10A NCAC 06S .0204 STAFF REQUIREMENTS

(a) Standards set forth in 10A NCAC 06R .0305(a), (b), and (d) shall be met by adult day health programs.

(b) The program director for adult day health programs with a capacity of 10 or fewer participants may also serve as the health care coordinator provided that the individual meets all the requirements set forth in 10A NCAC 06R .0305(d), Paragraph (c) of this Rule, and requirements in Rule .0203 of this Section. If requirements of 10A NCAC 06R .0305(d) and Paragraph (c) of this Rule are met, and the capacity is greater than 10 participants, the program director may serve as the substitute health care coordinator for no more than three consecutive weeks.

(1) Adult day health programs shall have a health care coordinator to coordinate the delivery of health care services and participate in direct care as specified in Subparagraph (c)(2) of this Rule. The health care coordinator shall be on‑site a minimum of four hours per day and any additional hours necessary to meet the requirements for the provision of health care services to satisfy the participants' service plans as set forth in this Subchapter.

(2) The nursing responsibilities of the health care coordinator, consistent with the Nursing Practice Act, G.S. 90-171.19, shall include:

(A) completing preadmission health assessment for initial acceptance into the adult day health program, including problem‑identification and care planning;

(B) implementing the health care components of the established service plan that include medication administration, wound care, enteral or parenteral feedings, bowel or bladder training and maintenance programs, tracheotomy care and suctioning, and delegating nursing care tasks to unlicensed personnel;

(C) monitoring a participant's response to a medical treatment plan and nursing interventions and revising a participant's service plan as necessary;

(D) reporting and recording results of the nursing assessment, care rendered, and the participant's response to care;

(E) collaborating with other health care professionals and caregivers regarding provision of the participant's health care;

(F) educating other staff members about emergency procedures and providing information to staff and caregivers about health concerns and conditions of the participants;

(G) providing first aid treatment as needed; and

(H) ensuring health and personal care services as outlined in 10A NCAC 06S .0403 are provided to participants consistent with the participant's service plans.

(3) The health care coordinator:

(A) shall be either a registered nurse or a licensed practical nurse licensed to practice in North Carolina;

(B) if the health care coordinator is a licensed practical nurse, supervision shall be provided by a registered nurse consistent with the Nursing Practice Act and 21 NCAC 36 .0224 and .0225. These Rules are hereby incorporated by reference, including subsequent amendments. The licensed practical nurse shall also receive on-site supervision by a registered nurse as determined by the supervising registered nurse or at minimum every two weeks;

(C) shall have knowledge and understanding of the physical and emotional aspects of aging, the resultant diseases and infirmities, and related medications and rehabilitative measures;

(D) shall be at least 18 years of age;

(E) shall present, prior to beginning employment, a written medical statement completed within the prior 12 months by a physician, nurse practitioner, or physician's assistant, certifying that the employee has no illness or health condition that would pose a risk to others and ability to perform the duties assigned on the job; and

(F) shall provide at least three reference letters or the names of individuals who can be contacted, one of which shall include previous employment verification. The individuals providing reference information shall have knowledge of the applicant health care coordinator's background and qualifications.

(d) Staff Responsible for Personal Care in Adult Day Health Programs. All adult day health program staff providing personal care shall present evidence of meeting the following qualifications prior to assuming such responsibilities:

(1) completion of nurse's aide, home health aide, or equivalent training course; or

(2) a minimum of one year of experience in caring for impaired adults.

History Note: Authority G.S. 131D‑6; 143B-153(2a); 143B‑153(6); 42 USC 3032c;

Eff. September 1, 1990;

Amended Eff. September 1, 2007; July 1, 2007; May 1, 1992;

Readopted Eff. November 1, 2019.