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Chapter III - Deunirions of Covered Services <br /> � Introduction <br /> The following are service definitions and desc:iptions of the types and scope of se:vices <br /> that may be rendered to Medicare Alzheimez's Disease Demonstration participaats for <br /> which reimbursement may be made under the demonstrarion. All services must be <br /> rendered in accerdance with a written plan of care established by the case mana�e: and <br /> approved and s;�ned by the care2iver, if available, the pamcipant, where appropriate, <br /> and a health proiessionai. The services provided should be reasonable and necessary for <br /> the diagnosis, care and treatment of individuals who have a primary dia�nosis of <br /> AIzheimer's disease or related disorder. When circumstances warrant a change in the <br /> plan of care, cemonstration requirements will be satisfied as long as there is an <br /> aQreement to the chan2es by all applicable parties and proper documentation is secsred. <br /> A. - Dav Care Services <br /> Adult Dav Care <br /> Day care is a pro¢ram of services provided in an ambulatory care setting for <br /> individuals who, due to the severity of their funcrional impairment(s), are not <br /> capabie of living fully independent The essential elements of �.;day care <br /> program are directed toward meeting the supervisory, social and health <br /> restorarion and maintenance needs of the participants. The goal of day care <br /> is to foste: and sustain optimal capacity for self-care. As a component of a <br /> total plan of care, day care provides a congregate setting for se:vice delivery <br /> durin� any part of a day, but less than 24 hours. <br /> To be considered reimbursable under the Niedicare Alzheimer's Disease <br /> Demonstrarion, a day care program must be operated under a single <br /> administrative unit responsible for the overall management and conduct of <br /> program activities. Also, the day care program must be administered under <br /> a set of written policies and procedures which reflect the objectives of the <br /> program and govern the provision of services to program participants. <br /> III-1 <br />