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Chapter III - Definitions of Covered Services <br /> Introduction � <br /> The following are service definitions and descriptions of the types and scope of services <br /> that may be rendered to Medicare Alzheimer's Disease Demonstration participants for <br /> which reunbursement may be made under the demonstration. All services must be <br /> rendered in accordance with a written plan of care established by the case manager and <br /> approved and signed by the caregiver, if available, the participant, where appropriate, <br /> and a health professional. The services provided should be reasonable and necessary for <br /> the diagnosis, care and treatment of individuals who have a primary diagnosis of <br /> Alzheimer's disease or related disorder. When circumstances warrant a change in the <br /> plan of care, demonstration requirements w�l be satisfied as long as there is an <br /> agreement to the changes by all applicable parties and proper documentation is secured. <br /> A. Dav Care Services <br /> Adult Day Care <br /> Day care is a program of services provided in an ambulatory care setting for <br /> individuals who, due to the severity of their functional impairment(s), are not <br /> � capable of living fully independent The essential elements of a day care <br /> � - program are directed toward meeting the snpervisory, social and health <br /> restoration and maintenance needs of the participants. The goal of day care <br /> is to foster and sustain optimal capacity for self-care. As a component of a <br /> total plan of care, day care provides a congregate setting for service delivery <br /> during any part of a day, but less than 24 hours. <br /> To be considered reimbursable under the Medicare Alzheimer's Disease <br /> Demonstration, a day care program must be operated under a single <br /> administrative unit respons�'ble for the overall management and conduct of <br /> program activities. Aiso, 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 /> � <br /> �.. <br /> III-1 <br />