| Changes to Select Adult Day Services Center Questions | |
| 2014 Change | 2012 Questionnaire Number and Wording |
| DROP | ADSC Q3. Is this adult day services center owned by any other type of organization? |
| DROP | ADSC Q3 For each item (a-f) below, please indicate whether or not this type of organization owns this center. Mark Yes or No in each row a. Hospital b. Nursing home or skilled nursing facility c. Home health agency d. Hospice agency e. Assisted living or similar residential care community (e.g., adult care or personal care residence) f. Other |
| DROP | ADSC Q7. Based ona typical week, how many respite care participants does this center serve?/ Of the residents currently living in this residential care community, how many are respite care residents? |
| DROP | ADSC Q10. Other than from Medicaid, does this adult day services center receive funding from any federal, state, county or city community care agencies? For example, Older American Act Funding, State Unit on Aging, Area Agencies on Aging, or Councils on Aging. |
| DROP | ADSC Q13. Is this center licensed or certified under some other type of provider? For example, nursing home, rehabilitation center, or hospital. |
| DROP | ADSC Q14. A continuing care retirement community is a community that offers multiple levels of care such as independent living, residential care and skilled nursing care, and provides residents the opportunity to remain in the same community as their needs change. Is this adult day services center part of a continuing care retirement community? |
| DROP | ADSC Q16_d. Any case management services--generally a process of assessment, planning and facilitation of options and services for an individual |
| DROP | ADSC Q20. On a regular basis, does this center create daily schedules based on each participant's life history, abilities, and interests? |
| DROP | ADSC Q21. On a regular basis, does this center seek input from participants and their families into what personal care services are received by the participant? |
| DROP-FTEs. (2014 ADSC Q14) | ADSC Q23 For each item (a-d) below, please indicate the number of staff that currently work at this adult day services center full-time and part-time. Please report either the number of full-time and part-time staff OR the number of full-time equivalent (FTE) staff, not not both, for the center employee category and the contract staff category. |
| DROP | ADSC Q22. On a regular basis, does this center give participants choices for each of the following? a. Meals b. Meal types/menus |
| DROP | ADSC Q29. Of the participants currently enrolled at this center, how many live in each of the following places? Enter "0" for any categories with no partcipants. a. An assisted living or similar residential care community (e.g., adult care or personal care residence) b. a private residence (house or apartment) c. a nursing home or other institutional setting d. some other place |
| DROP | ADSC Q31. Before or upon admission, does this center use a standardized tool to conduct a formal assessment of its participants to identify anyone with a cognitive impairment? |
| DROP | ADSC Q31a Based on this assessment, about how many of the participants currently enrolled at this center have been identified as having a cognitive impairment? |
| DROP | ADSC Q32a. Transferring in and out of bed |
| DROP | ADSC Q33 Of the participants currently enrolled at this center, about how many use a manual, electric, or motorozed wheelchair or scooter? |
| DROP | ADSC Q34a. Of the participants who were discharged from an overnight hospital stay in the last 90 days, about how many of those participants were re-admitted to the hospital for an over night stay within 30 days of their hospital discharge? |
| DROP | ADSC Q36. In the last 12 months, about how many participants were newly enrolled into this center? Count all participants who were newly enrolled--including respite care participants, participants who later died, and participants who are no longer enrolled--regardless of the reason. |
| DROP | ADSC Q37 In the last 12 months, about how many participants died? Include respite care participants. |
| DROP | ADSC Q38. In the last 12 months, about how many participants, including respite care participants, permanently stopped using this adult day services center? Exclude deaths. |
| DROP | ADSC Q38a. Where did each of these participants go immediately after they stopped using the center? Enter "0" for any categories with no participants. a. Another adult day services center b. Assisted living or similar residential care community (e.g., adult care or personal care residence) c. Hospital d. Nursing home e. Private residence (house of apartment) f. Some other place |
| DROP | ADSC Q40 For each item (a-s) below, please indicate in Column 1 whether or not this adult day services center collects or tracks this information about participants. If this center does collect or track the information, please indicate in Column 2 whether or not this center has the computerized capability to collect or track it. |
| REVISE--response categories. (2014 ADSC Q12 | ADSC Q16 Services offered 1=Not provided 2=Provided only by center employees 3=Provided only by others through arrangement 4=Provided by both center employees and others through arrangement |
| REVISE- response categories to distinguish between community screening and use of outside screening (2014 ADSC Q10) | ADSC Q18. As a part of the admission process, does this center screen participants for depression with a standardized tool such as the Geriatric Depression Scale, Beck Depression Inventory, or the Center for Epidemiological Studies-Depression (CES-D) scale? Yes, No |
| ADD-response categories cardiovascular disease and diabetes (2014 ADSC Q18) | ADSC Q30 Of the participants currently enrolled at this center, about how many have been diagnosed with each of the following conditions? a. Alzheimer’s disease or other dementias? b. Developmental disability, such as mental retardation, autism, or Down's syndrome? c. Severe mental illness, such as schizophrenia and psychosis d. Depression |
| ADD response category hospital. (2014 ADSC Q26) | ADSC Q41. Does this adult day services center's computerized system support electronic health information exchange with each of the following providers? a. Physician b. Pharmacy |
| ADD question on full-time and part-time hours. (2014 ADSC Q13a,b) | NA |
| ADD question on falls (2014 ADSC Q22) | NA |
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |