ADSC Question Changes

Attachment D-2 ADSC Question Changes
2020 Change	2018 Questionnaire Number and Wording
DROP	ADSC 5. What is the total number of years this center has been operating as an adult day services center at this location?
DROP	ADSC 9.What days of the week and times of the day is your center typically open?
DROP	ADSC 11 When does this adult day services center screen each participant with a standardized tool for each of the following? a. Alcohol or substance abuse b. Anxiety c. Cognitive impairment d. Depression e. Pain f. Pressure injury/ulcer risk g. Activities of Daily Living (ADLs) h. Instrumental Activities of Daily Living (IADLs)
DROP	ADSC 13. Does this adult day services center use computerized capabilities to… a.Record participant demographics b.Record clinical notes c.Record participant medications and allergies d.Record participant problem list e.Record individual service plans f.View lab results g.View imaging reports h.Order prescriptions
DROP	ADSC 15. For each of the following statements, please indicate how often this is your adult day services center’s current practice. Participants choose the times they prefer to eat. Participants have access to food in the centerat any time. Participants participate in choosing the typesof activities that are offered to them. Participants participate in developing their care plan. Participants participate in deciding whichaides are assigned to care for them. Participants with memory problems have special activities designed for them. Participants or their family members are provided with opportunities to express their preferences about end-of-life care.
DROP	ADSC 21. In the last 12 months, about how many participants permanently stopped using this adult day services center? Exclude deaths. If none, enter “0”.
DROP	ADSC 22. Of those participants who stopped using this center in the last 12 months, how many left because the cost of attending the center, including meals and services required to meet their needs, exceededtheir ability to pay? If none, enter “0”.
DROP	ADSC 24 For each specialized service listed below… MARK ALL THAT APPLY IN EACH ROW This adult day services center… Provides the service by paid center employees Arranges for the service to be provided by outside service providers Refers residents or family to outside service providers Does not provide, arrange, or refer for this service a. Management of behavioral symptoms, such as agitation b. Pressure injury or wound care c. Continence management d. Palliative care—treatment of the pain, discomfort, and symptoms of serious illness
DROP	ADSC 25.Fall risk assessment tools often address gait, mobility, strength, balance, cognition, vision, medications, and environmental factors. Examples of tools include but are not limited to CDC’s “Stopping Elderly Accidents,Deaths & Injuries” or STEADI; Timed Up and Go or TUG test; 30-second chair stand test; and 4-stage balancetest. Does this adult day services center typically evaluate each participant’s risk for falling using any fall risk assessment tool?
DROP	ADSC 26.Fall reduction interventions may include but are not limited to environmental safety measures; medication reconciliation; exercise, gait, or balance training; and participant or family education. Does this adult day services center currently use any formal fall reduction interventions?
DROP	ADSC 27.Please indicate how often your adult day services center engages in the following practices when a participant is dying or has died.
DROP	ADSC 29.Of the number of full-time and part-time employees currently employed in this center, indicate how many have been employed at this center for more than 1 year.
DROP	ADSC 30. For each of the following employees, indicate how many full-time and part-time employees this center had onJanuary 1, 2017.
DROP	ADSC 31.Of the number of full-time and part-time employees this center had on January 1, 2017, indicate how many left this center between January 1, 2017 and December 31, 2017. This would include both voluntary and involuntary terminations (retired, dismissed, resigned).
DROP	ADSC 32. If hired today in this center, what would be the lowest and highest hourly wage that might be offered to anentry-level aide employee?
DROP	ADSC 33. How many hours of training does this center require newly employed aide employees to have prior to providingcare to participants?
DROP	ADSC 34. How many hours of on-going continuing education or in-service training annually does this center provide orarrange for your aide employees?
DROP	ADSC 35. Does this center offer the following benefits to full-time aide employees? Health insurance for the employee only. Health insurance that includes family coverage. Life insurance A pension, a 401(k), or a 403(b). Paid personal time off, vacation time, or sick leave
DROP	ADSC 36. For each of the items below, please indicate how often this occurs at this center. a. Aides attend participant care plan meetings b. Changes in participants’ care are made as a result of aide input c. Aides work with the same participants
REVISE--delete Human immunodeficiency virus (HIV)/AIDS and Post-stroke physical or cognitive impairments with a need for rehabilitative therapies (ADSC 10)	ADSC Q8 In which of the following diagnoses, conditions, or disabilities does this center specialize?
REVISE- delete Behavioral health provider from the list (ADSC 15)	ADSC Q14.Does this adult day services center’s computerized system support electronic health information exchange with each of the following providers? Do not include faxing.
REVISE- collapsed the under 65 years categories into one (ADSC 20)	ADSC Q18 Of the participants currently enrolled at this center,what is the age breakdown? Enter “0” for any categories with no participants.
ADD BACK IN provider questionnaire-- questions that were in a services user questionnaire in 2018--advance directives. (ADSC 12-13)	NA
ADD BACK IN provider questionnaire--questions that were in a services user questionnaire in 2018--race-ethnicity. (ADSC 21)	NA
ADD BACK IN provider questionnaire-- questions that were in a services user questionnaire in 2018--medical conditions. (ADSC 22)	NA
ADD BACK IN provider questionnaire--questions that were in a services user questionnaire in 2018--all six Activities of Daily Living. (ADSC 27)	NA
ADD BACK IN provider questionnaire-questions that were in a services user questionnaire in 2018--emergency department visits and overnight hospital stays (ADSC 28-29)	NA
ADD BACK IN provider questionnaire--questions that were in a services user questionnaire in 2018-- falls. (ADSC 30)	NA
ADD item on current operating status (ADSC 4)	NA
ADD two items on COVID-19 prevalence (ADSC 34-35)	NA
ADD four items on COVID-19 experience (ADSC 36-40)	NA
ADD one item on general infection control practices and policies (ADSC 17)	NA
ADD question on opioid administration (ADSC 23)	NA