Adult day care is a supervised nonresidential program providing services as defined in WAC 388-106-0800. Services are appropriate for adults with medical or disabling conditions that do not require the intervention or services of a registered nurse or licensed rehabilitative therapist acting under the supervision of the client's authorizing practitioner. The adult day care center must offer and provide on-site the following services. These services must meet the level of care needed by the client as assessed by the department case manager for waiver funded clients and do not exceed the scope of services that the adult day care center is able to provide.

1. (1) Assistance with activities of daily living:

   1. (a) Locomotion outside of room, locomotion in room, walks in room;
   2. (b) Body care;
   3. (c) Eating;
   4. (d) Repositioning;
   5. (e) Medication management that does not require a licensed nurse;
   6. (f) Transfer;
   7. (g) Toileting;
   8. (h) Personal hygiene at a level that ensures client safety while in attendance at the program; and
   9. (i) Bathing at a level that ensures client safety and comfort while in attendance at the program.

2. (2) Social services on a consultation basis, which may include:

   1. (a) Referrals to other providers for services not within the scope of COPES waiver or RCL reimbursed adult day care services;
   2. (b) Caregiver support and education; or
   3. (c) Assistance with coping skills.

3. (3) Routine health monitoring with consultation from a registered nurse that a consulting nurse acting within the scope of practice can provide with or without an authorizing practitioner's order. Examples include:

   1. (a) Obtaining baseline and routine monitoring information on client health status, such as vital signs, weight, and dietary needs;
   2. (b) General health education such as providing information about nutrition, illnesses, and preventative care;
   3. (c) Communicating changes in client health status to the client's caregiver;
   4. (d) Annual and as needed updating of the client's medical record; or
   5. (e) Assistance as needed with coordination of health services provided outside of the adult day care program.

4. (4) General therapeutic activities that an unlicensed person can provide or that a licensed person can provide with or without an authorizing practitioner's order. These services are planned for and provided based on the client's abilities, interests, and goals, which are not limited by funding source. Examples include:

   1. (a) Recreational activities;
   2. (b) Diversionary activities;
   3. (c) Relaxation therapy;
   4. (d) Cognitive stimulation; or
   5. (e) Group range of motion or conditioning exercises.

5. (5) General health education that an unlicensed person can provide or that a licensed person can provide with or without an authorizing practitioner's order, including but not limited to topics such as:

   1. (a) Nutrition;
   2. (b) Stress management;
   3. (c) Disease management skills; or
   4. (d) Preventative care.
6. (6) A nutritional meal and snacks every four hours, including a modified diet if needed and within the scope of the program, as provided under WAC 388-71-0770;
7. (7) Supervision and/or protection if needed for client safety;
8. (8) Assistance with arranging transportation to and from the program; and
9. (9) First aid and provisions for obtaining or providing care in an emergency. note: If the client requires the intervention or services of a registered nurse or licensed rehabilitative therapist acting under the supervision of an authorizing practitioner, consider adult day health services.

[Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0704, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0704, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-71-0704, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-71-0704, filed 5/17/05, effective 6/17/05. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0704, filed 2/24/03, effective 7/1/03.]