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Adult Day Health Care FAQ’s

Family members and candidates for San Simeon’s Medical-Model Adult Day Health Care program have many questions about what to expect and the services we can provide. Here are a few questions and answers to give you a better understanding of our program. Of course you can always call us or schedule a visit for a more thorough discussion.

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What is Adult Day Health Care?

A community-based long-term care program that provides comprehensive health care services in a congregate day setting. Registrant needs are assessed and met through an individualized plan of care that is developed and implemented by an interdisciplinary team of medical professionals.

What are the requirements for Adult Day Health Care?

A person that is not home-bound and requires supervision or monitoring; preventive, therapeutic rehabilitative care, among others, but does not require 24 hour a day inpatient care or services. An assessment called an “RAI” (Registrant Assessment Instrument) must be completed by a Registered Nurse from our facility in addition to your physician’s agreement that there is a need. A completed history and physical must be sent from your physician’s office to us prior to admission.

There must be a source of payment from one of the following:

  • Private pay
  • Medicaid
  • Long-term care insurance

What services are provided in the ADHC program?

We are staffed with medical professionals, including Licensed Registered Nurses, Licensed Practical Nurses, NYS Certified Nurses Aides with 100 hours of training, Registered Dietitians, Licensed Social Workers, professional Rehabilitation Therapists, and Certified Recreational Therapists.

What is the benefit of attending ADHC?

The program of comprehensive, integrated care leads to stabilization of chronic health conditions and reduced incidence of costly hospitalizations, physician and emergency room visits. Registrants are provided with the medical and social services they need to remain at home.

Who is eligible for ADHC?

Adult Day Health Care is designed to meet the health care needs of chronically ill, frail elderly, and disabled adults who require certain primary, preventative, diagnostic, therapeutic, rehabilitative, or palliative services.

How do I enroll in ADHC?

The ADHC program RN will conduct a comprehensive assessment to identify the individual’s health care needs and the type and intensity of services required. The individual will be admitted if it is the professional opinion of the RN, the individual’s personal physician, the other interdisciplinary staff, the Registrant and the caregiver that his/her assessed needs can be satisfactorily met, either entirely or in part, by the delivery of services in the ADHC program.

Medical orders are written by the personal physician regarding the Registrant’s care in the adult day health program. The appropriate number of days to attend is determined by the same interdisciplinary team so that optimum outcomes can be achieved. In some instances, the local department of social services or other approving agency must approve the service for transportation purposes.

Approval must be obtained when a Registrant is enrolled in the Long Term Home Health Care program or a managed long term care program applies for admission to the ADHC program. This eliminates duplication of services and promotes effective use of Medicaid funds.

How do I pay for ADHC?

An individual must be Medicaid eligible, or willing to pay privately or have a private insurance source.

When should a person consider Adult Day Health Care services?

An individual might seek the services of a medical model program:

  • If existing and necessary caregiver support is eliminated or compromised
  • When a medical condition develops and a new diagnosis is rendered requiring acute or chronic medical care
  • Following an accident or acute episode
  • If an existing condition is exacerbated
  • When hospice care is required
  • If restorative therapy is needed following an acute episode
  • During the end stage of a disease process

Is transportation available to San Simeon?

Yes. Door-to-door transportation to and from the Adult Day Health Center is available. This permits individuals who need physical assistance or are wheelchair bound to leave the isolation of their home and join a group settings.

medical transportation bus

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