Documentation
Though similar, this term is not interchangeable with “guardian”.
POA
This should be used during each member assessment to ensure required practices are met.
Reassessment Checklist
This is the timeframe auditors are looking for to determine if a face to face assessment was timely.
6 months
These need to be entered prior to a decision on a service or item.
RAD/Medically Necessary Case note
This is signified on the auth screen in MIDAS by the “@” symbol.
Essential Provider
The terms “provider concerns” and “critical incident” should not be referenced here.
Case Notes
This indicator evaluates for discrepancies between the Functional Screen and MCP or assessments.
LTCFS Consistency
This is the timeframe care teams have to send an NOA if no extension letter is sent.
14-calendar days
These can be initiated by member, legal rep or provider and start the timeline for a decision to be made.
Request
This is the IDTs role in setting up a service or item and typically occurs one time.
Coordination
This is the best time for documentation of ongoing monitoring but also an area where most gaps are created in follow up.
Monthly Contact
These need to be itemized in the MCP to identify who in particular assists the member.
Supports/identified needs
This is the timeframe care teams have to make a decision/enter an NOA if a Notice of Extension letter is sent.
28-calendar days
This is present on the MCP since 9/8/2022 and ensures member is aware of their choice in providers and covered services.
Checkbox
For bathing DME consistency purposes, this term is interchangeable with “tub bench”.
Shower chair
Hospitalizations referenced in case notes should have a corresponding _________ in member file.
Hospital Admission Entry or Care Transition Assessment
If the team enters a case note to indicate the SDS worker obtained copies of the MCP, this phrase should be noted on the signature page.
“See note on this date”
This is the amount of time assessments and MCPs have to be updated in following a change in condition.
30-calendar days
Locking of food, audio and video monitoring, cigarette rationing and withholding funds may all be an indication of this.
Rights Limitation
For toileting DME consistency purposes, this term is interchangeable with “raised toilet seat”.
Commode
This strategy is highly encouraged to ensure all follow up loops are closed prior to making a monthly contact.
Print case note feature
If this is missing at the time of an audit, the IDT should still attach in MIDAS and have the indicator marked as "met."
Signature Page
If an essential provider is authorized between MCP reviews, this is the time frame care teams have to obtain their signature on the SP page.
30-calendar days from the service start date
Wheelchair belts, hands on holds and bedrails may all be an indication of this.
Restrictive Measures
In the absence of case notes, these can be utilized to determine if a service was coordinated in a timely manner.
Authorizations