March Jeopardy!

Audits

100

If applicable, is there a question in the audit that states adding a goal for preventing falls is necessary?

yes

200

What section in the care plan is the auditor looking for the caregiver names, number of hours, and services provided?

Informal and Formal Support

300

Which section in the NCQA template is this paragraph referring to?

• Member gets along well with others and is able to form positive relationships. He is married with no children. He used to go hunting with friends. Since his accident he is unable to see his friends and he misses them. He has made some new friends in the nursing facility. His social functioning has a positive impact on his physical and mental health by promoting healthy eating, physical activity, and ability to recover from stress.

Social Functioning

400

What is question number51? It is the last applicable question on the audit.

Vulnerable member

500

What are three factors that the audit looks for in question number 5 (initial evaluation)?

Health status, self-reported health status, CSA, see medication integrated file, diagnosis of interest, special interest group, interRAI completed within 30 days of enrollment, NCQA template with bullet points

Desktops/SOP

100

This workflow talks about notifying enrollment of a member’s death

Deceased Member Workflow

200

what template goes with the interRAI?

NCQA

300

Per the Assessing and Evaluating LTSS Program desktop, how often do members in the nursing facility need to have a face to face visit?

180 calendar days/6 months

400

these two assessments are valid for mental health and substance abuse. One should be completed with InterRAI

UNCOPE and CRAFFT

500

this desktop talks about what to do if a member needs to be re-stratified, their eligibility has ended, or member has re-enrolled

Closing and Re-opening Episode

Critical incident

100

 What is a fall with injury called?

Medical emergency

200

Where are we documenting a CI?

Critical Incident and Follow-up event

300

If member is UTL with an open CI, how many outreaches do we need to complete?

5 outreaches

400

These reports are are from what agency: report of investigation and report of substantiation

APS

500

What does FWA stand for?

fraud, waste, and abuse

Dynamo events

100

This event is to show people you have spoken to someone other than the member with member's permission

HIPAA

200

 this event is for when you speak with member’s care team regarding care plan goals

IDCT

300

This event is done initially, annually, and as needed for community transition

NF diversion

400

This event is where you indicate which method of outreach and at what time member likes best

Member Preferences

500

This event describes a member's admission and when they discharged from a hospitalization

Care transition event

Miscellaneous

100

This spreadsheet shows which case manager is working with which facility

NH Assignment Grid

200

A new BH program that provides telephonic outreaches to our members at the nursing facility

Brave

300

$25 eligible for members to spend at CVS

OTC benefit program

400

This resource shows a member's SDOH, health care equity, and you can even mail an insurance card

Snapshot/CEC

500

What does IHMG stand for?

IHMG/in home medical group