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In addition, an adult day care program must have provisions for monitoring the <br /> health status of participants and for dealing with emergency health/medical <br /> situations, in case they occur during the period covered by the day care <br /> program. These services may include general nursing services and rehabiiitative <br /> services. <br /> r 1. General nursing services include such services as preparing and <br /> administering medications, charting, carrying out treatments, changing <br /> ` dressings, rehabilitative nursing, etc. <br /> 2. Rehabilitative services include, at a minimum, physical therapy, <br /> occupational therapy and speech pathology services designed to improve <br /> or maintain a participant's optunal capacity for self-care. These services <br /> may be provided by the program directly, or indirectly through contractuai <br /> arrangements with qualified providers. <br /> B. In-Home Care Services <br /> All of the following services are covered if provided to the participant in his/her <br /> home. Certain restrictions apply to those services which are normally covered <br /> under Medicare and they aze described below. <br /> � All sk�led care services must be provided in accordance with the approved plan <br /> � of care which is developed in consultation with appropriate professional staff. <br /> Regularly Medicare covered home health services such as skilled nursing <br /> services, rehabilitation nursing services, therapy services and home health aide <br /> services must be provided by a Medicare certified home health agency. <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 N, Subpart E, Part 409.42 (b) (1)-(3) (42 CFR 409.42 (b) (1)-(3)), <br /> do not apply. <br /> � � <br /> ` III-3 <br />