Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.106 - Supportive and Optional Services

Current through Reg. 50, No. 138; July 16, 2024
In addition to the minimum Basic Services, the Center may
				  choose to provide Supportive and Optional Services. If provided, such services
				  must be administered by Staff qualified to provide such services and within the
				  criteria established by relevant Florida Statutes. The following are examples
				  of such services:
(1) Health or social
				services such as assessment, counseling, treatment and referral.
(2) Speech therapy provided by or under the
				supervision of an individual licensed under chapter 468, part I, F.S., who has
				a certification of clinical competence from the American Speech and Hearing
				Association, and who has completed the equivalent education requirements and
				work experience necessary for certification, or who has completed the academic
				program and is acquiring supervised work experience to qualify for the
				certificate. Progress notes shall be maintained and must be written in the
				Participant's File and signed by the speech therapist as services are
				provided.
(3) Physical therapy must
				be provided by, or under the supervision of, an individual who is a graduate of
				a program of physical therapy approved by both the Council on Medical Education
				of the American Medical Association and the American Therapy Association, or
				the equivalent, and licensed by the State. Progress notes shall be maintained
				and must be written in the Participant's File and signed by the physical
				therapist as services are provided.
(4) Occupational therapy as an adjunct to
				treatment of persons with physical and mental limitations must be provided by,
				or under the supervision of, an individual who is registered by the American
				Occupational Therapy Association; or a graduate of a program approved by the
				Council on Medical Education of the American Medical Association and engaged in
				the supplemental clinical experience required before registration by the
				American Occupational Therapy Association. Progress notes shall be written in
				the Participant's File and signed by the occupational therapist as services are
				provided.
(5) Modified diets or
				diets based on the normal diet and designed to meet the requirements of a given
				situation such as altering individual nutrients, caloric values, consistency,
				flavor, techniques of service or preparation, content of specific foods, or a
				combination of these factors, may be provided as an optional service. When
				modified diets are provided, a physician's written or documented oral order for
				each Participant receiving a modified diet shall be on file. A menu including
				types and amounts of food to serve will be on file in the food service area.
				Diets shall be prepared and served as ordered by the physician.
(6) Adult day health care services for
				disabled adults or aged persons, provided the Center complies with the
				following:
(a) Make services available for a
				minimum of five hours per day five days per week, excluding legal holidays as
				posted by the facility. For purposes of this subsection, legal holiday shall
				mean any day which, by the laws of this state or the United States, is
				designated or recognized as a legal or public holiday or any day on which
				businesses or institutions are customarily closed.
(b) Provide or coordinate, in addition to the
				Basic Services specified in rule
				59A-16.105, F.A.C., and
				Supportive and Optional Services, pursuant to subsections (1), (2), (3), (4)
				and (5), the following adult day health care services:
1. Medical screening emphasizing prevention
				and continuity of care which includes routine blood pressure checks or blood
				glucose diabetic maintenance checks,
2. Nursing services including a configuration
				of services at different levels of intensity as determined by the nursing
				assessment, Participant Care Plan, and physician's orders. Services shall
				include:
a. Health education and counseling
				including nutritional advice, liaison with the Participant's personal
				physician, and notification of the Participant's physician, as well as the
				caregiver or family of any changes in the Participant's health status,
b. Coordination of the provision
				of other health services provided outside the Center,
c. Supervision of health services provided by
				program aides.
3. Social
				services including: counseling for Participants' families and caregivers;
				compilation of a social history and psychosocial assessment of formal and
				informal support systems; mental and emotional status; caregiver data;
				information on planning for discharge; and referral for persons not appropriate
				for adult day care.
4. Additional
				medical services such as dental, ophthalmological, optometric, hearing aid, or
				laboratory services.
5.
				Transportation Services to and from the adult day health care
				services.
(c) In addition
				to the minimum staffing required in chapter 59A-16, F.A.C., provide the
				following Staff:
1. The Operator shall: have
				a minimum of a Bachelor's degree in a health or social services or related
				field, with one year of supervisory experience in a social or health service
				setting; hold a registered nurse license with one year of supervisory
				experience; or have 5 years of supervisory experience in a social or health
				service setting.
2. A registered
				nurse (RN) or licensed practical nurse (LPN) shall be on-site during the
				primary hours of program operation and on-call during all hours the Center is
				open. Arrangements shall be formalized for obtaining the services of an LPN or
				RN in anticipation of potential absences, planned and unplanned, of the regular
				nursing Staff.
3. A social worker
				with a minimum of a Bachelor's degree in social work or a case worker with a
				minimum of a Bachelor's degree in sociology, psychology, nursing, or
				gerontology, or a Bachelor's degree with at least two years of experience in a
				human service field. Services provided by program aides in this service area
				must be provided under the direct supervision of a social worker or case
				manager who meets or exceeds these standards (e.g., a Master's degree in a
				related field).
4. An activity
				director or Recreational Therapist with a Bachelor's degree in a social or
				health service field or an Associate's degree in a related field plus 2 years
				of experience. All services provided by program aides must be provided under
				the direct supervision of the activity director or recreation therapist. The
				recreation therapist may be retained as a consultant.
(d) Documentation of services provided under
				this section must be in the Participant Care Plan and stored in the Participant
				File. Participant Care Plans must be reviewed at least quarterly by a
				multidisciplinary team. At a minimum, narrative nursing, social work, and
				activity notes must be entered in the participant's record quarterly,
				indicating the Participant's progress toward achieving health goals. More
				frequent notes are required if indicated by the Participant's
				condition.