016.06.71-213.500. Adult Day Services
AR ADC 016.06.71-213.500Arkansas Administrative CodeEffective: October 1, 2022
Effective: October 1, 2022
Ark. Admin. Code 016.06.71-213.500
016.06.71-213.500. Adult Day Services
Procedure Code | Required Modifier | Description |
|---|---|---|
S5100 | U1 | Adult Day Services, 8-20 Units Per Date of Service |
S5100 | -- | Adult Day Services, 21-40 Units Per Date of Service |
Adult day services facilities are licensed by the Division of Provider Services and Quality Assurance (DPSQA) to provide care and supervision to meet the needs of four (4) or more functionally impaired adults for periods of less than 24 hours but more than two (2) hours per day, in a place other than the participants' own homes.
When provided according to the participant's written PCSP, participants may receive adult day services for 8 or more units (2 or more hours) per day, not to exceed 40 units (10 hours) per day, according to the participant's written PCSP. Adult day services of less than 8 units (2 hours) per day are not reimbursable by Medicaid. Adult day services may be utilized up to 200 units (50 hours) per week, not to exceed 920 units (230 hours) per month. One (1) unit of service equals 15 minutes.
As required, participants who are present in the facility for more than 20 units (5 hours) a day (procedure code S5100) must be served a nutritious meal that equals one-third of the Recommended Daily Allowance. Therefore, participants are not eligible to receive a home-delivered meal on the same day they receive more than 20 units (5 hours) of adult day services. Additionally, participants who attend an adult day service for more than 20 units (5 hours) are not eligible to receive Attendant Care services on the same date of service unless authorized by the DHS PCPS/CC Nurse.
NOTE: As stated in this manual, home-delivered meals may not be provided on the same day for a participant who attends adult day services, adult day health services, or facility-based respite care for more than 20 units (5 hours). The time of day the participant is receiving day services, day health services or respite services is also a factor in the application of this policy. The time of day services are received will be reviewed by the PCSP/CC NURSE and/or Department of Human Services (DHS) audit staff and considered when determining any duplication in services for participants participating in the ARChoices Waiver program.
Providers must consider the following to determine whether a home-delivered meal is billable for a participant receiving day services, day health services or facility-based respite services on a specific date of service.
If a participant is receiving day services, day health services or facility-based respite between the hours of 11:00 a.m. and 1:30 p.m. and the noon meal is routinely served to others at the facility during this time frame, the noon meal must also be served to this participant. A home-delivered meal is not allowable on the same date of service. This is true regardless of the total number of day services or respite units provided.
Adult day services and day health services providers are required to maintain a daily attendance log of participants. Section 214.000 contains information regarding additional documentation requirements.
Credits
Adopted Dec. 27, 2015. Amended Oct. 6, 2016; Jan. 1, 2019; Oct. 1, 2022.
Current with amendments received through May 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.71-213.500, AR ADC 016.06.71-213.500
| End of Document |