6 Pa. Code § 11.101 - Intake screening
(a) The
center shall complete, or arrange for the completion of, an intake screening
for each applicant in order to determine the appropriateness of the older adult
daily living center for that individual. The screening shall be completed
within 60 days prior to admission.
(b) The following information shall be
included in an individual client file:
(1)
The applicant's name, address, birth date, social security number and phone
number.
(2) The referral
source.
(3) The usual living
arrangement, describing the following:
(i) The
dwelling unit.
(ii) The present
address.
(iii) The usual means of
transportation.
(4) A
social history, including past and present occupation and types of activities
enjoyed.
(5) Client-rated health
status, allergies or contraindicated medication and current
medications.
(6) The names and
phone numbers of the primary physician, other physicians or CRNP involved, and
of an emergency contact person.
(7)
The community agencies involved in providing formal services, and the
designation of care manager, if any; a list of informal supports; identity of,
and limitations or restraints on, the primary caregiver, problems with
caregiving, the extent of perceived caregiver burden, and the extent of
caregiver need for support.
(8) The
limitations of the client relating to ADLs, IADLs and mobility; and the use of
physical aids.
(9) Special
instructions for the client's diet, food allergies and special diets.
(10) Cognitive functioning, describing:
(i) The client's orientation.
(ii) Recent memory.
(iii) Distant memory.
(iv) The ability to understand directions and
to communicate needs.
(v) The
awareness of danger, risks and consequences.
(11) The emotional status and behavior,
describing:
(i) Recent stressful
events.
(ii) Response to
illness.
(iii) Emotional strengths,
expectations and motivation.
(iv)
Mental health treatment.
(v)
Current emotional problems or related behaviors, such as wandering or
sleeplessness.
(vi) The need for
supervision.
(12) The
identity of the person authorized to make decisions under advance directives,
such as durable power of attorney.
(13) Religious affiliation, if the client
chooses to divulge this information.
(c) An applicant cannot become a center
client unless the center determines, based on the information in subsection (b)
and other information available to the center, that the applicant meets the
criteria for admission in §
11.4 (relating to admissions
criteria).
(d) The center shall
notify applicants who do not meet criteria for admission, as specified in this
section and in §
11.4, of the determination within 30 days of the
completion of intake screening.
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