| (a) The facility director:
(1) manages the DAHS program and the facility;
(2) trains and supervises facility staff, contractors,
and volunteers;
(3) monitors the facility building and grounds to ensure
compliance;
(4) maintains all financial and client records;
(5) develops relationships with community groups and
agencies for identification and referral of clients;
(6) maintains communication with clients' family members
or responsible parties;
(7) ensures development and maintenance of the clients'
plans of care; and
(8) ensures that, if the facility director also serves
as the RN consultant, the facility director fulfills the responsibility
as director.
(b) The facility nurse:
(1) assesses clients' nursing and medical needs;
(2) develops clients' plans of care;
(3) obtains prescribing practitioner's orders for medication
and treatments to be administered;
(4) determines whether self-administered medications
have been appropriately taken, applied, or used;
(5) enters, dates, and signs monthly progress notes
on medical care provided;
(6) administers medication and treatments;
(7) provides health education;
(8) maintains medical records; and
(9) oversees implementation of the facility's infection
prevention and control policies.
(c) The activities director:
(1) plans and directs the daily program of activities,
including physical fitness exercises or other recreational activities;
(2) records client's social histories;
(3) assists clients' related support needs;
(4) ensures that the identified related support services
are included in clients' plans of care;
(5) signs and dates monthly progress notes about social
and related support services activities provided; and
(6) ensures clients have a choice in whether to participate
in activities.
(d) An attendant:
(1) provides personal care services to assist with
activities of daily living;
(2) assists the activities director with recreational
activities; and
(3) provides protective supervision through observation
and monitoring.
(e) Food service personnel:
(1) prepare meals and snacks; and
(2) maintain the kitchen area and utensils in a safe
and sanitary condition.
(f) A facility must obtain consultation at least four
hours per month from a dietitian consultant.
(1) The dietitian consultant plans and reviews menus
and must:
(A) approve and sign snack and lunch menus;
(B) review menus monthly to ensure that substitutions
were appropriate; and
(C) develop a special diet for clients if ordered by
a prescribing practitioner.
(2) A facility must obtain consultation from a dietitian
consultant even if the facility has meals delivered from another facility
with a dietitian consultant or the facility contracts for the preparation
and delivery of meals with a contractor that employs a registered
dietician. A consultant who provides consultation to several facilities
must provide at least four hours of consultation per month to each
facility.
(g) If a facility employs an LVN as the facility nurse,
the facility must ensure that an RN consultant provides consultation
at the facility at least four hours per week. The RN consultant must
document the consultation provided. The RN consultant must provide
the consultation when clients are present in the facility. The RN
consultant may provide the following types of assistance:
(1) review plans of care and suggest changes, if appropriate;
(2) assess clients' health conditions;
(3) consult with the LVN in solving problems involving
care and service planning;
(4) counsel clients on health needs;
(5) train, consult, and assist the LVN to maintain
proper medical records; and
(6) provide in-service training for direct service
staff.
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