Section 1240-07-10-.07 - PROGRAM(1) Individuals who present a significant threat to themselves or others, or whose intellectual, emotional, or behavioral needs prevent them from benefiting from the center's program, shall not be enrolled. The center shall refer these individuals to appropriate service providers and resources.(2) Each center shall provide supervision and personal care of the participants as needed.(3) The program shall be designed to maintain the dignity of, and demonstrate respect for, each participant, allow for individual choices, and allow for each participant to experience successes each day.(4) Participants shall take part in program development and activity planning to the extent possible.(5) A participant who appears to the center's staff to be mentally capable of making his or her own decisions may act on his or her own behalf without having another person as responsible party.(6) Adult day services programs located in, or affiliated with, a licensed nursing home, a licensed hospital, a licensed assisted care living facility, a licensed home for the aged, a licensed residential hospice, a senior citizens center, church, or a school may utilize the resources of the facility/agency to act as support to the adult day services program. However, adult day services are not intended to serve as a substitute for the services of skilled nursing care or a senior citizens center. The adult day services program, regardless of its location or affiliation, shall comply with the program content requirements as described in paragraph (7).(7) Contents of the Adult Day Services Program.(a) Participants shall be offered a variety of activities throughout the day.(b) The adult day services program shall consist of individual and group activities and therapies offered through individualized plans for each participant which set forth measurable goals or behaviorally-stated objectives.(c) Activities and therapies shall be designed to activate, motivate, and/or retrain participants to maximize their functional capacity.(d) The following activities shall be offered daily: physical exercise, rest, social interaction, learning opportunities, mental stimulation, and, if needed, personal care. These social, educational and life-enrichment activities may include, but are not limited to, the following: arts, crafts, music, pet therapy, outings, current events, memory-enhancing activities, history, games, puzzles, cards, physical activity, reminiscence sessions, movies, guest speakers, and presentations, discussions about feelings, and appropriate recreational activities.(e) Although leisure activities comprise an integral part of the adult day services program, activities which are limited to passive participation, including watching television, reading, etc. shall comprise no more than 20% of the center's planned activity schedule.(f) Participants shall always be given free choice about whether or not to take part in a particular activity.(g) Group size should be appropriate to the type of activity, functional capability, and individual needs of the participants.(h) The program shall include assistance from community referrals and resources when appropriate and available.(i) A planned activity schedule shall be posted at all times.(j) Routines shall encourage consistency and structure.(8) Staff Interaction with Participants.(a) Staff shall always address participants by the name preferred by the participant.(b) Staff shall interact with participants in a manner that maintains the dignity and sense of autonomy of the participant; and(c) Staff shall interact with each participant in a manner that displays knowledge of his/her individual needs, likes, dislikes and individualized plan.(9) Restraints. (a) Restraints may be applied or administered to participants only on a signed order of a physician. The signed physician's order must be for a specified and limited period of time and must document the necessity of the restraint. There shall be no standing orders for restraints.(b) This section regarding restraints excludes passive restraints which are ancillary to a participant's equipment such as geri chair trays, lap belts, wheelchairs, leg braces, slings, and the like.(c) When a participant's safety or safety of others is in imminent jeopardy, the medial professional or onsite director shall use his/her judgment to use physical restraints if a physician's order cannot be immediately obtained. A written physician's order must be obtained as soon as possible, but no later than within seven (7) calendar days.1. In the event that this subsection is used the onsite director shall notify the Department.(d) Locked restraints and chemical restraints are prohibited.(10) Any center offering a program for participants with Alzheimer's disease is subject to the requirements of T.C.A. §§ 68-11-1401, et seq.Tenn. Comp. R. & Regs. 1240-07-10-.07
Original rule filed December 14, 1999; effective 2/27/2000. Repeal and new rule filed February 23, 2018; effective 5/24/2018. Amendments filed October 25, 2022; effective 1/23/2023.Authority: T.C.A. §§ 4-5-201, et seq.; and 71-2-401, et seq.