Case Management be tough!! Do you know your stuff?

Caregiver Skills Verification

100

• What tasks on the caregiver skills verification form are the only tasks that require RN delegation?

What are medically orientated tasks.

200

• The RN has this many days to do a caregiver skills verification form when an existing member is identified as a VHRM?

What is 30 days

300

• The caregiver skills verification form will be completed, a minimum, of how often?

What is every 6 months

400

• Where will the RN upload the completed caregiver skills verification form?

What is MIDAS attachments, under SDS (even for VHRM )

500

• If the RN deems the caregiver unable to perform a medically oriented task they will follow up by doing these 3 things.

1. Notify their LS

2. Provide education and resources to the caregiver to improve their skills

3. RN will reassess the caregiver skills in 30 days, (each caregiver will have 90 days or up to 3 reassessments to demonstrate satisfactory completion)

RN Misc.

100

RN’s should check these 2 notifications daily on the Welcome Screen.

What is Unverified WISHIN hospital visits and Members Currently Hospitalized

200

• You will find the Hospital Admission and Care Transition, under what MIDAS tab.

What is the Medical Management tab

300

• The RN must complete the Post Discharge Coordination Physician letter in how many days

What is 10 days after discharge

400

• An IMD admission requires what additional form to be completed in MIDAS

What is a high priority CI

500

• A referral should be made to this person, when a member is hospitalized, and placement cannot be found

Who is the Care Transition Specialist

CM Misc.

100

Your member has Dedicated Staffing and requires 1:1 including overnights. You are obtaining monthly behavioral tracking from the AFH and uploading into Midas. What other document is required the AFH complete and CM upload monthly?

What is a sleep tracker

200

Your member was hospitalized on Jan.19th and discharged on Jan. 22nd. This member resided in an AFH. What dates do you enter this member's leave of absence?

What is Jan 19th, Jan. 20th, Jan. 21st. 

*as a reminder you enter auths for "head in bed at midnight". Because this member returned on the 22nd the member leave of absence auth will end on the 21st and on the 22nd the CM will enter member's residential auth. 

300

Member was living in her own home and was hospitalized for 1 week. Member was discharged to the SNF for rehab with goal of returning home. What notification should be completed when a member is discharging and admitting to a SNF?

What is Change Routing Form or will also accept Member Status Chang Form. 

*As a friendly reminder do not forget to enter Change Routing forms for SNF admissions, discharges and enroll in place. 

400

Member AFH and guardian are requesting dedicated staffing for 16 hrs per day. CM completed Specialty Consult. 14 days after the request is was approved by the behavioral health team and IDT is in agreement. What paperwork should the CM complete to show this was an approved service?

What is a written RAD

* this might be a new concept to teams but we are not required to complete a written RAD for dedicated staffing. As a reminder these requests can take time and may go beyond the 14 days. You will need to track if delay of decision letters need to be sent out if a decision is not reach within the 14 days. 

500

Your member has guardianship in Washington County and is moving to Racine County. In addition to having guardianship in Washington County your member is also protectively placed and under a Chp. 51. What 2 forms need to be completed by Care Manager prior to this member's move?

What is Notice of Transfer Protective Placement  and Out of County Notification Form. 

*Cm's need to ensure they and/or a guardian updated the Circuit Courts that a member is moving when they are under protective placement. Out of County notification form is completed for members that may require Crisis plans etc in their new county of residence. This form is sent to the new residential APS county for their review. 

To CIC or to NOT CIC-that is the question

100

Member had a relocations with no changes to ADLs, IADLs, HRS or DME. Do you complete a CIC?

What is DO NOT CIC 

*this is an edit request

200

Member needs increased help with bathing, mobility and transferring. Do you complete a CIC?

What is DO NOT CIC

*complete a CIC LTCFS case note and note the differences from your assessment and current screen. 

300

Member was recently provided a CPAP machine and will require AFH staff to clean it, reminders to wear CPAP, starting the machine and ensuring the pressure and alarms are correctly set. Do you complete a CIC?

What is CIC

*this is a change in member's HRS table for needing assistance. All changes to HRS table that expected to last beyond 3 weeks require a CIC. 

400

Member was admitted to hospice with a new terminal diagnosis. Do you complete a CIC?

What is CIC

*new terminal diagnosis' do warrant a CIC but not if there is already a terminal diagnosis on member's screen.

500

Non-NHLOC member reports to you that they are no longer able to dress their lower body and would like some more assistance in their home. Do you complete a CIC?

What is CIC. 

*A changed in only 1 ADL or 1 IADL or 1 pc. of DME for Non-NHLOC of care does require a CIC.  

Do you know your dates?

100

Member enrolled. How many days does the IDT have to contact member?

What is 3 days. 

200

• RN has this many days to do a caregiver skills verification form for a new enrollment identified as a VHRM?

What is 10 days

300

Initial Cm and RN visit for a newly enrolled member should be completed in how many days?

What is 10 days

400

Newly enrolled member signature page was completed at the required 10 days from enrollment. When is the 2nd signature page due?

What is 60 days from enrollment

500

You were notified that your member's Annual screen is completed and requires IDT ACK. How many days do you have to review the screen?

What is 5 days from completion