Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 480 - HOME AND COMMUNITY-BASED SERVICES › Chapter 4 - PROVIDER REQUIREMENTS › Section 480-4-003 - SERVICE SPECIFIC PROVIDER REQUIREMENTS

Current through June 17, 2024
003.01
ADULT DAY HEALTH SERVICES (ADHS).
The Department
  enrolls providers of Adult Day Health Services (ADHS) ensuring all applicable
  federal, state, and local laws and regulations are met. These standards include
  but are not limited to, regulations located in Title 175 NAC
  5-000. Providers are subject to the
  additional standards that follow.
003.01(A)
PROVIDER STANDARDS.
Providers of Adult Day Health
  Services (ADHS) must obtain adequate information on the medical and personal
  needs of each participant, if applicable; and observe and report all changes to
  the services coordinator.
003.01(B)
FACILITY STANDARDS.
Each Adult Day Health Service
  (ADHS) facility must meet all applicable federal, state, and local fire,
  health, and other standards prescribed in law or regulation. The provider is
  responsible for ensuring that services are provided in an integrated,
  community-based setting. This includes the following standards:
(i)
ATMOSPHERE AND
  DESIGN.
(1) The facility must be
  architecturally designed to accommodate the needs of the participants being
  served;
(2) Furniture and equipment
  used by participants must be adequate;
(3) Toilets must be in working order and
  easily accessible from all program areas; and
(4) A telephone must be available for
  participant use.
(ii)
LOCATION AND SPACE.
The provider must ensure that the
  facility has sufficient space to accommodate the full range of program
  activities and services including:
(1)
  Flexibility for large and small group and individual activities and
  services;
(2) Storage space for
  program and operating supplies;
(3)
  A rest area, adequate space for special therapies, and designated areas to
  permit privacy and isolate participants who become ill;
(4) Adequate table and seating space for
  dining;
(5) Outside space available
  for outdoor activities and accessible to participants; and
(6) Adequate space for outer garments and
  private possessions of the participants.
(iii)
SAFETY AND
  SANITATION.
The facility must ensure that:
(1) The facility is maintained in compliance
  with all applicable local, state, and federal health and safety regulations.
  See 175 NAC
  5-000, Nebraska Revised Statute §
												81-2,257.01
  and
  81-2,244.01,
  and the Nebraska Food Code as published by the Nebraska Department of
  Agriculture;
(2) If food is
  prepared at the center, the food preparation area must comply with all
  applicable federal, state, and local laws. See 175 NAC
  5-000, Nebraska Revised Statute §
												81-2,257.01
  and
  81-2,244.01,
  and the Nebraska Food Code as published by the Nebraska Department of
  Agriculture;
(3) At least two
  well-identified exits are available;
(4) Stairs, ramps, and interior floor have
  non-slip surfaces or carpet;
(5)
  The facility is free of hazards including but not limited to, exposed
  electrical cords, improper storage of combustible material;
(6) All stairs, ramps, and barrier-free
  bathrooms are equipped with usable handrails; and
(7) A written plan for emergency care and
  transportation is documented in the participant's file.
003.01(C)
STAFFING.
Each center must be staffed at all times by
  at least one full-time trained staff person during operating hours. The center
  must maintain an appropriate ratio of direct care staff to participants
  sufficient to ensure that participant needs are met. The center must develop
  written job descriptions and qualifications for each professional, direct care,
  and non-direct care position.
003.01(D)
PROVIDER SKILLS AND
  KNOWLEDGE.
Direct care staff members must:
(i) Have training or, one or more years of
  experience in working with adults in a health care or social service
  setting;
(ii) Have training or
  knowledge of cardiopulmonary resuscitation (CPR) and first aid;
(iii) Be able to recognize distress or signs
  of illness in participants;
(iv)
  Have knowledge of available medical resources, including emergency
  resources;
(v) Have access to
  information on each participant's address, telephone number, and means of
  transportation; and
(vi) Know
  reasonable safety precautions to exercise when dealing with participants and
  their property.
003.01(E)
LICENSED NURSE.
The provider must have a licensed
  nurse on staff, or contract with a licensed nurse, who will provide the health
  assessment and nursing service component of Adult Day Health Service (ADHS) and
  supervise activities of daily living (ADLs) as well as activities of daily
  living (ADL) training components.
003.01(F)
ADULT DAY HEALTH
  SERVICE (ADHS) RATES AND FREQUENCY.
The frequency of service is a
  calendar day of at least four hours. In the event that a Waiver participant
  must leave the Adult Day Health Services (ADHS) facility due to an unplanned
  need and has been there less than four hours, this is considered a full day for
  reimbursement purposes. The Department establishes a statewide rate for Adult
  Day Health Services (ADHS).