(a)  Standards as 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(b) and in Paragraph (c) of this Rule and if requirements in Rule .0203 of this Section related to program capacity are met.  If requirements of 10A NCAC 06R .0305(b) 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 up to but not exceeding three consecutive weeks.

(c)  Health Care Coordinator of Adult Day Health Programs:

(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 as set forth in this Subchapter.

(2)           The nursing responsibilities of the health care coordinator, consistent with the Nursing Practice Act, include:

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

(B)          implementing the health care components of the established service plan which 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 participant's response to medical treatment plan and nursing interventions and revising plan of care as necessary;

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

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

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

(G)          providing first aid treatment as needed; and

(H)          making certain 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 G.S. 90-171 and 21 NCAC 36 .0224 through .0225.  Copies of these Rules may be obtained from the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC 27699-6714, telephone (919) 733-2678, at a cost of two dollars and fifty cents ($2.50) for up to 10 pages and twenty-five cents ($.25) for each additional page, or available at the following website:  http://reports.oah.state.nc.us/ncac.asp.  The licensed practical nurse shall also receive on-site supervision by a registered nurse as needed, 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 with whom a reference interview may be conducted, including at least one former employer.  The individuals providing reference information shall have knowledge of the applicant coordinator's background and qualifications.

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

(1)           successful 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;

Eff. September 1, 1990;

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