DHHS Internet Website - Public Health

Adult Day Service

Adult Day Service regulations apply to a person or any legal entity which provides care and an array of social, medical, or other support services for a period of less than 24 consecutive hours in a community-based group program to four or more persons who require or request such services due to age or functional impairment.  ( description continued)

Application/Licensure Requirements           Initial Licensure           Renewal Licensure           Forms Change of Notification Complaints - How to File Contact Information           Contact Us           Other Related Contacts

Disciplinary Actions Duplicate License Fees Inspections Listings and Labels Medicaid Certification Rules and Regulations

continued description..................

Adult Day Service does not include services provided under the Developmental Disabilities Services Act.

Licensure means: The Department has issued a license to operate a facility in the State of Nebraska to an individual, government, corporation, partnership, limited liability company, or other form of business operation that is legally responsible for the facility's operation.

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Application/Licensure Requirements

Any person intending to establish, operate, or maintain an Adult Day Service must first obtain a license from the Department.  A facility must not hold itself out as an Adult Day Service or as providing health care services unless licensed from the Department.  An applicant for an initial or renewal license must demonstrate that the Adult Day Service meets the care, treatment, and operational and physical plant standards contained in 175 NAC 5  Section 007.

A license is issued only for the premises and persons named in the application and is not transferable or assignable.

Initial Licensure:

The first stage consists of the applicant's submission of affirmative evidence of the ability to comply withy the operational and physical plant standards contained in 175 NAC 5  Sections 003 and 004.  The application is not complete until the Department receives documents specified in 175 NAC 5 Section 003.01B.

The second stage consists of the Department's review of the completed application together with an inspection of the Adult Day Service.  The Department determines whether the applicant for an initial license meets the standards contained in 175 NAC 5 and the Health Care Facility Licensure Act.

An applicant must:

1. Submit a written application to the Department which includes 175 NAC 5  Section 003.01B; or
2. Pass an on-site inspection as specified in 175 NAC 5 Section 005.01-005.02.

Upon receipt of a completed application, contact will be made to schedule an initial inspection date.  An Adult Day Service cannot operate until the inspection has been completed and a license can be issued.

All Adult Day Service licenses expire July 31 of each year.

All application materials must be submitted to:

Nebraska Department of Health and Human Services
Division of Public Health,  Licensure Unit
Adult Day Service
PO Box 94986
Lincoln, NE 68509-4986

R enewal Licensure

All Adult Day Service licenses expire July 31 of each year.

Notice of renewal is sent to the licensee's preferred mailing address not later than 30 days prior to the license expiration date.  To renew a license the following must be submitted:

1. A completed written application with the information required by 175 NAC 5  Section 003.02A.
2. Required licensure fee specified in 175 NAC 5 Section 004.10.
3. List of names and addresses of all persons in control of the facility.   The list must include all individual owners, partners, limited liability company members, parent companies and members of boards of directors owing or managing the operations and any other persons with financial interests or investments in the facility.   In the case of publicly held corporations, the individual owners listed must include any stockholders who own 5% or more of the company's stock.
4. Current Certificate of Occupancy issued by the Nebraska State Fire Marshal or delegated authority dated within 18 months prior to the license expiration date.

Final Notice

If a renewal application is not postmarked or received by August 1, the Adult Day Service will be sent a final notice.

If a renewal is not received by September 1, the license will be placed in lapsed status.  During lapsed status, the facility may not operate until the license has been reinstated.

Refusal to renew

The Department can refuse to renew a license ( 175 NAC 5  Section 008).

Forms

Initial License Application
Renewal License Application

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Duplicate License

The form may be completed on-line, however, it cannot be submitted via e-mail due to the fact that all applications and forms require original signatures. If you complete the form on-line, you must print the form and mail it to the address below.

A duplicate or reissued license is available for a fee of $10.00. Duplicate/Reissue Form

Licensure Unit
Attn: Adult Day Services
PO Box 94986
Lincoln, NE 68508-9486

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Medicaid Certification

To participate in the Medicaid Aged and Disability Waiver Program, contact the local Health and Human Services office in your area

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Fees

Fee Schedule

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Rules and Regulations

Neb. Rev. Stat §§ 71-402 through 71-463 - Health Care Facility Licensure Act
Neb. Rev. Stat. §§ 71-516 through 71-516.04 - Alzheimer's Special Care Disclosure Act
Neb. Rev. Stat. §§ 71-8401 through 71-8407 - Medical Records
Neb. Rev. Stat. §§ 71-2084 through 71-2096 - Receivers
175 NAC 5 Regulations Governing Licensure of Adult Day Services
Medication Aide Act
172 NAC 95 Regulations Governing the Provision of Medications by Medication Aides and other Unlicensed Persons
172 NAC 96 Regulations Governing the Medication Aide Registry
 Nebraska Food Code Book

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Contact Us

Office Address:

Phone: (402) 471-4967
Fax: (402) 742-2308

Office Hours:

8:00 a.m. to 5:00 p.m. (central time)
Monday through Friday

Pam Kerns, Administrator
Phone: (402) 471-3651
e-mail: pamela.kerns@nebraska.gov  

Trish Lang, Staff Assistant
Phone: (402) 471-4967
e-mail: trish.lang@nebraska.gov  

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Other Related Contacts

Nebraska Child Abuse and Neglect Central Register
Department of Health and Human Services
Protection and Safety Division
PO Box 95026
Lincoln, Nebraska 68509-5044
Suzanne Johnson, Staff Assistant
Phone: (402) 471-9322

Nebraska Adult Abuse and Neglect Central Register
Department of Health and Human Services
Adult Protective Services Program
PO Box 95026
Lincoln, Nebraska 68509-5044
Phone: (402) 471-9190
Web page: http://www.dhhs.ne.gov/hcs/programs/APS.htm

Nebraska Nurse Aide Registry
Department of Health and Human Services
Division of Public Health,  Licensure Unit
PO Box 94986
Lincoln, Nebraska 68509-4986
Wanda Vodehnal, Licensing Specialist
Phone: (402) 471-0537
E-Mail: wanda.vodehnal@nebraska.gov
Web page: http://www.dhhs.ne.gov/crl/nursing/NA/na.htm

Nebraska State Patrol Sex Offender Registry
PO Box 94907 Lincoln, NE 68509-4907
Phone: (402) 471-4545
E-mail: webmast@nsp.state.ne.us
Web page: http://www.nsp.state.ne.us/sor/index.cfm
 

Nebraska State Fire Marshal
246 South 14th Street
Lincoln, NE  68508-1804
Pat Dudley, Staff Assistant
Phone: (402) 471-2027
Fax: (402) 471-3118
E-mail: pdudley@sfm.state.ne.us
Web page: http://www.sfm.state.ne.us/

Aged and Disabled Medicaid Waiver Program
web site: http://www.dhhs.ne.gov/HCS/Programs/AD-Waiver.htm

Social Services Block Grant for Adults Program
web site: http://www.dhhs.ne.gov/hcs/ssbg/ssbg.htm

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Change of Notification

Change of Ownership or Location

A change of ownership (sale, whether of stock, title or assets, lease, discontinuance of operations) or premises terminates the license.  An initial application is required.

The Department must be notified in writing within five working days when a facility is sold, leased, discontinued or moved to a new location.

Capacity

An Adult Day Service must not serve more clients at one time than the maximum occupancy for which the facility is licensed.

Increase in number of clients for which the facility is licensed

Notify the Department at least 30 working days prior to the date the Adult Day Service wishes to increase the number of clients for which the facility is licensed.

New Construction

If new construction is planned, submit construction plans for Department approval prior to any new construction affecting client service portions of the facility. The Department may accept certification from an architect or engineer in lieu of Department review.

Change of Administrator

The Department must be notified in writing within 5 working days when:

• a vacancy in the administrator position occurs including who will be responsible for the position duties until another administrator is appointed.
• the vacancy of the administrator position is filled including the effective date and name of the person appointed.

Change of Facility Name

The Department must be notified in writing within 5 working days when a facility has a change in name. Name Change Form

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Disciplinary Actions

The Department may deny, refuse to renew a license or take disciplinary action against an adult day service license.  See 175 NAC 5  Section 008 for complete information.

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Inspections

To determine compliance with operational, care, treatment and physical plant standards, the Department inspects the adult day service prior to and following licensure. The Department determines compliance through on-site inspections, review of schematic and construction plans, and reports of qualified inspectors.

Initial Inspections ( 175 NAC 5  Sections 005.01-005.02E):

Initial Inspections (   Sections 005.01-005.02E):

The Department must conduct an initial on-site inspection to determine compliance with 175 NAC 5  Sections 006 and 007. The inspection must occur within 30 working days, or later if requested by the applicant, of receipt of a completed application for an initial license. The Department must provide a copy of the inspection report to the adult day service within ten working days after completion of an inspection.

Physical Plant Inspections ( 175 NAC 5  Sections 005.03-005.03B2):

The Department must conduct inspections for conformity with construction plans and compliance with 175 NAC 5  Section 007 at new facilities or new construction prior to use or occupancy.

Compliance Inspections ( 175 NAC 5 Sections 005.04-005.06B):

The Department may conduct an onsite inspection at any time as deemed necessary.

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Complaints - How to file

The Department investigates complaints regarding Adult Day Services. To register complaints, contact the Health Care Facility and Services Complaints.

Written complaints may be submitted to:

Nebraska Department of Health and Human Services
Division of Public Health,  Licensure Unit
Health Care Facility and Services Complaints
301 Centennial Mall South, 3rd floor
P O Box 94986
Lincoln, NE 68509-4986

Fax: (402) 471-1679
web site: www.dhhs.ne.gov/crl/invest/invest.htm

Due to their confidential nature, complaint allegations should not be sent via e-mail.

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