(a) An operator must:

1. (1) provide services to registrants consistent with the requirements of this Title and other applicable statutes and regulations;
2. (2) provide appropriate staff, equipment, supplies and space as needed for the administration of the adult day health care program in accordance with the requirements of this Part. Such staff are to be experienced in the care and management of persons with AIDS or HIV-related illness as well as in the care and management of other high-need populations that may be registrants of the program. Equipment and space are to be sufficient to meet the assessed needs of registrants, including sufficient bath and toilet facilities, pursuant to Part 714 of this Title;

3. (3) provide each registrant with a copy of a bill of rights specific to the operation of the adult day health care program. These rights include, but are not limited to:

   1. (i) confidentiality, including confidential treatment of all registrant records;
   2. (ii) freedom to voice grievances about care or treatment without discrimination or reprisal;
   3. (iii) protection from physical and psychological abuse;
   4. (iv) participation in developing the comprehensive care plan;
   5. (v) receiving written notification by the program at admission and following the continued stay evaluation of the services the registrant shall receive while attending the adult day health care program; and

   6. (vi) freedom to decide whether or not to participate in any given activity.

      (b) Administration.

      Without limiting its responsibility for the operation and management of the program, the operator must designate a person responsible for:

4. (1) coordinating services for registrants with services provided by other community-based agency programs, including but not limited to, certified home health agencies, social service agencies, clinics and hospital outpatient departments and services; provided, however, with respect to registrants referred to the adult day health care program by a managed care organization or care coordination model, the coordination of such services shall be the responsibility of the managed care organization or care coordination model; and

5. (2) day-to-day direction, management and administration of the adult day health care services; such person must be a practitioner who has experience in the care and clinical management of persons with AIDS or HIV-related illness and other high-need populations that enroll as registrants, including but not limited to:

   1. (i) assigning adequate and appropriately licensed personnel to be on-duty at all times when the program is in operation to ensure safe care of the registrants;
   2. (ii) assigning and supervising activities of all personnel to ensure that registrants receive assistance in accordance with their comprehensive care plans, including nursing services under the supervision of a registered professional nurse with experience in the care and management of persons with AIDS or HIV-related illness and other high-need populations that enroll as registrants;
   3. (iii) ensuring supervision of direct care staff in accordance with State rules and regulation;
   4. (iv) developing and implementing or arranging for in-service orientation, training and staff development, staff counseling and supportive services, and infection control specific to AIDS and HIV-related illness and other high-need populations that enroll as registrants; and

   5. (v) maintaining records in accordance with provisions of sections 400.2, 415.3(d)(1), 425.20 and 751.9(m)-(o) of this Title.

      (c) Policies and procedures for service delivery.

      The operator must:

6. (1) establish and implement written policies and procedures, consistent with the approved application for operation of the adult day health care program, concerning the rights and responsibilities of registrants, the program of services provided to registrants, use of physical structures and equipment, and the number and qualifications of staff members and their job classifications and descriptions;
7. (2) ensure that written policies and procedures, consistent with current professional standards of practice, are developed and implemented for each service and are reviewed and revised as necessary;
8. (3) develop protocols for each involved professional discipline to indicate when the service of such discipline should be included in the registrant assessment;
9. (4) ensure that professional personnel are fully informed of and encouraged to refer registrants to other health and social community resources that may be needed to maintain the registrant in the community; provided, however, with respect to registrants referred to the adult day health care program by a managed care organization or care coordination model, such referrals shall be the responsibility of the managed care organization or care coordination model;
10. (5) establish and implement written policies for the storage, cleaning and disinfection of medical supplies, equipment and appliances;
11. (6) establish and implement written policies and procedures governing medications brought to the program site by registrants;
12. (7) establish and implement written policies and procedures concerning refunds and prepayment for basic services in accordance with existing rules and regulations;
13. (8) establish and implement written policies and procedures concerning transfer and affiliation agreements covering registrants that are consistent with the standards specified in section 400.9 of this Title;
14. (9) provide in such agreement(s) reasonable assurance of assistance to each registrant in transferring to inpatient or resident status in a residential health care facility whenever the registrant is deemed by a practitioner to be medically appropriate for such care; and
15. (10) establish and implement a written affiliation agreement with a designated AIDS center or other hospital for the transfer of registrants requiring emergency care, acute inpatient care services and clinical, sub-specialty clinical, and ancillary services.