No. 26993 (Amendment): R432-150-6. Reserved

DAR File No.: 26993
Filed: 03/12/2004, 11:49
Received by: NL

 

RULE ANALYSIS

Purpose of the rule or reason for the change:

This change allows nursing care facilities licensed by the Department of Health to offer adult day care services within a licensed health care facility without needing to be licensed by the Department of Human Services as well.

 

Summary of the rule or change:

This rulemaking establishes standards for adult day care services offered by licensed nursing care facilities.

 

State statutory or constitutional authorization for this rule:

Title 26, Chapter 21

 

Anticipated cost or savings to:

the state budget:

There will be some cost to print the modifications of the rule and distribute it to licensed health care facilities.

 

local governments:

No cost increase or decrease anticipated since this is an optional service for a nursing care facility owned or operated by a local government. There may be an additional income to the government-owned facility that decides to operate adult day care.

 

other persons:

No cost increase or decrease anticipated since this is an optional service for a nursing care facility owned or operated privately. There may be an additional income to the privately-owned facility that decides to operate an adult day care.

 

Compliance costs for affected persons:

This is an optional service therefore there should not be a cost unless the organization elects to offer this service.

 

Comments by the department head on the fiscal impact the rule may have on businesses:

This rule requires nursing care facilities that choose to offer adult day services to meet the same standards required of free standing adult day care operations. Fiscal impact should be minimal. Scott D. Williams, M.D.

 

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Health Systems Improvement, Licensing
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY UT 84116-3231

 

Direct questions regarding this rule to:

Debra Wynkoop at the above address, by phone at 801-538-6152, by FAX at 801-538-6325, or by Internet E-mail at [e-mail]

 

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

05/03/2004

 

This rule may become effective on:

05/04/2004

 

Authorized by:

Scott D. Williams, Executive Director

 

 

RULE TEXT

R432. Health, Health Systems Improvement, Licensing.

R432-150. Nursing Care Facility.

R432-150-6. [Reserved.]Adult Day Care Services.

[Reserved.](1) Nursing Care Facilities may offer adult day care and are not required to obtain a license from Utah Department of Human Services. If a facility provides adult day care, it shall submit policies and procedures for Department approval.

(2) In this section:

(a) "Adult Day Care" means nonresidential care and supervision for at least four but less than 24 hours per day, that meets the needs of functionally impaired adults through a comprehensive program that provides a variety of health, social, recreational, and related support services in a protective setting.

(b) "Consumer" means a functionally impaired adult admitted to or being evaluated for admission in a facility offering adult day care.

(3) The governing board shall designate a qualified Director to be responsible for the day-to-day program operation.

(4) The Director shall maintain written records on-site for each consumer and staff person, which shall include the following:

(a.) demographic information;

(b.) an emergency contact with name, address and telephone number;

(c.) consumer health records, including the following:

(i) record of medication including dosage and administration;

(ii) a current health assessment, signed by a licensed practitioner; and

(iii) level of care assessment.

(d.) signed consumer agreement and service plan.

(e) employment file for each staff person which includes:

(i) health history;

(ii) background clearance consent and release form;

(iii) orientation completion, and

(iv) in-service requirements.

(5) The facility shall have a written eligibility, admission, and discharge policy that includes the following:

(a) intake process;

(b) notification of responsible party;

(c) reasons for admission refusal, including the Director's written, signed statement;

(d) resident rights notification; and

(e) reason for discharge or dismissal.

(6) Before a facility admits a consumer, it must first assess, in writing, the consumer's current health and medical history, immunizations, legal status, and social psychological factors to determine whether the consumer may be placed in the program.

(7) The Director or designee, the responsible party, and the consumer if competent shall develop a written, signed consumer agreement. The agreement shall include:

(a) rules of the program;

(b) services to be provided and cost of service, including refund policy; and

(c) arrangements regarding absenteeism, visits, vacations, mail, gifts and telephone calls.

(8) Within three days of admission to the program, the Director or designee, shall develop an individual consumer service plan that the facility shall implement for the consumer. The service plan shall include the specification of daily activities and services. The Director or designees shall reevaluate, and modify if necessary, the consumer's service plan at least every six months.

(9) The facility shall make written incident and injury reports to document consumer death, injuries, elopement, fights or physical confrontations, situations which require the use of passive physical restraint, suspected abuse or neglect, and other situations or circumstances affecting the health, safety or well-being of a consumer while in care. The facility shall document the actions taken, including actions taken to avoid future incident or injury, and keep the reports on file. The Director shall notify and review the incident or injury report with the responsible party no later than when the consumer is picked up at the end of the day.

(10) The facility shall post and implement a daily activity schedule.

(11) Consumers shall receive direct supervision at all times and be encouraged to participate in activities.

(12) There shall be a minimum of 50 square feet of indoor floor space, excluding hallways, office, storage, kitchens, and bathrooms, per consumer designated for adult day care during program operational hours.

(13) All indoor and outdoor areas shall be maintained in a clean, secure and safe condition.

(14) There shall be at least one bathroom designated for consumers use during business hours. For facilities serving more than 10 consumers, there shall be separate male and female bathrooms designated for consumer use.

(15) Staff supervision shall be provided continually when consumers are present.

(a) When eight or fewer consumers are present, one staff member shall provide continuous, direct supervision.

(b) For each eight additional consumers, or fraction thereof, the facility shall provide an additional staff member to provide continuous, direct supervision. For example, ten consumers require two staff members.

(c) If one-half or more of the consumers is diagnosed by a physician's assessment with Alzheimer's or other dementia, the ratio shall be one staff for each six consumers, or fraction thereof.

 

KEY: health facilities

[December 1, 1999]2004

Notice of Continuation October 9, 2002

26-21-5

26-21-16