ACRONYMS
TOA'S
SPL
FORMS
PAYMENT SYSTEMS
100

D.O.R.

What is Date of Request?

100

The TOA that indicates a client receives Supplemental Security Income.

What is SSIR?

100

The care task of helping an individual transfer in/out of a tub/shower is assessed in what ADL?

What is Bathing?
100

Client Employer Representative

What is a 737?

100

The document authorizing an in home care agency to be paid for providing services to our clients is entered into what system?

What is MMIS?
200

C.A.P.S.

What is Client Assessment and Planning System?

200

This TOA indicates that an individual has protected eligibility through the Pickle Amendment

What is PTCC?

200

Name one of the IADLs that assesses the need to puree' a client's food to consume?

What is Breakfast, Lunch or Dinner?

200
This form allows a client advocate to interact with our office for medical applications.

What is a 231 - Authorized Representative?

200

Name the entries needed to bring up the Suspend List in DHR.

What is SCFP,B,Branch?

300

I.H.C.A.

What is In Home Care Agency?

300

This TOA indicates that a client has been approved/authorized for a Medicare Savings Program covering Medicare Part A/B copays and deductibles.

What is QMBP?

300

Name the level of need and ADL assessed when an individual requires daily assistance to understand and manage their basic health and safety needs as well as how to act on those needs. (2-part answer)

What is Substantial Assist in Self Preservation?

300

This notice advises a Home Care Worker of the authorized hours they can work for an in-home client.

What is a 4105?

300

What is the name of the payment authorization document indicating payment to an adult foster home?

What is a 512?

400

S.P.L.

What is Service Priority Level?

400

This TOA indicates that an individual has been approved/authorized for OSIPM in an acute care setting.

What is OSIPMAC?

400

Name the 3 tasks assessed in Dressing.

What is getting dressed, undressed and socks/shoes?

400

This form must be on file for an in-home client that hires a Home Care Worker advising the client of the State's Worker's Compensation program.

What is a 354?

400

A client's liability has been reduced and the Assisted Living Facility has already been paid. What type of payment adjustment would need to be submitted to correct the facility payment? 

What is an Underpayment?

500
O.S.I.P.M.

What is Oregon Supplemental Income Program Medical?

500

These TOAs indicate that a client over age 65 has been approved for LTCSS.

What is NMAGISERV and LTCSERV?

500

Identify the level of need in the following scenario: a client requires assistance to braid their hair at least once a week and toenail care every 3 months.

What is Full Assist?

500

This form must be signed when a client waives their right to a Title XIX assessment.

What is a 457D?

500

What is the frequency of payment entered into a Plan of Care when setting up payment to a Nursing Facility?

What is Daily?

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