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� i <br /> C�a�cer III - De�nitions of Cove:ed Services <br /> Introduction <br /> 1''ne foIlowin� z e service definitioBs and descri tions of the es and sco e oz se:vices <br /> - P � P <br /> that ma be re�eered to e ' isease <br /> y Medicar Al.zheimer s D Demons�a�ion parici��ts for <br /> wnich re:mbi:rse.:lent may be �ade under the demonstra�o� All services �t:st be <br /> rendezed in ac��rdance with a �ren plan of care establisned 'oy t�e case mana�e: and <br /> ap�roved and si�e� by the care�ve; ii available, the pal-tic;�znt wnere approprate, <br /> and a health proiessional. Tne se:vic:s provided should be reaso�aole and•necessary for <br /> the dia�nesis, care and treatment of individuals wno �ave a primary dia��sis of <br /> Alz.heime:'s dise2se or relate� disorder. When circumstanc�s war.ant a change in the <br /> pIan of care; ce�onstrarion requirements witl be sa�sfied as long as the:e is an <br /> agre�nent to the czarr:�es by aIl a�plicable par�ies and prope: docT�nea�rion is sec�,ired. <br /> A � � Dav C�-e Servic�s <br /> Adult Dav Care <br /> Day �e is a groeram of se:vices provide� in an a�cu�atory care se:—un� ior <br /> indivicuals who, due to the severity of their functional impairment(s), are not <br /> capabie of Iiving fully independent T'ne essez�al eie�ents of a day care <br /> pros?r� are direc,ed toward me�zing the supervis�ry, social �nd health <br /> resora�ion and maintenanc� ne��s ot" the participanu Tne goaI oi aay care <br /> is to fes�er and sus;ain ootimal capacity for self-care. As a comDone�t of a <br /> total plan of care, day care provides a congregate se:�n� for service deIive:y <br /> durin� any gart of a dav, but Iess than 24 houn. <br /> To be c�nsidered rei�bunable unde: the Medica..rc Alzheimer's Disease <br /> Demo�s�ation, a day care program mt:st be ooe:ate� under a singie <br /> aar�t-����razive unit ra-�onsiole for the ove:aIl managenent and conduct of <br /> pro�-� ac�viries. Also, the day care program mur be administered under <br /> a se: oi wri�ten poiicies and procedures wizich retlec: the objectives oi the <br /> pro�� and govem the provisian of servic�s to proQ-an paracipants_ <br /> III-1 ' <br />