or as specified in the service plan, in a non-institutional, community-based center encompassing both health and social services needed to ensure the optimal functioning of the Participant. Adult Daily Living includes two (2) components: Basic Adult Daily Living services and Enhanced Adult Daily Living services. Basic Adult Daily Living services are comprehensive services provided to meet the needs noted above in a licensed center. Per licensing regulations under Title 6 PA Code, Chapter 11, Subchapter A, and 11.123 Core Services (Older Adult Daily Living Center or OADLC Regulations § 11.123 (2)), the required core services for these settings include personal assistance, nursing in accordance with regulation, social and therapeutic services, nutrition and therapeutic diets and emergency care for Participants. Basic Adult Daily Living services can be provided as either a full day or a half day. The Participant’s service plan initiates and directs the services they receive while at the center. In addition to providing Basic Adult Daily Living services, Enhanced Adult Daily Living services must include the following additional service elements:
34 • Nursing Services: In addition to the requirements found in the OADLC Regulations §11.123 (2), a Registered Nurse (RN) must be available on-site one (1) hour weekly for each enrolled waiver Participant. At a minimum, each waiver Participant must be observed every other week by the RN with the appropriate notations recorded in the Participant’s service plan, with the corresponding follow-ups being made with the Participant, family, or physician. • Staff to Participant Ratio of 1:5. • Operating Hours: open a minimum of eleven (11) hours daily during the normal work week. A normal work week is defined as Monday through Friday. • The guidelines for the required specialized services for the OADLC provider to include physical therapy, occupational therapy, speech therapy, and medical services can be found in Subchapter B, § 11.402. • Enhanced Adult Daily Living services can be provided as either a full day or a half day. • Adult Daily Living providers that are certified as Enhanced receive the Enhanced full day or Enhanced half day rate for all Participants attending the Enhanced center. As necessary, Adult Daily Living may include assistance in completing activities of daily living and instrumental activities of daily living. This service also includes assistance with medication administration and the performance of health-related tasks to the extent State law permits. This service must be provided in accordance with 42 CFR §441.301(c)(4) and (5), which outlines allowable settings for home and community-based waiver services. Services can be provided as either a full day or half day. Providers may bill for one (1) day when Basic or Enhanced Adult Daily Living services are provided for four (4) or more hours in a day. Providers must bill for a half day when Basic or Enhanced services are provided for fewer than four (4) hours in a day.
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