Acronyms
What does the acronym PACE stand for?
What is Program of All-Inclusive Care for the Elderly?
What is the age of eligibility?
What is 55 years of age or older?
When should the IDT develop a comprehensive plan of care for a new enrollee?
What is within 30 days of enrollment?
Who can make a service determination request?
What is the participant, their designated representative or unpaid caregiver?
What is a grievance defined as?
What is a compliant expressing dissatisfaction with services or care furnished?
What does the acronym CMS stand for?
What is Center for Medicare and Medicaid Services?
What level of care must someone meet to be eligible for PACE?
What is nursing facility?
What 4 areas are covered during the IDT's assessments of participants?
What are medical, physical, emotional, and social?
The individual making a request can do so in what method?
What is orally or in writing?
Who can file a grievance?
What is a participant, their family member, their legal representative or their caregiver?
What does the acronym SAA stand for?
What is State Administering Agency?
To be eligible for PACE, someone must live within the service areas of the PACE organization. How are these services areas geographically defined?
What is by designated zip codes?
How often is the plan of care reevaluated?
What is atleast a semi-annual basis?
The staff member who received the request must bring the request to the IDT in what timeframe?
What is no later than 3 calendar days from the time the request is made?
How can a grievance be filed by an individual?
What is written or oral?
What does the acronym IDT stand for?
What is Interdisciplinary Team?
An individual must be able to live in a community setting without jeopardizing their what?
What is their health or safety?
Where is the Plan of Care documented?
What is within the medical record?
What 3 requests define a SDR? A request to...
What is the request to initiate, modify or continue a discontinued/reduced service?
The PACE organization is required to report appeals to who?
Who is CMS and DSHS?
What does the acronym SDR stand for?
What is Service Determination Request?
What counties does PNW PACE Partners accept enrollees in?
What is Pierce and South King counties?
In regard to Plan of Care, participants/family/legal representatives have the right to request what action from the IDT?
What is a reassessment?
An individual has the right to ____ a denied or partially denied SDR?
What is appeal?
After an individual has exhausted the internal appeal process, they have the right to an external appeal through what agency?
What is Medicare or Medicaid?