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Home and Community Based Services Manual

Policy Clarification Questions

Home and Community Based Services Manual


Policy Clarification Questions

Table of Contents

Advanced Personal Care

Home and Community Based Services Manual


Policy Clarification Questions

Table of Contents

Agency Model Personal Care (In-Home Services)

Home and Community Based Services Manual


Policy Clarification Questions

Agency Model Personal Care (In-Home Services)

Table of Contents

Assessment / Reassessment

Home and Community Based Services Manual


Policy Clarification Questions

Table of Contents

Assisted Living Facility/Residential Care Facility Personal Care

Home and Community Based Services Manual


Policy Clarification Questions

Table of Contents

Authorized Nurse Visits

Home and Community Based Services Manual


Policy Clarification Questions

Table of Contents

Consumer Directed Services

Home and Community Based Services Manual


Policy Clarification Questions

Table of Contents

Consumer Directed Services/Transportation (Essential Transportation)

Home and Community Based Services Manual


Policy Clarification Questions

Consumer Directed Services/Transportation (Essential Transportation)

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General

Home and Community Based Services Manual


Policy Clarification Questions

General

Table of Contents

Overview

Home and Community Based Services Manual


Policy Clarification Questions

The purpose of this document is to clarify policy and apply it situationally. This is not intended to create new policy. The contents are subject to change based on revisions to statutes, regulations or Centers for Medicare and Medicaid Services (CMS) requirements. Each question and answer is phrased and categorized based on how it was presented to the Division of Senior and Disability Services (DSDS) and may be applicable to other sections as well.

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Respite Care

Home and Community Based Services Manual


Policy Clarification Questions

Respite Care

Table of Contents

Shared Living Spaces

Home and Community Based Services Manual


Policy Clarification Questions

Shared Living Spaces

Table of Contents

Structured Family Caregiving Waiver (SFCW)

Home and Community Based Services Manual


Policy Clarification Questions

Structured Family Caregiving Waiver (SFCW)

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Task Chart

Home and Community Based Services Manual


Policy Clarification Questions

Task*Basic Personal Care*Advanced Personal CareNursing Level of Care Tasks
Manual Assistance with self-administration of non-injectable medicationsPhysical assistance only-Opening medicine planner or bottles and guiding/steadying participant’s hand for oral medication and inhalants, oxygen and equipment – adding distilled water, changing tubing and cleaning equipment/ filterPrompting participant, opening lockbox and guiding/steadying participant’s hand for ear and eye drops, steady hand for pin-prick blood sugar monitor/PT INR and read levelsFilling the medicine planner/ administration of injectable medications, filling insulin syringes, administering blood sugar check or PT INR check finger prick tests
Catheter HygieneN/AEmptying and changing the bag, cleaning (soap and water around catheter site) for indwelling or suprapubic catheters, removal/replacement of external (condom/Texas, etc.) catheters onlyCatheter change of indwelling or suprapubic catheters.
Bowel ProgramN/AEnemas (prepackaged), sphincter stimulation, suppository administration for participants w/o contraindicating rectal or intestinal condition, Malone Antegrade Continence Enema (MACE) for well healed stomasAdministration of all other enemas, removal of fecal matter digitally
Central Line CareN/AN/AFlushing lines, dressings, blood draws
Ostomy Care-tracheostomies, gastrostomies and colostomiesN/AChanging bags and/or wafer, and soap and water hygiene around a well healed ostomy siteInsertion of treatments or medications
Medicated lotion/ointment applicationApplication of nonprescription topical ointments or lotionsApplication of prescription lotions, ointments and powders and/or dry aseptic dressings to unbroken skin (Stage I only)Application of aseptic dressings to Stage II and above
Application of compression dressings/stockingsApplication of Class I stockings/dressingsLymphedema wraps and sleeves, and Class II dressings/stockings placement and removal of physician ordered orthotics.Compression dressings/stockings higher than a Class II
Mobility/Transfer assistanceAssist with transfer/ ambulation when participant able to bear most of their own weight, gait belt for mobility assistanceUse of assistive devices for transfer (participant able to bear little to no weight), including mechanical/Hoyer, sit-to-stand, slide board, sling, Barton chair, trapeze, gait belts and pivot discsN/A
Passive Range of Motion (PROM)N/AWith physicians order, flexion of joint within normal rangeN/A
BathingAssist with bathing including shampooing of hairN/AN/A
Toileting / ContinenceAssist in transporting to/from restroom, changing of bed linensN/AN/A
DietaryAssist with meal prep/ clean up, and eating/ feeding, including participants requiring softened, pureed, liquid, or prep with a thickening agent for their dietN/ATube feeding
Dressing / GroomingAssistance in dressing/ undressing, combing hair, nail care, oral hygiene/ denture care, shaving, application of Class I compression stockingsN/ANail care for participants who are diabetic, prescribed anticoagulants, diagnosed with peripheral vascular disease or with a compromised immune system
Medically Related Household Tasks: Homemaker ServicesCleaning kitchen, bath, living areas, changing linens, laundry (home/off site), iron/mend, washing windows and blinds, trash, shopping/errands, essential correspondenceN/AN/A

*CDS may complete all Basic Personal Care and Advanced Personal Care tasks

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