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In adcirion, an adult day care program must have provisions for monitoring the <br /> heaith status of participants and for dealing with emergency health/medical <br /> situations, in case thev occur during the period covered by the day care <br /> " pro�am. These services may include general nursin; services and rehabiiitarive <br /> services. <br />, rl. General nursing services inc:ude such servic�s as preparinQ and <br /> administering medications, charting, carrying out treatments, chan�ing <br /> L dressings, rehabilitative nursin�, etc. <br /> 2. R�habilitative se:vices include, at a minimum, physical therapy, <br /> oc:.upational therapy and speech patholo�y services designed to improve <br /> or maintain a participant's optimal capacity for se?f-care. These services <br /> may be provided bv the program directly, or indirectly through cont;actual <br /> ar.anQemencs with qualified providers. <br /> B. In-Ho*-�e Care Services <br /> All of the following seivices are cove:ed if provided to the participant in his/her <br /> home. Certain restrictions apply to those services which are normally covered <br /> unde: �Iedicare and they are described below. <br /> All slfliled care services must be provided in accordance with the app*�ved pIan <br /> of care which is developed in consultation with appropriate professional staff. <br /> Regulariy Medicare covered home health services such as sldlled nursing <br /> services, rehabiIitation nursing services, therapy services and home health aide <br /> services must be provided by a Medicare certified home health a;ency. <br /> However, Medicare criteria, such as intermittent care and the homebound <br /> requirements, as referenced in the Code of Federal Regulations, Title 42, <br /> Chapter IV, Subpart E, Part 4Q9.42 (b) (1)-(3) (4'' CFR 409.42 (b) (1)-(3)), <br /> do not apply. <br /> III-3 <br />