Mini Mental State Exam (MMSE)
CDPAP
Health Care Proxy (HCP) & Advance Directives (AD)
coding
Misc
100
It must be verified x 3 before proceeding with the MMSE.
The member's identity.
100
Can the spouse of your member be the CDPAP Assistant?
No.
*Reach out to manager for any extenuating circumstances.
100
Which of the following is not an end-of-life request which might be found on an HCP?
DNR
DNI
DME
CPR
DME
100
Your member requires the weight bearing assistance of 2 helpers to ambulate. The most accurate UAS response for walking would be:
Independent, setup help only
Limited assistance
Extensive assistance
Maximal Assistance
Maximal assist: Weight-bearing support (including lifting limbs) by 2+ helpers - OR - weight-bearing support for more than 50% of subtasks.
100
You are completing an assessment of a member with a MMSE 15/30. The member's daughter is unavailable, but the PCA reports she can provide you with all the information you need to complete the UAS. May you proceed with this assessment?
No.
If the member is not self-directing, the assessor cannot accept information from the PCA in the absence of family or informal caregivers.
The visit must be rescheduled until an informal caregiver or other responsible party (HCP, POA, etc.) is available to answer UAS questions about the member as needed.
200
Because the member cannot legally give consent or participate in the UAS assessment, we must reschedule the visit if the member is alone and has scored ____ or below on their MMSE exam.
17
200
When educating on the CDPAP benefit, this form describes the member's responsibilities in receiving CDPAP services and the plan’s responsibilities within the service.
The CDPAP Agreement.
200
What document is described below?
A legal document that allows you to appoint someone to make medical decisions about your health if you are unable to do so.
A Health Care Proxy (HCP)
Note: You must use this language when educating HF members on the HCP.
200
Member reports he went to the ER 2x in the last 90 days. The 1st time he was transferred to CCU from the ER and stayed for 3 nights. For the 2nd ER visit, he was treated for SOB and sent home the same night. Member also states that 6 months ago he fell and was taken to the ER by ambulance for observation. How many ER visits and Hospital stays has the member had in the last 90 days?
1 ER Stay, 1 Hospital Stay
200
Member states she is alone for hours after the PCA leaves until 8pm, when her daughter returns from work. Because she is afraid she will fall walking to the bathroom unassisted, she holds her urine as long as she can and then relieves herself in her diaper. You ask if the member ever has any other incontinence episodes. She reports she wets the bed almost every night but reports no leakage during the day. The best UAS response for Bladder Continence over the last 3 days is:
- Continent
- Control with any catheter or ostomy over last 3 days
- Frequently incontinent - Daily, but some control present
- Incontinent - No control present
Frequently incontinent - Daily, but some control present
300
The only acceptable alternative to the serial 7s calculation exercise is to ask the member to spell this word backwards.
What is the word W-O-R-L-D.
300
Where do we document CDPAP teaching and outcome (please be specific).
Section A Intake & History, Comment Section (lower box) of the UAS.
300
True or False: We need to notarize the Health Care Proxy in NY state for it to be valid.
False. The HCP does not need to be notarized in NY State for it to be valid.
The HCP is considered valid if it has the signature of two witnesses along with all the requested contact information.
300
Member’s daughter has taken over responsibility for bill payment after the member forgot to pay the gas bill & went 1 week without heat. Member still goes to the bank to make small deposits & withdrawals. Based on this information, the best UAS response for Finances, both Performance and Capacity, would be:
Setup Help Only
Limited assistance
Maximal Assistance
Total Dependence
What is Maximal assistance - member helps throughout task but performs less than 50% of task on his own.
Managing Finances - How bills are paid, checkbook is balanced, household expenses are budgeted, credit card account is monitored.
300
What are the numbering conventions for the following documents:
CAPS Report, UAS Comprehensive Report, MMSE, ATSP, CDPAP Agreement, HCP, Visit Card, UAS Checklist
31, 22, 2, 4, 14, 12, 39, 37
400
It is the criteria for correctly drawn pentagons.
To be correct, the figures must intersect, and each pentagon must have 5 sides.
400
True or False: At every visit we must provide a CDPAP Physician Order Form 4359 to all SHP & CC members who are interested in, or wish to continue, the CDPAP program.
True.
Reminder: We do not leave this form with PHSP members.
400
Question 4 of the Health Care Proxy allows members to make these wishes known, aka advance directives.
What are end of life wishes. 
400
Member's daughter reports member has been increasingly forgetful, misplacing items and forgetting how to use her coffee maker. The member has not made any unsafe decisions nor does she need any supervision to maintain her safety. Daughter does report that member has some difficulty making decisions in new or unfamiliar situations.
The best UAS selection for Cognitive Skills for Daily Decision Making question would be:
- Independent
- Modified Independence
- Minimally Impaired
- Moderately Impaired
- Modified Independence - Some difficulty in new situations only.
Note: If the word 'Impaired" appears in your coding selection for decision making, you are communicating that the member does not make safe decisions and is therefore not self-directing.
400
UAS refers to a “Helper” in its description of levels of assistance for tasks in Section F. The definition of a “Helper” in UAS is:
- An assistive device
- Any person providing assistance
- An object the member uses, such as a wall or piece of furniture
- All of the above
- A helper is ANY person providing assistance to the member.
500
We must make sure to have the member's attention when we give these instructions because we can only say them once.
What are instructions for the three-step command, which assesses procedural memory.
I'd like you to take this paper in your right hand
Fold it in half
Place it on the floor
500
What is the function of the Fiscal Intermediary (FI) in the CDPAP process?
To process payroll for the CDPAP Personal Assistant (PA).
500
What number do we use to attach the HCP form to Sharepoint?
#12
500
Due to forgetfulness, Jose requires the pharmacy to prepour and dispense his medications in a pillbox for proper administration. Based on this information, the best UAS response for Managing Medications would be:
- Set up Help Only
- Limited Assistance
- Extensive Assistance
- Maximal Assistance
Extensive Assistance
Note: We automatically begin coding for ALL medication pre-pours at Extensive Assistance and then look at the subtasks to determine if we need to code the member up to Maximal assistance.
Subtasks - How medications are managed (e.g., remembering to take medicines, opening bottles, taking correct drug dosages, giving injections, applying ointments)
500
You arrive at your scheduled assessment and find the client masked and visiting with a neighbor at her kitchen table who is not involved in the member's care. After you introduce yourself, what should be the next step you should take?
HIPAA guidelines require you to ask the member if it is ok to discuss her private medical information in front of the guest.
*FYI: Masking is no longer mandatory for HF assessors. However, the assessor is directed to follow the member's wishes. If the member wants the assessor masked, the assessor is required to do so.
600
How many times may an assessor repeat the list of words for the 3-word recall exercise before deciding that the member will not be able to repeat the list correctly?
6 times.
Reminder: we must repeat the entire list of all 3 words, not just the word or words they missed.
600
What is the numbering convention for the CDPAP Agreement when attaching it to Sharepoint?
14
600
Do MDs always follow a patient's end of life wishes?
No. The member/representative should have an ongoing discussion with the participating MD to make sure the MD remains committed to following the member's Advance Directives (end of life wishes).
600
In the last 3 days, the member became short of breath every day as she climbed the stairs to her 3rd floor walkup after attending Social Day Care. The best response for dyspnea on UAS should be scored as:
- Absence of symptom
- Absent at rest, but present when performed moderate activities
- Absent at rest, but present when performed normal day-to-day activities
- Present at rest
- Absent at rest, but present when performed moderate activities
Note: Qualifying question for member who states they were SOB in last 3 days - Were you so short of breath that you had to stop what you were doing or couldn't speak? If the answer is no, we code for Absence of symptoms.
600
You are assessing your member for SOB. Last year he started using an inhaler for asthma. When you ask if he has had trouble breathing in the last 3 days, he says yes. What clarifying question might you ask this member before coding him for Dyspnea?
In the last 3 days were you so short of breath that you had to stop what you were doing or were unable to speak?
700
It is how we reflect non-cognitive deficits on the MMSE.
For any task the member is unable to complete due to non-cognitive deficits, we must subtract the total points for the task from the denominator of the MMSE score and document the reason on the back of the form.
700
True or False: Assessors are required to educate all members on the CDPAP Program at every visit.
False. Assessors must only educate on the CDPAP program if information has been requested by the member/family. Assessors must also document required CDPAP comments for members who are already in the program at the time of the assessment visit. Please refer to your Required Comments Job Aid.
700
Why do we use this summary statement when discussing the HCP:
“As required by NY state, I need to talk to you about appointing someone to make decisions about your health if you are unable to do so.”
We want the member to remember we spoke to them about the HCP when they get the IPRO survey inquiry from the state, so use this phrase when discussing the HCP with your members.
700
At Healthfirst, we reserve the coding selection "Total Dependence" only for those HF members who are____________ or _____________.
What is in a comatose or vegetative state
OR
who are so cognitively impaired that they cannot make their needs known.
700
Facilitator's question about anything at all.
800
True or False: We must complete an MMSE on every member even if they cannot participate in the assessment.
True. We must complete an MMSE even for those members who are vegetative or comatose, or so cognitively impaired that they cannot provide responses to the MMSE.
800
Can the parent of a 7-year-old epileptic be their CDPAP PA?
No. Anyone legally responsible for a member cannot be their CDPAP PA.
EX: A spouse cannot be the PA of their wife or husband.
EX: A parent cannot be the PA of their minor child.
Note: All HF members are assessed as pediatric until they are age 21.
800
Your member states he and his daughter completed their HCP with Advance directives the last time the HF assessment nurse came, but you cannot find this document in Sharepoint, TruCare, or the clinical archive tool, and the member cannot produce it at the visit. How do we code the member in the UAS for the HCP question in Section L of the Functional Supplement?
If the member states he has a signed HCP, but the assessor can find no evidence of it and the member cannot produce it at the visit, we must take the member's word and code YES for the HCP in the UAS. 
800
Your member states that he has urinary incontinence, and the last episode was 4 days ago when he leaked urine after his son made him laugh out loud. How would you code him for urinary incontinence?
Infrequently incontinent
Occasionally incontinent
Frequently incontinent
Incontinent
Infrequently incontinent - Not incontinent over last 3 days, but does have incontinent episodes.
800
True or False: Members who are not self-directing may have a responsible adult assume CDPAP program responsibilities on their behalf.
True. Members who are not self-directing will need to have a responsible adult direct care within the program.
900
Facilitator's question about anything at all.
What question must we ask to determine if the member has been lonely in the last 3 days?
"Do you feel satisfied with the amount of interaction and socialization that you have had with family and friends in the last 3 days?"
900
According to your Required Comments Job Aid, in what section of the UAS is information about ER visits and hospitalizations documented?
What is Section L: Treatments and Procedures
We also document the dates of certain vaccines and preventative exams in this section.
900
True or False: All fillable columns on the MMSE hard copy must be completely filled out by an assessor in order to get credit from the audit team.
True. These fields are automatically populated in the pdf telehealth version, but not on the hard copy. 