Client Management›Adult Day Health Care (ADHC)

Adult Day Health Care (ADHC)

Overview

Adult Day Health Care organization and management processes are different from typical in-home care processes. See below for an administrative overview of the ADHC model in Ankota. NOTE: Please be sure to review the Ankota Quick Launch video prior to reading the information below.

Index

I. Set-up

  • Initial Configuration
  • Facility Management
  • Authorization Management
  • Authorization Management for ADHC with Family Check-in
  • Pre-Scheduled vs. Unscheduled Visits
  • Automated Visit Closure
  • Schedule Limitations
  • Client Check-in Notifications

II. General Use

  • Overview
  • Kiosk Management (Client Check-in/Check-out)
  • Signatures
  • Cancel Check-in
  • Manual Visit Correction
  • Shift Management - Scheduled Visits
  • Shift Management - Unscheduled Visits
  • Activity Management
  • Retroactive Activity Attendance Reporting
  • Attendance Report

III. Troubleshooting

I. Set-up

Initial Configuration

Initial configurations are generally performed by an Ankota specialist. If your company was not implemented with the Adult Day management modules, you will want to request the ADHC package (Client Check-in, Activity Attendance, and Staff Check-in), as well as a staff/caregiver kiosk profile, most likely.

Please note that in addition to the standard configurations, you may need to request the following to be added to your system:

  • Visit types (since these are usually unique to each organization)
  • ADHC activities (care plan items). If you wish to break up care plan items by categories, the Adult Day Activities screen has the option to work by category with drop-down lists if that is preferred

The Activity Attendance page displays a form for recording facility attendance with fields for selecting a facility (3A Care Day Program), participants (All selected - 24), tags, and visit date (6/20/2023). Below are expandable Care Plan Items sections including Adult Day, Adult Day Mornings, Adult Day Afternoons, and Adult Day Habilitation, alongside a Notes text area and an Admins and Employees dropdown field.

  • Facilities
  • Signature function - turn on if desired

Facility Management

Facilities are the backbone of Adult Day management in Ankota. These facilities are usually added by your implementation specialist as part of your Ankota implementation process. As you add clients AND caregivers or admins, each one should be assigned to a facility on their main profile page.

Client Detail page for Edgar Degas showing personal information fields including Client ID, name, date of birth (08/04/1949), gender, and status (Active as of 02/09/2021), with the Facility field highlighted in red showing "Facility, Sunny Days" selected.

Should you need to add more facilities, reach out to Support for assistance.

Authorization Management for ADHC (Staff Check-in)

Most Adult Day service providers have staff members check in their clients. In this case, there are many options for authorization/visit type management. Best practice is to create an authorization, which will allow the system to correctly choose visit type for each client during check-in, even without scheduled visits.

Create Authorization

To create an authorization, simply follow the standard authorization entry process.

Automatic Authorization/Visit Type Management

If you have any of the following structures in place, Ankota will automatically apply the correct visit type during Adult Day check-in:

  • One authorization per day for the client
  • Pre-scheduled visits
  • A single default visit type

Manual Authorization Management

In some cases, companies will not want to pre-schedule visits, and there will be more than one Adult Day visit type. In this scenario, the staff member handling check-in will need to choose the authorized visit type and hours at the time of check-in.

Once this configuration is set up, as part of the client's regular check-in process, a staff member can enter the appropriate hours and minutes that you plan to authorize for the client's day by visit type.

Example:

The Authorized Visit Types dialog allows allocation of hours to different visit types for a patient. Two visit types are displayed: "Community Based HI (99)" with 496 available hours and "Day Habilitation Tier E" with 128 available hours, each with dropdown menus to select hours and minutes allocations, and a Save button to confirm changes.

Authorization Management for ADHC with Family Check-in

Unlike the staff check-in model, family (or other caregivers) would not be expected to know the funding/visit type/authorizations associated with the service. To ensure the family member/caregiver will not have to choose the visit type, use one of three methods of visit type management:

  • One authorization per day for the client
  • Pre-scheduled visits
  • A single default visit type

Automated Visit Closure

Some organizations may need check-ins but not check-outs, usually because they have private pay visits that are billed at per-visit rates. If this is the case, the system can be updated to automatically close visits after the scheduled duration or a specific standard duration. (This is not defaulted.)

For example, if the limit was set to 8 hours on the Adult Day visit type, clients' Adult Day visits would automatically close out at 8 hours.

Schedule Limitations

The Schedule Limitations tab is not defaulted on, except for in private pay environments. This access must be requested to use this feature.

Some organizations may need to track when clients are not supposed to come in, yet at the same time, allow them to clock in if needed against their authorization. Specifically, this function is aimed at clients with long-term care insurance that may be approved for only certain days of the week, but, if specifically requested, may allow an additional or make-up day. These unauthorized check-ins can then be tracked in a special Adult Day health care tracking report.

To turn on schedule limitations:

  1. Open the client's profile
  2. Click the Schedule Limitations tab
  3. Add constraints as needed (typically full-day)
  4. Save

For example, here only Tuesday, Wednesday, and Thursday are allowed service days.

The Client Detail page shows the Schedule Limitations tab for Test Patient, displaying a Time Constraints table with days of the week and constraint settings. The table includes columns for Days, Constraint Type, Available Time, Duration, Visit type, and Client Address, with Monday currently highlighted and set to "NotAllowed" constraint type. A Save button is located at the bottom of the form.

When the client is checked in, staff will receive a warning notification that service is not authorized for the client this day. If they wish, they can override the warning. The system will track the override in the appropriate report.

The Client Check-in screen displays a warning message stating "Client is not allowed to receive services today" with options to PROCEED or CANCEL the check-in, while the background shows fields for Facility (Bronx Center), First Name, Last Name, and client filtering options.

Client Check-in Notifications

Some organizations want their staff to be notified of reminders during client check-in. Ankota provides an option for these reminders.

On each client's Notes/Overview tab, there is a special checkbox for "Include note in check-in."

Client Detail page showing the Information tab with a notes section containing client preferences, including a note that the client requires a gold armband and prefers to be called Jilly, with a "Save Note" button and "Include note in check-in" checkbox option.

When checked, notifications will be provided. When the client is checked in to the Adult Day module, a flashing yellow pop-up will appear including the first paragraph (up to 200 characters) of information from the client's profile.

The Client Check-in page shows a form to select a facility (Bronx Center) and filter clients by first name, last name, and skill level, with radio button options to view clients with scheduled visits, all clients, or clients without scheduled visits. The page displays two sections: "Clients who are not at the Facility" on the left with a Check in button, and "Clients who are at the Facility" on the right showing a checked-in client with options to view details, check out, or remove the client.

When the flashing yellow notification is clicked, a new pop-up will appear with a list of all unread client check-in notifications. To close out this window, the user will need to confirm they have read and acknowledged this information.

The Notifications panel displays a single notification titled "Client Test" with a message stating the client requires a gold armband and prefers to be called Jilly, followed by a "Read and Acknowledged" button at the bottom.

II. General Use

Overview

Adult day functionality in Ankota allows for client check-in/out, activity attendance, and staff check-in/out. Once configured, these options will appear in the left menu under the Adult Day module.

Not all Adult Day facilities use all three Adult Day options. In addition, for those organizations which choose the "kiosk" method, only the Adult Day section will be visible to staff for client management (unless other sections, such as Mapping, are requested). See below for more information on kiosk management.

Full Ankota Access

The AIM Dashboard displays multiple data panels including Census (showing 35 active contacts, 0 referral contacts, prospects, on hold, and pending items), Phone Calls, Visits (3 scheduled, 5 closed), and Open Visits. The left sidebar shows navigation options including Dashboard, Action Center, Visits, Employees, Scheduling, Clients, Reporting, Billing/Payroll, Settings, and an expanded Adult Day menu with Client Check In, Activity Attendance, and Staff Check In options.

Kiosk Management (Client Check-in/Check-out)

Most facilities will choose to make the Adult Day Health Care section available through a single login, or "kiosk." More on kiosk management is available in the Caregiver Resources Adult Day Kiosk walkthrough, but in general, caregivers should simply drag and drop the appropriate client from the "not at the facility" left side to the "at the facility" right side.

NOTE: most tablet users find the "Check in" and "Check out" links easier to use, while desktop users generally prefer the drag-and-drop.

The Client Check-in screen displays a facility selection dropdown set to "Aim. Facility" at the top, with First Name and Last Name search fields and a skill filter dropdown. The page is divided into two sections: "Clients who are not at the Facility" on the left listing clients like Chagal, Marc and Degas, Edgar with "Check in" links, and "Clients who are at the Facility" on the right showing Dactyl, Teri with "Check out" and other action buttons.

NOTE: There is an option to require DUAL LOG-INS, where the user first logs in with the Kiosk log-in, then logs in with their personal credentials. This is a custom feature. Contact Ankota Support for more.

Signatures

For facilities that require signatures at check in and check out, a pop-up will appear at check in and check out. (This can be turned on/off as needed.) If a picture is registered for the client, that picture will be included during clock-in and clock-out.

The Client Check-in screen displays a signature pad for "Kahlo, Frida" to sign on arrival, with a drawn signature visible in the center canvas area and buttons for Clear, Sign, and Sign By Topaz at the bottom.

Cancel Check-In

If a client was accidentally checked in and check-in needs to be cancelled, click the X next to the client's name in the "Clients who ARE at the Facility" section. A prompt will confirm cancellation. If yes, the client will return to the "Clients who are NOT at the Facility" section and the visit will be cancelled on the schedule board. If no, the client will remain checked in.

A "Cancel Check-In" confirmation dialog is displayed with the message "Do you wish to cancel this check-in?" and two buttons: "YES" and "NO". This dialog appears to be overlaying a facility check-in interface that includes a "Check out" button and other options in the background.

The schedule board will look like this:

This is a weekly scheduling calendar view showing client appointments for "Client, Test" from July 31 to August 6, with a red indicator highlighting 2 canceled appointments on August 2-3 that are connected by a line to two scheduled sessions on Friday, August 5 (11:22 AM - 11:22 AM and 11:27 AM - 11:27 AM, both ADI-ADC Ankota Support sessions). The top of the screen displays status counters for Hours Scheduled, Hours Completed, Open Shifts, Arrived, On Hold, Rework, Needs Approval, and Late appointments.

Manual Visit Correction

If clients are accidentally clocked in, the visit can either be cancelled as shown above, or the visit can be changed to the status of scheduled, then deleted, by any admin in ankota.net. This can be done either on any scheduling board, or on the Visits page.

Visits in the status of Arrived cannot be deleted, so they must first be saved in the status of Scheduled before they can be re-opened and deleted.

Deletion via Calendar Access

This screenshot shows the Details page for a scheduled visit (ID 7480320) for Paul Cezanne, displaying key information including visit type (Adult Day Care), duration (4 hours), scheduled start and end times (09/11/2021, 8:00 AM to 12:00 PM), current status (Scheduled), and assigned caregiver. The Status field is highlighted with a red border, and a red message indicates that visits in Scheduled status can be deleted; action buttons include "Update Visit Detail," "Delete Visit," and "Cancel" at the bottom of the form.

Deletion via Visits Page

The Search for Visits page in AIM displays a query interface with multiple filter fields on the left and center (Visit Date, Client ID, City, Visit Status, Agency, etc.) and a results table below showing 2 visits with columns for Client Name, Assigned Caregiver, Visit Type, Scheduled Date, and Status. A red annotation highlights a visit with "Scheduled" status and indicates it can be deleted.

Arrival and departure times can be updated via the Visit Approval Dashboard.

Shift Management - Scheduled Visits

For organizations which manage shifts in Ankota, the Staff Check-in page is available under the Adult Day module. Caregivers can clock in and out from the Staff Check-in page using their user name and password, then clock in and out of scheduled office shifts. In short, click Visits and follow the prompts to clock in and out. For a more detailed walkthrough, see the Mobile App walkthrough.

This is the main navigation menu of a dashboard interface titled "Hello Test!" with a vertical menu listing options including My Visits (highlighted with a red border), My Clients, Notifications (0), Visit History, Payroll, and Settings. The menu appears to be the primary navigation for a client or visit management system.

Shift Management - Unscheduled Visits

For organizations which wish to manage shifts in Ankota and limit available mobile app sections, the Staff Check-in page is available under the Adult Day module. Caregivers can clock in and out from the Staff Check-in page using their user name and password, then clock in and out of office shifts as needed.

The unscheduled visits method allows caregivers to clock in and out of office shifts at any time, without scheduling caregivers to office visits in advance. These visits will be flagged only if the caregiver is in the wrong location at the time of check-in/out. This function does require special set-up; reach out to Ankota to add this configuration if desired.

AIM software home dashboard showing a personalized greeting "Hello Jennifer!" with menu options including "Office Check-in/out" (highlighted with red border) and "Settings" buttons, alongside a left sidebar containing Adult Day Care navigation with Client Check-in, Staff Check-in, and Log Out options.

The Assigned Patients screen displays a list of patients assigned to the West Facility with a blue "Report Arrival" button in the top right corner. The left sidebar shows the Adult Day Care menu with options for Client Check-in, Staff Check-in, and Log Out.

Activity Management

Care Plan (Activity List) Buildout

Activity lists for Adult Day are created by creating a care plan and assigning it to a facility. Typically, a single care plan will be built with the assistance of an implementation specialist, then assigned to the facility once. Until the care plan changes, no updates are needed. Clients do not need individual care plans for Adult Day activity management, although they can have personal care plans so that non-standard care plan items can be addressed specifically for that client.

The facility care plan will normally be developed hand-in-hand with an Ankota implementation specialist.

To update an Adult Day care plan:

  1. Click Settings
  2. Click Services Settings
  3. Click on the Adult Day care plan to open it
  4. Change the selected care plan items inside the care plan
  5. Scroll to bottom and save

The "Care Plan Items from Selected Category and Type" page displays a care plan configuration form for an "Adult Day Care Plan" with Plan Type set to "Caregiver" and Plan Status set to "Active." The form contains two main sections—"Personal Care" with vital sign activities (Bingo, Arts & Crafts, Exercise Classes, Special Events, Animal Therapy, Games, Meditation, Book Club, Music Activities) and "Adult Care Info Only" with activities like Independent Living, Housing, Psycho-Social, Rehab, and Recovery—each with checkboxes and time input fields, along with "Save Plan" and "Close" buttons at the bottom.

If new or altered care plan items are needed, contact support@ankota.com to request an update to care plan items.

Individual Daily Activity Management

Since not every activity will apply to every client every day, the activity must be added to the client one of two ways:

  • apply the activity to the caregiver on the main Activities page
  • add the activity to the caregiver using the drop-down list

The Care Plan Items section displays a list of caregiving tasks and services organized by category, with a dropdown menu showing options like "Appointment Transportation," "Personal Care," and "Home Management." The left panel shows status options (Not Set, Completed, Not Needed, Refused by Client) for tracking care plan items, along with an "Add Item" button and "Report Items" button below.

Clients' applied activities/care plan items can be viewed by clicking on their "list" icon on the main check-in page:

The "Clients who are at the Facility" list displays three client names (Anderson, Kylie; Brown, Julie; and DeVinci, Jane) with action icons on the right side of each row, including a red highlighted delete/remove button for the first client.

The Care Plan Items dialog displays a list of scheduled activities for an adult day program, including "Adult Day I - Arts & Crafts," "Adult Day I - Bingo," and "Adult Day I - Exercise Classes" with their respective status dropdowns showing options like "Checked In," "Checked In," and "Not Set." A "Report Items" button appears at the bottom of the dialog for generating reports on these care plan activities.

The client's personal, unique care plan information (not the facility care plan) will show up on this page without anything needing to be selected, so long as the visit type is set up to ask the questions in the category.

For example, Test Testerson here has a diabetic prompt in her care plan that is being asked about:

The Care Plan Detail page for Test Testerson shows the Care Plan Items Category section with "ADULT DAY" and "PRIVATE PAY" categories; the ADULT DAY category displays "No results found with the search criteria" while the PRIVATE PAY section contains a table with columns for Item, Note, and Time (Minutes), with "Diabetic Prompts" listed as one item.

Her visit type is also set to ask questions for that Private Pay category:

The Private Pay - Details dialog shows the Configuration tab with Care Plan checkboxes (including Adult Day, Angela Murphy, Barbara Cave, etc.) and Care Plan Item Category checkboxes, with PRIVATE PAY currently selected and highlighted in red. A Save Configuration button is located at the bottom of the form.

So now the client check-in board is asking about the diabetic prompt:

The Care Plan Items dialog shows a selected item "Test Testerson - Diabetic Prompts -" with status options including "Not Set" (currently selected), "Completed", "Not Needed", and "Refused by Client", along with an "Add Item" button and a "Report Items" section below.

Group Daily Activity Management

Activities can also be managed at a group level at each facility via the Activity Attendance page. The Activity Attendance page generally looks like this:

The Activity Attendance page shows filter options at the top (Facility set to "Aim, Facility", Participants set to "All selected (3)", Tags set to "None tags", and Visit Date set to "5/23/2023"), followed by a Care Plan Items section listing multiple Adult Day Basic Care Plan activities (Arts & Crafts, Exercise Classes, Special Events, Animal Therapy, Games, Meditation, Book Club, Music Activities, and Bingo) with dropdown menus set to "Not Set". A Notes section and Admins and Caregivers section appear on the right, with a Save button at the bottom.

To manage activities as a group:

  1. Select a facility

  2. Select a tag, if desired (to pull up a specific group of clients)

  3. Select participant(s); if more than one participant is selected, the activity will be updated for everyone selected

The Participants dropdown menu showing "-- None participants --" with a search field and checkboxes for selecting individual participants including "Dactyl. Teri" and "Degas. Edgar", along with a "Select all" option.

  1. The activity list will appear

The Care Plan Items screen for Adult Day services displays four Basic Care Plan categories (Arts & Crafts, Exercise Classes, Special Events, and Animal Therapy), each with a dropdown menu currently set to "Not Set". This configuration page allows users to set care plan options for adult day programs.

  1. Select status (same status will apply to EVERY client selected)

The Care Plan Items page displays four Adult Day Basic Care Plan categories with their participation status. Each row shows a care plan item (Arts & Crafts, Exercise Classes, Special Events, and Animal Therapy) with a dropdown menu indicating the participant's engagement level, such as "Participated and engaged" or "Present but not engaged."

  1. Add notes if desired

Notes section showing a sample note that reads "Edgar and Teri had a lot of fun together today." with a text input field for entering or editing notes.

  1. Select your name

The top navigation bar shows "Admin" on the left side and a dropdown menu labeled "Support, Ankota, Support" on the right side with a down arrow indicating additional options.

  1. Save

Retroactive Activity Attendance Reporting

If activities were not reported for a previous day, this can be corrected using the date picker on the group Activity Reporting page. Any client who was checked in OR checked in and out can have activities reported retroactively. (Unchecked in clients cannot have activities reported retroactively.)

To report, select the Facility and participants as usual, then pick the Visit Date. Then report as usual, knowing that these activities will be reported on the selected date. Clients must have been checked in on this day for retroactive activity reporting to work. If front desk workers need clients checked in retroactively, they will need to ask an admin with schedule board or general visits access to update the check-in status retroactively.

The Activity Attendance page displays filters for Facility and Participants at the top, along with a Tags section and a calendar date picker showing May 2023 with a highlighted visit date of 5/23/2023. Below is a Care Plan Items section listing multiple Adult Day Basic Care Plan activities (Arts & Crafts, Exercise Classes, Special Events, etc.) with "Not Set" status dropdowns, and a Save button at the bottom.

Attendance Report

Ankota provides an adult day attendance report which includes the following:

  • Visits Authorized and Attended
  • Visits Authorized and Missed
  • Visits Unauthorized and Attended

This report provides an overview of client attendance, wanted or not. For full use, use the Schedule Limitations function so that Ankota can identify the days which are not permitted.

III. Troubleshooting

If issues arise, the following troubleshooting steps may help resolve them.

Visit Type Choice Missing From Adult Day Check-in Board

If the visit type choice option does not appear on the adult day check-in board, review the following:

  • Is the system set up for visit type choice upon check-in? If not, reach out to Support to request this feature.
  • Does the client have an authorization for the visit type options they should have?
  • Is the authorization active?
  • Is the authorization exhausted?
  • Does the client have pre-scheduled visits? If only one visit type is scheduled for the day, they will automatically be checked in for that visit type.

Visit Type Choice Appearing (Unwanted) on Adult Day Check-in Board

If visit type choice should not appear on the adult day check-in board, reach out to Support to request this feature be turned off. Be sure to request a default visit type for each facility to ensure that clients are checked in on the correct visit type.

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