HAR 11-96 — FREESTANDING ADULT DAY HEALTH CENTERS (§ 11-96-1 to 11-96-42)

The purpose of this chapter is to establish minimum requirements for the protection of health, welfare, and safety of clients and the public in adult day health centers. Notes Haw. Code R. § 11-96-1 [Eff ] (Auth: HRS § 321-11) (Imp: HRS § 321-11)

(a) Meals served in the center shall meet the recommended dietary allowances of the Food and Nutrition Board of the National Research Council, and be adjusted for age, sex, activity and disability. (b) A minimum of one meal per day shall be provided in accordance with the followi…

(a) A plan for discharge of each client shall be based on the assessment of the client by the multidisciplinary team and shall be reviewed and updated at the time of each reassessment if discharge planning is appropriate. (b) As appropriate, each client's health record shall incl…

(a) Each center shall have a written plan for a fire or disaster occurring within the center, or a natural disaster occurring in the community. (b) The disaster plan shall be in writing and shall include: (1) Designation of administrative authority and employee assignments; and (…

The provider shall establish emergency procedures in writing. These procedures shall include the following: (1) An easily located file on each client listing the name and telephone number of the client's physician, treatments or medications for a client's special disabilities, an…

(a) Each center shall maintain an employee record which shall be available for review by the director or designated representative. (b) Each employee record shall contain at least the following: (1) Full name; (2) Date of employment; (3) Credentials and pertinent experience; and …

(a) Employees shall be sufficient in numbers, qualified, and competent to provide the services for which the center is licensed. (b) Each supervisor shall be at least eighteen years of age. (c) Each employee shall have either training or related experience in the job assigned. (d…

Medical equipment and supplies in each center shall be of the quality and in the quantity necessary for care of clients as ordered or indicated in the plans of care, and shall include standard first aid supplies. These shall be provided and properly maintained at all times. Notes…

No adult day health center shall assume responsibility for the funds of its clients. Notes Haw. Code R. § 11-96-17 [Eff ] (Auth: HRS § 321-11) (Imp: HRS § 321-11)

(a) There shall be written policies and procedures available to staff, clients and the public which govern: (1) All services provided by the center; and (2) Admission and discharge of clients, (b) These policies shall insure that: (1) The center shall not deny admission to any in…

(a) Each licensee shall be responsible for the operation of the center. (b) The licensee shall exercise general supervision over the center, shall establish written policies concerning the center's operation, and shall make available these written policies for inspection by the d…

As used in this chapter: "Activity coordinator" means a person having responsibility for developing and implementing an activity program in an adult day health center who: (1) Has two years of experience in a social, recreational, or educational program, one year of which was ful…

(a) Each center shall be kept clean, safe, and in good repair at all times. (b) There shall be records that document that inspection of all devices essential to health and safety of clients and personnel shall be carried out daily or at sufficiently frequent intervals to ensure o…

(a) There shall be appropriate policies and procedures written and implemented for the prevention and control of infectious diseases and management and disposal of infectious waste. (b) Efforts shall be made to promptly return to their homes those clients who have infectious cond…

(a) There shall be a staff inservice education program that includes: (1) Orientation for all new employees to acquaint them with the philosophy, organization, program, policies and procedures, practices, and goals of the center; (2) Training for employees who have not achieved t…

(a) Where laundry service is provided, daily clothing and linen needs shall be met without delay. (b) Provisions shall be made for the proper handling, storage, and transportation of soiled and clean laundry and for satisfactory cleaning procedures. Notes Haw. Code R. § 11-96-23 …

(a) There shall be available appropriately qualified staff to facilitate the accurate processing, checking, indexing, filing, and prompt retrieval of records and record data. (b) The following information shall be obtained and entered in the clients' record at the time of admissi…

(a) Each program shall have nursing staff sufficient in number and qualifications to meet the needs of the clients. (b) Nursing services shall be under the supervision of a registered nurse. (c) If there are clients admitted who require skilled nursing, the services will be provi…

(a) Occupational therapy services which utilize purposeful activity shall be made available in each center as necessary, and be provided under a physician's order, and shall include, but not be limited to, the following: (1) Assessment of the client and formation of an individual…

(a) Physical therapy services shall be made available in each center as necessary, and be provided under a physician's order, and shall include, but not be limited to, the following: (1) Provide initial and continuing assessment of the client by the physical therapist in the form…

(a) The center shall provide to the director current information in regard to: (1) The name of each person owning 10 percent or more of the business, either directly or indirectly; (2) If a corporation, the names of the officers and directors; (3) If a partnership, the names of e…

(a) The center shall consult with a licensed pharmacist on methods and procedures for storage, administration, disposal, and record keeping of drugs and biological substances. (b) A pharmacy policy manual shall be developed and kept current by the licensed nursing staff, consulta…

(a) No person, firm, corporation, institution, association, organization, or any other entity, non-profit or for profit, may operate a freestanding adult day health center unless it is licensed by the department. (b) Any person, firm, corporation, institution, association, organi…

(a) The center shall be fully accessible to and functional for physically handicapped clients, personnel, and the public. (b) Each center shall comply with state and local building requirements. (c) Each center shall have a working, listed telephone on the premises. (d) Temperatu…

(a) All clients admitted to a center shall be under the care of a physician selected by the client. (b) The physician shall authorize the client's initial individualized plan of care and major revisions thereafter. The plan of care shall be reviewed at least annually. (c) There s…

(a) Each center shall have a full time program director. (1) The administrator may serve in this capacity except as specified in section 11-96-4(d); (2) The program director shall be present on the premises and available to clients, employees, and relatives; and (3) When the prog…

(a) Every adult day health center shall have available appropriate consultant staff trained in psychiatric care when there is a client in the adult day health center requiring the services while at the center. (b) The consultant shall: (1) Participate in the initial and continuin…

(a) Every adult day health center shall provide a program of social and recreatioal activities that is supervised and directed by an activity coordinator to meet the needs and interests of each client. (b) The activity coordinator's duties shall include at least the following: (1…

(a) There shall be written policies and procedures governing the use of restraints. (b) Physical restraints shall be used only under physicians' orders for specified and limited periods of times and their use shall be documented. (1) If physical restraints are used in an emergenc…

(a) Every center shall be in compliance with all applicable laws of the State of Hawaii and rules of the department relating to sanitation. (b) Reports of annual inspections by state or county health authorities and records of action taken in correction of deficiencies and recomm…

(a) Every adult day health center shall have available social services as appropriate to assist clients and their families to solve social problems that arise as a result of the client's disability. (b) Social services shall consist of the following: (1) Providing initial and con…

(a) Speech therapy services shall be made available in each center as necessary, and be provided under a physician's order, and shall include: (1) Initial and continuing assessment of the client by the speech therapist in the multidisciplinary team; and (2) Progress notes, writte…

(a) Staffing shall be sufficient to carry out daily activities, nursing services, physician orders, and individualized plans of care. (b) The program director of a center whose average daily attendance is twenty or less may also serve as the registered nurse, social worker, occup…

(a) Each center shall have an administrator. The administrator shall have the responsibility and authority to carry out the policies of the center. The center shall notify the Department in writing within fourteen working days following a change of administrator. (b) The administ…

(a) Every adult day health center which provides direct transportation services for clients shall meet specific operational standards. The motor vehicle shall: (1) Be operated only by drivers who have appropriate valid Hawaii drivers license; (2) Be equipped with safety devices t…

Transportation for clients to and from the center may be provided or arranged by the center. Notes Haw. Code R. § 11-96-41 [Eff ] (Auth: HRS § 321-11) (Imp: HRS § 321-11)

If a provision of this chapter or the application thereof to any person or circumstances is held invalid, the remainder of this chapter or the application of the provisions to other persons or circumstances shall not be affected thereby." Notes Haw. Code R. § 11-96-42 [Eff ] (Aut…

(a) Requirements for admission to an adult day health center shall include: (1) Referral from a community or health agency, physician, or hospital; and (2) Need for the health, nursing, therapeutic, or social services provided by the adult day health center in order to reach or m…

Where the center does not employ a qualified person to render a required or necessary service, it shall have a written agreement or contract with an outside person or provider to provide the needed service. Notes Haw. Code R. § 11-96-6 [Eff ] (Auth: HRS § 321-11) (Imp: HRS § 321-…

The configuration of services available to clients will be appropriate to the assessed needs of the clients. Basic program requirements of an adult day health center shall include provisions for medical services, nursing services, dietetic services and planned therapeutic and soc…

(a) Each center shall make available a multidisciplinary team, either through regular staff or contracted arrangement, for the purpose of client assessment and development of the plan of care. (b) A written individualized plan of care shall be developed to meet the needs of each …

(a) Written policies regarding the rights and responsibilities of clients during their stay in the center shall be established and shall be made available to the client, to any guardian, next of kin, sponsoring agency or representative payee, and to the public. The center's polic…