PROGRAM COMPONENTS
§ 11.101. Intake screening.
(a) The center shall complete, or arrange for the completion of, an intake screening for each applicant in order to determine the appropriateness of the older adult daily living center for that individual. The screening shall be completed within 60 days prior to admission.
(b) The following information shall be included in an individual client file:
(1) The applicant’s name, address, birth date, social security number and phone number.
(2) The referral source.
(3) The usual living arrangement, describing the following:
(i) The dwelling unit.
(ii) The present address.
(iii) The usual means of transportation.
(4) A social history, including past and present occupation and types of activities enjoyed.
(5) Client-rated health status, allergies or contraindicated medication and current medications.
(6) The names and phone numbers of the primary physician, other physicians or CRNP involved, and of an emergency contact person.
(7) The community agencies involved in providing formal services, and the designation of care manager, if any; a list of informal supports; identity of, and limitations or restraints on, the primary caregiver, problems with caregiving, the extent of perceived caregiver burden, and the extent of caregiver need for support.
(8) The limitations of the client relating to ADLs, IADLs and mobility; and the use of physical aids.
(9) Special instructions for the client’s diet, food allergies and special diets.
(10) Cognitive functioning, describing:
(i) The client’s orientation.
(ii) Recent memory.
(iii) Distant memory.
(iv) The ability to understand directions and to communicate needs.
(v) The awareness of danger, risks and consequences.
(11) The emotional status and behavior, describing:
(i) Recent stressful events.
(ii) Response to illness.
(iii) Emotional strengths, expectations and motivation.
(iv) Mental health treatment.
(v) Current emotional problems or related behaviors, such as wandering or sleeplessness.
(vi) The need for supervision.
(12) The identity of the person authorized to make decisions under advance directives, such as durable power of attorney.
(13) Religious affiliation, if the client chooses to divulge this information.
(c) An applicant cannot become a center client unless the center determines, based on the information in subsection (b) and other information available to the center, that the applicant meets the criteria for admission in § 11.4 (relating to admissions criteria).
(d) The center shall notify applicants who do not meet criteria for admission, as specified in this section and in § 11.4, of the determination within 30 days of the completion of intake screening.
Cross References This section cited in 6 Pa. Code § 11.4 (relating to admissions criteria); and 6 Pa. Code § 11.212 (relating to applicability).
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