1. (1) A nursing care facility licensee may provide adult day care without an additional license from OL.
2. (2) The licensee shall submit policies and procedures for adult day care to the OL for approval.
3. (3) The governing body shall designate a qualified director to be responsible for the day-to-day program operation.

4. (4) The director shall maintain the following information on-site for each staff member:

   1. (a) a background check consent and release form;
   2. (b) an emergency contact with name, address, and telephone number;
   3. (c) health history;
   4. (d) in-service training requirements; and
   5. (e) verification of orientation completion.

5. (5) The director shall maintain the following information on-site for each client:

   1. (a) a health record to include:

      1. (i) a current health assessment signed by a licensed practitioner;
      2. (ii) a level of care assessment; and
      3. (iii) a record of medication including dosage and administration;
   2. (b) a signed client agreement and care plan;
   3. (c) an emergency contact with name, address, and telephone number; and
   4. (d) demographic information.

6. (6) The licensee shall have a written eligibility, admission, and discharge policy that includes:

   1. (a) intake process;
   2. (b) notification of responsible person of any upcoming admission or discharge;
   3. (c) reason for discharge or dismissal;
   4. (d) reasons for admission refusal, including the director's written, signed statement; and
   5. (e) resident rights notification.

7. (7) Before the licensee may admit a client to the facility, the licensee must ensure the following are addressed in writing to determine client eligibility for the program:

   1. (a) current health status;
   2. (b) immunizations;
   3. (c) legal status;
   4. (d) medical history; and
   5. (e) psychological factors.

8. (8) The licensee shall ensure that the director or designee, the responsible person, and the client if competent develops a written, signed client agreement that includes:

   1. (a) arrangements regarding:

      1. (i) absenteeism;
      2. (ii) gifts;
      3. (iii) mail;
      4. (iv) telephone calls;
      5. (v) vacations; and
      6. (vi) visits.
   2. (b) rules of the program; and
   3. (c) services provided and cost of service, including refund policy.

9. (9) The licensee shall ensure the director or designee:

   1. (a) develops an individual client care plan that is implemented for the client within three days of admission to the program;
   2. (b) ensures the care plan includes the specification of daily activities and services; and
   3. (c) reevaluates and changes, if necessary, the client's care plan at least every six months.
10. (10) The licensee shall comply with Rule R380-600 regarding critical incident reporting.
11. (11) The director shall notify and review the incident report with the responsible person no later than when the client is picked up at the end of the day.
12. (12) The licensee shall post and implement a daily activity schedule.

13. (13) The licensee shall:

    1. (a) ensure a client is always directly supervised and are encouraged to participate in activities;
    2. (b) ensure one staff member provides continuous, direct supervision when eight or fewer clients are present;
    3. (c) ensure staff supervision is provided continually when a client is present;
    4. (d) if one-half or more of the clients are diagnosed by a physician's assessment with Alzheimer's or other dementia, the ratio is one staff for every six clients, or fraction thereof;
    5. (e) maintain any indoor and outdoor areas in a clean, secure, and safe condition;
    6. (f) provide at least 50 square feet of indoor floor space, excluding hallways, office, storage, kitchens, and bathrooms, per client designated for adult day care during program operational hours;
    7. (g) provide at least one bathroom designated for client use during business hours;

    8. (h) provide continuous, direct supervision at a ratio of one staff to every eight clients; and

       1. (i) provide at least two designated bathrooms designed for client use if serving more than ten clients.

KEY: health care facilities

Date of Last Change: February 18, 2025

Notice of Continuation: January 24, 2022

Authorizing, and Implemented or Interpreted Law: 26B-2-202