Monthly Contacts
Minimum required frequency for member contact
Monthly
True or False:
All acronyms should be defined before using them
True
This support system includes family, friends and community relationships
Natural Supports
Members should be offered one of these for their planning meeting
an advocate
The case manager checked in and spoke with staff monthly but had no contact with the member themselves for 4 months.
NAY
Monitoring requires contact with the member- if not, reason why must be accurately documented
A new concern is identified during contact. What document may need updating?
The PCP
Comp Assessment
True or False:
A progress note can be entirely copied and pasted from the previous month
False
For best practice, the comprehensive assessment must be completed _____ days before the PCP Effective Date.
90 days
A PCP must be based on this foundational document.
Why?
Comprehensive Assessment
Strengths, Needs and Barriers (and goals) populate over
Note states:
"CCM met with client. Everything is fine."
NAY
Lack of substantive monitoring details, insufficient documentation per OADs guidelines (no health/safety review, no PCP goal discussion, no member satisfaction, no next steps, no purpose of contact)
During monitoring, a case manager should review progress towards what?
PCP Goals and Outcomes
Notes should be entered within this timeframe
48hrs
True or False:
You can develop a PCP without a current Comprehensive Assessment.
False. The assessment supports PCP development.
At the time of State Review, services and supports are often referred to as a shell- why is this necessary?
The shell is replaced at what status/phase?
Shells are entered for service/supports by listing service type and requested hours/wk or days/yr
Phase 4 (Pending Provider Status), providers/actual services entered after state review
Progress Note Includes:
- members present, location, goal discussed, satisfaction reviewed, follow up plan
YAY
best practice
True or False:
"Left voicemail. No answer." meets the monthly contact requirement.
False
This note states:
"The member was rude and lazy"
An auditor would call this type of documentation?
Subjective Language
Besides annual updates, when should a reassessment occur?
When there is a significant change in needs or services
There are this many phases of the PCP process
AND
Name the phases
1. Record Review and Meeting Coordination
2. Annual PCP Meeting
3. Complete Sections Needed for State Review
4. Pending Provider Selection, Provider Linking and SIPS
5. Final Review, Completion and Distribution
A PCP goal states:
"Be healthier"
NAY- too vague, does not identify measurable outcomes, actions, or what success looks like.
'Over the next 6 months, I will walk for 30 minutes at least 3 days per week and attend all scheduled primary care appointments'
Name three topics that would make a monthly contact substantive.
Goal Progress, Referrals, Service Effectiveness, Health/Safety Concerns, Unmet Needs, Barriers, Satisfaction
The most important thing a progress note should connect back to
PCP Goal or Assessed Need
Name the 8 domains/elements that are evaluated in the Comprehensive Assessment.
Employment, Community Engagement, Communication/Advocacy, Home and Housing, Lifelong Learning, Social Relationships, Health/Wellness, Safety and Security
How many goals auto populate over from "My Life Planning" to the Goals section?
Why?
16
8 domains, 'what I want to be same' and 'what I want to be different' mandatory for each (8x2=16)
Note:
"Member reported difficulty paying utility bills and stated she is worried about keeping her apartment. Member stated she has borrowed money from family members on multiple occasions. CM listened and provided support. Follow up next month."
NAY
significant need identified, no resource referral, no housing stabilization discussion, no care coordination, no action plan, no follow up tasks, potential health and welfare issue not explored