10-144-117 Me. Code R. § 4

Current through 2024-51, December 18, 2024

Section 144-117-4 - Administration

4.1Administrator Requirements.

4.1.1Qualifications. The administrator of an Adult Day Services Program shall have management and supervisory experience in a social or health service setting or comparable technical or human service training or experience, with demonstrated competence and experience in a health or human service setting. The administrator shall perform his/her duties in compliance with all applicable laws and regulations and consistent with the standard of conduct that a reasonable and prudent person would observe in the same situation. The administrator shall be at least twenty-one (21) years of age.

4.1.2Determination of Qualification. A determination of qualification shall require the applicant and proposed administrator to demonstrate their willingness and ability to operate and manage an Adult Day Services Program with mature judgment, compassionate regard for the best interests of the consumers and consistent compliance with these regulations and all relevant laws. In making this determination, the Department shall consider each of the following factors to the extent that they are relevant to the proposed program, ownership interest and/or employment: The applicant/licensee and administrator, as part of the license application process, shall consent to the release of all information that may be reviewed in this Section.

4.1.2.1 . Record and reputation for honest and lawful conduct in business and personal affairs. The provider shall authorize the Department to review the records of professional licensing boards or registers, any criminal record, child protective record or adult protective record necessary to determine compliance with these rules;

4.1.2.2 . Experience in the field of health care, social services or areas related to the provision of Adult Day Services programs;

4.1.2.3 . Conduct which demonstrates an understanding of, and compliance with, consumer rights;

4.1.2.4 . Information which relates to the ability, willingness or disposition towards compliance with all applicable laws and regulations;

4.1.2.5 . Any information reasonably related to the ability to provide knowledgeable, safe and quality services to the consumer

4.1.2.6 Management and supervisory experience, including the capacity to manage the financial operations and staff of the program.

4.2Complaints

4.2.1 Any person may file a complaint regarding program operation directly with the program administrator or any member of the program staff.

4.2.2 A system shall be established for the review of each complaint received, within forty-eight (48) hours of receipt of the complaint, by the administrator and/or any designated member of the program staff. A written report of findings and action taken shall be prepared and kept on file and made available for review upon request of the Department. The complainant shall be given a copy of the written findings and resolution within ten (10) days of making the complaint. The complainant may appeal to the Department, if dissatisfied with the written findings and resolution. A complaint may also be directed to the Ombudsman Program. The provider is responsible for informing the complainant of the appeal procedure in writing, including the appropriate address and telephone numbers of the Division of Licensing and Certification, Community Services Programs, and the Long Term Care Ombudsman (see 22 M.R.S.A. §5107-A) .

4.2.3 The program shall not retaliate against any consumer or his/her representative for filing a complaint.

4.2.4 Complainants have immunity from civil or criminal liability when the complaint is made in good faith.

4.2.5 Any licensing violations noted as a result of a complaint investigation will be provided to the program in writing.

4.3Refunds. The program shall refund payments to consumers for services not received within thirty (30) days of the overpayment. The program's refund policy shall detail circumstances for refunds, consumer and provider obligations.

4.4Rates/Contracts.

4.4.1Rates. Each program shall make its rates available to the public upon request. Each program shall describe the services covered as part of the rate and any other charges not covered by the basic rate. The provider shall give at least thirty (30) days written notice prior to any changes in rates and charges, responsibilities or services to be provided.

4.4.2Provisions of the Contract. When there is a contract, the consumer or designated representative shall be given an original of the signed contract and the Adult Day Services provider shall keep a duplicate original in the consumer's file. Each contract shall specify services included in the program as well as a provision prohibiting the program from holding anyone but the consumer responsible for the contract charges. No contract may contain a provision which is contrary to the services, rights and obligations of these regulations.

4.5Reporting of Abuse and Neglect.

4.5.1 The program must ensure that all staff members are knowledgeable of the Adult Protective Services Act ( 22 M.R.S.A. §§3470, et seq.). When, while acting in a professional capacity, a mandated reporter suspects that an adult has been abused, neglected or exploited, and has reasonable cause to suspect that the adult is incapacitated, then that person shall immediately report or cause a report to be made to the Division of Licensing and Certification, Community Services Program, the Office of Elder Services, and Adult Protective Services. When the alleged victim has mental retardation, the report must be made to the Department of Health and Human Services (formerly the Department of Behavioral and Developmental Services, Adult Protective Services) and the Division of Licensing and Certification, Community Services Programs.

4.5.2 The provider is responsible for conducting an internal investigation when staff are implicated in the alleged violations while simultaneously reporting to Adult Protective Services. The program must have evidence that all alleged violations are thoroughly investigated in a timely manner. Policies must address administrative procedures to be implemented to prevent further potential neglect, abuse or exploitation while the investigation is in progress.

4.5.3 The results of all investigations conducted must be reported to the administrator or designated representative and to other officials in accordance with State law. If the alleged violation is verified, appropriate corrective action must be taken. All reports must be made available to the Department upon request. Documentation shall be maintained in the facility that a report has been made.

10-144 C.M.R. ch. 117, § 4