Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-02.1 - ODA provider certification: adult day service

Current through all regulations passed and filed through July 1, 2024
(A)
								"Adult day
			 service" ("ADS") means a regularly-scheduled service provided at an adult day
			 center (center) in a non-institutional, community-based setting and consisting
			 of the activities authorized in an individual's person-centered services plan.
			 ADS includes recreational and educational programming to support an
			 individual's health and independence goals; at least one, but no more than two,
			 meals per day; and, sometimes, health status monitoring, skilled therapy
			 services, and transportation to and from the center. Table 1 to this rule
			 defines the levels and activities of ADS.
Table 1: ADS Activities by Level of
				ADS
ENHANCED
						  ADS
INTENSIVE ADS
Structured activity
						  programming
Yes
Yes
Health
						  assessments
Yes
Yes
Supervision of
						  ADLs
All ADLs
All ADLs
Hands-on assistance with
						  ADLs
Yes, one or more ADL (bathing
						  excluded)
Yes, minimum of two ADLs
						  (bathing included)
Hands-on assistance with
						  medication administration
Yes
Yes
Comprehensive therapeutic
						  activities
Yes
Yes
Monitoring of health
						  status
Intermittent
Regular, with
						  intervention
Hands-on assistance with
						  personal hygiene activities
Yes
Yes
Social work
						  services
No
Yes
Skilled nursing services and
						  rehabilitative nursing services
No
Yes
Rehabilitative and restorative
						  services
No
Yes
(B)
								Requirements to become, and to remain, an ODA-certified
			 provider of ADS:
(1)
									General requirements: The provider is subject to rule
			 173-39-02 of the Administrative
			 Code.
(2)
									Service requirements:
(a)
										Transportation:
			 The provider shall transport each individual to and from the center by
			 performing transportation that complies with rule
			 173-39-02.18 of the
			 Administrative Code, unless the provider subcontracts with another provider
			 that complies with rule
			 173-39-02.18 of the
			 Administrative Code, or unless the caregiver transports or designates another
			 person, other than the center's provider, to transport the individual to and
			 from the center.
(b)
										Provider's initial assessment:
(i)
											The provider
			 shall assess the individual before the end of the individual's second day of
			 attendance at the center. The provider may substitute a copy of the case
			 manager's assessment of the individual if the case manager assessed the
			 individual no more than thirty days before the individual's first day of
			 attendance at the center.
(ii)
											The initial
			 assessment shall include both of the following components:
(a)
												The individual's
			 functional, cognitive, and social needs.
(b)
												A social profile
			 including social activity patterns, major life events, community services,
			 caregiver data, formal and informal support systems, and behavior
			 patterns.
(c)
										Health
			 assessment: No later than thirty days after the individual's initial attendance
			 at the center or before the individual receives the first ten units of service
			 at the center, whichever comes first, the provider shall obtain a health
			 assessment of each individual from a licensed healthcare professional whose
			 scope of practice includes health assessments or an employee who is such a
			 licensed healthcare professional to perform a health assessment of each
			 individual. The health assessment shall include the individual's psychosocial
			 profile and identify the individual's risk factors, diet, and medications. If
			 the licensed healthcare professional who performs the health assessment is not
			 an employee of the provider, the provider shall retain a record of the
			 professional's name and phone number.
(d)
										Activity plan: No
			 later than thirty days after the individual's initial attendance at the center
			 or before the individual receives the first ten units of service at the center,
			 whichever comes first, the provider shall obtain the services of a licensed
			 healthcare professional whose scope of practice includes developing activity
			 plans to draft an activity plan for each individual or an employee who is such
			 a licensed healthcare professional to draft an activity plan for each
			 individual. The plan shall do all of the following:
(i)
											Identify the
			 individual's strengths, needs, problems or difficulties, and
			 objectives.
(ii)
											Describe the individual's interest, preferences, and
			 social rehabilitative needs.
(iii)
											Describe the
			 individual's health needs.
(iv)
											Describe the
			 individual's specific goals, objectives, and planned interventions of ADS that
			 meet the goals.
(v)
											Describe the individual's level of involvement in the
			 drafting of the plan, and, if the individual has a caregiver, the caregiver's
			 level of involvement in the drafting of the plan.
(vi)
											Describe the
			 individual's ability to provide a unique identifier as an attestation that the
			 provider, or the provider's staff, completed an activity or unit of
			 service.
(e)
										Plan of treatment: Before administering medication or
			 meals with a therapeutic diet, and before providing a nursing service,
			 nutrition consultation, 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 individual that receives
			 medication, a nursing service, nutrition consultation, 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 is subject
			 to the diet-order requirements for therapeutic diets under rule
			 5160-44-11 of the Administrative
			 Code.
(f)
										Interdisciplinary care conference (conference):
(i)
											Frequency: The
			 provider shall conduct a conference for each individual at least once every six
			 months.
(ii)
											Participants: The provider shall conduct the conference
			 between the provider's staff and invitees who choose to participate. At least
			 seven days before the conference begins, the provider shall invite the
			 following persons to participate in the conference and provide those persons
			 with the date and time of the conference:
(a)
												The individual's
			 case manager.
(b)
												Any licensed healthcare profession who does not work
			 for the provider, but who provided the provider with a health assessment of the
			 individual or an activity plan for the individual.
(c)
												The individual's
			 caregiver, if the individual has a caregiver.
(iii)
											Revise activity
			 plan: If the conference participants identify changes in the individual'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 an employee who is such a licensed healthcare professional to
			 revise the activity plan accordingly.
(g)
										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)
											Email sent to individuals (and others) who agree to
			 receive the email.
(v)
											Monthly newsletters distributed to individuals by mail,
			 email, or at the center.
(h)
										Lunch and
			 snacks:
(i)
											The
			 provider shall provide lunch and snacks to each individual who is present
			 during lunchtime or snack time.
(ii)
											Each meal the
			 provider provides shall comply with all the requirements for home-delivered
			 meals under rules
			 173-39-02.14 and
			 5160-44-11 of the Administrative
			 Code, except for the requirements in those rules pertaining to the delivery of
			 the meal.
(3)
									Center
			 requirements: A provider qualifies to be an ODA-certified ADS provider only if
			 the provider's center has the following specifications:
(a)
										If the center is
			 housed in a building with other services or programs other than ADS, the
			 provider uses a separate, identifiable space and staff for ADS during all hours
			 that the provider provides ADS in the center.
(b)
										The center
			 complies with the "ADA Accessibility Guidelines for Buildings and Facilities"
			 in appendix A to 28 C.F.R. part 36.
(c)
										The center has at
			 least sixty square feet per individual that it serves (not just individuals who
			 are enrolled in an ODA-administered program), excluding hallways, offices, rest
			 rooms, and storage areas.
(d)
										The provider stores individuals' medications in a
			 locked area the provider maintains at a temperature complying with the storage
			 requirements of the medications.
(e)
										The provider
			 stores toxic substances in an area which is inaccessible to
			 individuals.
(f)
										The center has at least one working toilet for every
			 ten individuals present that the center serves (not just individuals who are
			 enrolled in an ODA-administered program) and at least one wheelchair-accessible
			 toilet.
(g)
										If the center seeks certification to provide intensive
			 ADS, the center has bathing facilities suitable to the needs of individuals who
			 need intensive ADS.
(4)
									Staffing
			 levels:
(a)
										The
			 provider shall have at least two staff members present, with at least one of
			 those staff members having a certification in CPR, when more than one
			 individual is present in the center.
(b)
										The provider
			 shall maintain a staff-to-individual ratio of at least one staff member to six
			 individuals at all times.
(c)
										The provider shall have an RN, or LPN under the
			 direction of an RN, available to provide nursing services that need the skills
			 of an RN, or LPN under the direction of an RN, and that are based on the needs
			 of the individuals and within the nurse's scope of practice.
(d)
										The provider
			 shall employ an activity director to direct activities.
(5)
									Provider qualifications:
(a)
										Type of
			 provider:
(i)
											Only an agency provider qualifies for ODA's certification to
			 provide ADS.
(ii)
											For each provider that ODA certifies, ODA shall certify
			 the provider as an enhanced or intensive provider. If ODA certifies a provider
			 to provide an intensive service level, the provider may also directly provide,
			 or arrange for, the enhanced service level.
(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, licensed dietitian, occupational therapist, occupational therapy
			 assistant, or other licensed professional qualifies to practice in the center
			 only if the person has a current, valid license to practice in their
			 profession.
(ii)
											A person qualifies to be an activity director only if
			 the person 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 coordinator, 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)
											A person qualifies to be an activity assistant only if
			 the person 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)
											A person qualifies to be a PCA only if the person 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 successfully completion of a vocational program in
			 a health or human services field.
(v)
											A person
			 qualifies to transport individuals for the provider only if the person meets
			 the qualifications for drivers under rule
			 173-39-02.18 of the
			 Administrative Code.
(c)
										Staff
			 training:
(i)
											Orientation: The provider shall comply with the requirements
			 for the orientation of PCAs in rule
			 173-39-02.11 of the
			 Administrative Code.
(ii)
											Task-based training: Before each new PCA provides ADS,
			 the provider shall provide task-based training.
(iii)
											Continuing
			 education and in-service training: Each PCA, activity director, and activity
			 assistant shall successfully complete at least eight hours of continuing
			 education or in-service training each calendar year. Any hour of continuing
			 education or in-service training successfully completed during a calendar year
			 to comply with the requirements for certification as an activity director or
			 activity assistant counts towards the eight-hour requirement in this
			 paragraph.
(iv)
											Verification of compliance: The provider shall comply
			 with paragraph (C)(3)(f) of rule
			 173-39-02.11 of the
			 Administrative Code regarding records of each PCA's successful completion of
			 any training and competency evaluation program, orientation, and inservice
			 training.
(6)
									Service
			 verification: The following are the mandatory reporting items that a provider
			 retains for each ADS session to comply with the requirements under paragraph
			 (B)(10)(a)(i) of rule
			 173-39-02 of the Administrative
			 Code:
(a)
										Individual's name.
(b)
										Service
			 date.
(c)
										Individual's arrival time.
(d)
										Individual's
			 departure time.
(e)
										Individual's mode of transportation.
(f)
										Unique identifier
			 of the individual to attest to receiving the service.