Reportable Events (RE)
What are the two types of REs?
Incidents and Complaints
What type of POS is done each year?
Annual POS
What does PERS stand for?
Personal Emergency Response System
How often do we complete eligibility?
Monthly and PRN
What does ATP stand for?
Authorization to Participate
What are the two sections of a RE?
Event Report and Intervention and Action Plan
Give an example of a non-flexible service in the POS.
Physician information, transportation, DMS, DME, Dentist Visit, Nurse Monitoring, Supports Planning, Environmental Assessment, Environmental Adaptations or Modifications, Assistive Technology, PERS (purchase and monitoring), Behavioral Health Consultation, Consumer Training, Transition Funds, Nutrition/Dietician Services, Respite
What's the max number of Home Delivered Meals (HDM) a client can request?
14 Meals per week (2 meals x 7 days)
How many days from the LOC/MedTech expiring date does an InterRAI need to be triggered?
60 days in advance
What are the two (2) LOC types?
Institutional LOC = Nursing Facility (NF) LOC
Community Personal Assistance Service (CPAS) LOC
How many days from notification do you have to complete the RE?
Regular REs = 3 days for the Event Report, 10 days for the I&AP
Immediate Jeopardy (IJ) REs = 24 hours
This is completed each year or as needed to update housing information for the POS.
Community Settings Questionnaire (CSQ)
You must obtain two (2) quotes for an Environmental Modification/Adaptation if it's over this price point.
$1,000
When do you email the Local Health Department (LHD) about an InterRAI?
On the 45th day
What must be signed to provide services before you develop a POS?
Consent Forms (e.g. Consent for Care Management, Rights and Responsibilities, HIPAA)
You use this when it's an incident that poses an immediate and serious threat of injury, harm, impairment or death to a participant.
Urgent Request to mark the RE as an IJ for urgent review
Who can sign a POS?
The client, a CFC rep., or a guardian (legal or minor)
Max number of Personal Care Hours to be requested.
84 hours (12 hours x 7 days)
For waiver applicants how long are Medicaid applications good for?
6 Months
What are emergency hours?
A temporary increase in PAS hours we can authorize for up to 12 hours per day for 7 consecutive days.
Who do you immediately notify if a client passes away?
Team Manager and RN Consultant, and Housing Team (if applicable)
What is a CR?
Clarification Request - when the reviewer sends back the POS asking for changes or updates.
Which program qualifies a client for an Assisted Living Facility?
Community Options Waiver
What three (3) criteria are needed to be enrolled into our programs?
Medical eligibility - the InterRAI
Technical eligibility - approved POS
Financial eligibility - EDD/DSS
To be enrolled in the waiver, a client must come from either:
A Nursing Facility or the waiver registry waitlist