtain a plan of treatment from a licensed healthcare
professional whose scope of practice includes making plans of treatment. The
provider shall obtain the plan of treatment at least every ninety days for each
consumer that receives medication, a nursing service, nutrition counseling,
physical therapy, or speech therapy. For diet orders that may be part of a plan
of treatment, a new diet order is not required every ninety days. Instead, the
provider
shall comply with
is subject to the diet-order requirements
for therapeutic diets under rule
173-4-06 of the Administrative
Code.
(g) Interdisciplinary care
conference (conference):
(i) Frequency: The
provider shall conduct a conference for each consumer at least once every six
months.
(ii) Participants: The
provider shall conduct the conference between the provider's staff members and
invitees who choose to participate.
If the consumer
receives case management as part of care coordination
At least seven days before the conference begins,
the provider shall invite the
case manager
following persons to participate in the
conference
and provide those persons with the date and
time of the conference. The provider shall
invite any licensed healthcare professional who does not work for the provider,
but who provided the provider with a health assessment of the consumer or an
activity plan for the consumer, to participate in the conference. If the
consumer has a caregiver, the provider shall invite the caregiver to the
conference. The provider shall also invite the consumer to the conference. The
provider shall invite the case manager, licensed healthcare professional,
caregiver, or consumer by providing the date and time to the case manager seven
days before the conference begins.
:
(a)
The
consumer.
(b)
The consumer's case manager, if the consumer receives
case management as part of care coordination.
(c)
Any licensed
healthcare profession who does not work for the provider, but who provided the
provider with a health assessment of the consumer or an activity plan for the
consumer.
(d)
The consumer's caregiver, if the consumer has a
caregiver.
(iii)
Revise activity plan: If the conference participants identify changes in the
consumer's health needs, condition, preferences, or responses to the service,
the provider shall obtain the services of a licensed healthcare professional
whose scope of practice includes developing activity plans to revise the
activity plan accordingly or
shall require
a staff member who is such a licensed healthcare professional to revise the
activity plan accordingly.
(iv) Records: The provider shall
retain records on each conference's determinations.
(h) Activities: The provider shall
announce daily and monthly planned activities through two or more of the
following media:
(i) Posters in prominent
locations throughout the center.
(ii) An electronic display (e.g., a
television) in a prominent location in the center.
(iii) The center's website.
(iv) A direct communication sent to consumers
(and others), such as email, text, mail, or another medium.
(i) Lunch and snacks:
(i) The provider shall provide lunch and
snacks to each consumer who is present during lunchtime or snacktime.
(ii) The provision of lunch shall comply with
paragraphs (A)(7) to (A) (12) of rule
173-4-05 of the Administrative
Code and paragraph (E) of rule
173-4-05.1 of the Administrative
Code.
(3)
Center requirements: A provider
only
qualifies
may qualify for an
AAA-provider agreement to provide ADS if the provider's center
has
meets the
following specifications:
(a) If the center
is housed in a building with services or programs other than ADS,
the provider shall assure that a separate,
identifiable space and staff are available for ADS activities during all hours
in which the provider provides ADS in the center.
(b) The center
shall comply
complies
with the "ADA Accessibility Guidelines for Buildings and Facilities" in
appendix A to 28 C.F.R. Part
36.
(c) The center shall have
has at
least sixty square feet per individual that it serves, excluding hallways,
offices, rest rooms, and storage areas.
(d) The provider shall store
stores
consumers' medications in a locked area that the provider maintains at a
temperature that meets the storage requirements of the medications.
(e) The provider shall store
stores
toxic substances in an area that is inaccessible to consumers.
(f) The center shall have
has at
least one toilet for every ten individuals present that it serves and at least
one wheelchair-accessible toilet.
(g) If the center provides intensive ADS, the
center shall have
has bathing facilities suitable to the needs of
consumers who require intensive ADS.
(4) Staffing levels:
(a) The provider shall have at least two
staff members present whenever more than one consumer is present, including one
who is a paid PCA and one who is certified in CPR.
(b) The provider shall maintain a
staff-to-consumer ratio of at least one staff member to every six consumers at
all times.
(c) The provider shall
have one RN, or LPN under the direction of an RN, available whenever a consumer
who receives enhanced ADS or intensive ADS requires components of enhanced ADS
or intensive ADS that fall within a nurse's scope of practice.
(d) The provider shall employ an activity
director to direct consumer activities.
(5) Provider qualification:
(a) Type of provider:
A provider shall only
Only agency providers qualify to provide ADS
if the provider is an agency
provider.
(b) Staff
qualifications:
(i) Every
person who is an RN, LPN under the direction of
an RN, social worker, physical therapist, physical therapy assistant, speech
therapist, dietitian, occupational therapist, occupational therapy assistant,
or other licensed professional planning
qualifies to practice in the adult day center
shall
only if the
person
possess
has a current and valid license to practice in
their profession.
(ii)
The
A person
qualifies to be an activity director
shall
only if the
person
possess
has at least one of the following:
(a) A baccalaureate or associate degree in
recreational therapy or a related degree.
(b) At least two years of experience as an
activity director, activity assistant or a related position.
(c) Compliance with the qualifications under
rule
3701-17-07 of the Administrative
Code for directing resident activities in a nursing home.
(d) A certification from the national
certification council for activity professionals (NCCAP).
(iii)
Each
A person qualifies to
be an activity assistant
shall
only if the person
possess
has at least
one of the following:
(a) A high school
diploma.
(b) A high school
equivalence diploma as defined in section
5107.40 of the Revised
Code.
(c) At least two years of
employment in a supervised position to provide personal care, to provide
activities, or to assist with activities.
(iv)
Each
A person qualifies to be a PCA
shall
only if the
person
possess
has at least one of the following:
(a) A high school diploma.
(b) A high school equivalence diploma as
defined in section 5107.40 of the Revised
Code.
(c) At least two years of
employment in a supervised position to provide personal care, to provide
activities, or to assist with activities.
(d) The successful completion of a vocational
program in a health or human services field.
(v) Each staff member who provides
transportation to consumers shall comply with all requirements under rule
173-3-06.6 of the Administrative
Code.
(vi) The provider shall retain
records to show that each staff member who has in-person interaction with
consumers meets the staff qualifications under paragraph (B)(5)(b) of this rule
for their job position.
(c) Staff training:
(i) Orientation:
Before each new PCA provides an ADS, the
The provider shall
train the staff member on all of the following:
comply with the requirements for the orientation of
PCAs in rule
173-3-06.5 of the Administrative
Code.
(a)The expectation of employees.
(b)The provider's ethical standards.
(c)An overview of the provider's personnel
policies.
(d)A description of the provider's organization and lines of
communication.
(e)Incident reporting procedures.
(f)Universal precautions for infection control.
(ii) Task-based training: Before
each new PCA provides an ADS, the provider shall provide task-based
training.
(iii) Continuing
education: Each staff member shall successfully complete at least eight hours
of in-service or continuing education on appropriate topics every twelve
months. A staff member's successful completion of one to eight hours of
continuing education or in-service training to maintain a professional license,
certification, or registration used to provide ADS counts towards this
eight-hour requirement if successfully completed during the same calendar
year.
(iv)
Records:
Verification of compliance: The provider shall
retain records showing that it complies with the
training requirements under paragraph (B)(4)(c) of this rule. In doing so, the
provider shall list the instructor's title, qualifications, and signature; date
and time of instruction; content of the instruction; and name and signature of
ADS personal care staff completing the training
comply with paragraph (B)(3)(f) of rule
173-3-06.5 of the Administrative
Code regarding records of each PCA's successful completion of any training and
competency evaluation program, orientation, and inservice training.
(d) Performance
reviews:
(i)(d)
Performance reviews: The provider shall complete
a performance review of each staff member in relation to the staff member's job
description.
(ii) The provider shall retain
records to show that it complies with paragraph (B)(5)(d)(i) of this
rule.
(6) Service verification:
(a) The provider shall verify that
each episode of adult day service for which it bills was provided by one of the
following two methods:
(i) The provider may use an
electronic system if the system does all of the following:
(a)Collects the consumer's name, date of service, consumer's
arrival and departure times (if the service is provided in the center),
consumer's mode of transportation (if the service is provided in the center),
and a unique identifier of the consumer.
(b)Retains the information it collects.
(c)Produces reports, upon request, that the AAA can monitor for
compliance.
(ii)(a) The
provider may use a manual system if the provider
documents all
following are the
reportable
mandatory reporting
information
items for
each episode of service
, including the consumer's
name, date of service, consumer's arrival and departure times (if the service
is provided in the center), and consumer's mode of transportation (if the
service is provided in the center), and collects a unique identifier of the
consumer.
that a provider retains to comply
with the requirements under paragraph (B)(9) of rule
173-3-06 of the Administrative
Code:
(i)
Consumer's name.
(ii)
Service
date.
(iii)
Consumer's arrival and departure times.
(iv)
Consumer's mode
of transportation.
(v)
Unique identifier of the consumer or the consumer's
caregiver to attest to receiving the service.
(b) In the AAA-provider agreement,
the AAA shall not prohibit a provider from using an electronic system or daily
attendance roster (if the service is provided in the center) to collect and
retain the records this rule requires.
(c)(b)
During a state of emergency declared by the governor or a federal public health
emergency, the provider may verify each episode of service provided without
collecting the unique identifier of the consumer or the
consumer's caregiver.
