Policy Clarification Questions
Home and Community Based Services Manual
Policy Clarification Questions
Table of Contents
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Advanced Personal Care
Home and Community Based Services Manual
Policy Clarification Questions
Table of Contents
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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
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Assessment / Reassessment
Home and Community Based Services Manual
Policy Clarification Questions
Table of Contents
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Assisted Living Facility/Residential Care Facility Personal Care
Home and Community Based Services Manual
Policy Clarification Questions
Table of Contents
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Authorized Nurse Visits
Home and Community Based Services Manual
Policy Clarification Questions
Table of Contents
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Consumer Directed Services
Home and Community Based Services Manual
Policy Clarification Questions
Table of Contents
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Consumer Directed Services/Transportation (Essential Transportation)
Home and Community Based Services Manual
Policy Clarification Questions
Consumer Directed Services/Transportation (Essential Transportation)
Table of Contents
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General
Home and Community Based Services Manual
Policy Clarification Questions
General
Table of Contents
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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.
Table of Contents
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Respite Care
Home and Community Based Services Manual
Policy Clarification Questions
Respite Care
Table of Contents
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Shared Living Spaces
Home and Community Based Services Manual
Policy Clarification Questions
Shared Living Spaces
Table of Contents
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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 Care | Nursing Level of Care Tasks |
|---|---|---|---|
| Manual Assistance with self-administration of non-injectable medications | Physical 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/ filter | Prompting 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 levels | Filling the medicine planner/ administration of injectable medications, filling insulin syringes, administering blood sugar check or PT INR check finger prick tests |
| Catheter Hygiene | N/A | Emptying and changing the bag, cleaning (soap and water around catheter site) for indwelling or suprapubic catheters, removal/replacement of external (condom/Texas, etc.) catheters only | Catheter change of indwelling or suprapubic catheters. |
| Bowel Program | N/A | Enemas (prepackaged), sphincter stimulation, suppository administration for participants w/o contraindicating rectal or intestinal condition, Malone Antegrade Continence Enema (MACE) for well healed stomas | Administration of all other enemas, removal of fecal matter digitally |
| Central Line Care | N/A | N/A | Flushing lines, dressings, blood draws |
| Ostomy Care-tracheostomies, gastrostomies and colostomies | N/A | Changing bags and/or wafer, and soap and water hygiene around a well healed ostomy site | Insertion of treatments or medications |
| Medicated lotion/ointment application | Application of nonprescription topical ointments or lotions | Application 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/stockings | Application of Class I stockings/dressings | Lymphedema 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 assistance | Assist with transfer/ ambulation when participant able to bear most of their own weight, gait belt for mobility assistance | Use 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 discs | N/A |
| Passive Range of Motion (PROM) | N/A | With physicians order, flexion of joint within normal range | N/A |
| Bathing | Assist with bathing including shampooing of hair | N/A | N/A |
| Toileting / Continence | Assist in transporting to/from restroom, changing of bed linens | N/A | N/A |
| Dietary | Assist with meal prep/ clean up, and eating/ feeding, including participants requiring softened, pureed, liquid, or prep with a thickening agent for their diet | N/A | Tube feeding |
| Dressing / Grooming | Assistance in dressing/ undressing, combing hair, nail care, oral hygiene/ denture care, shaving, application of Class I compression stockings | N/A | Nail care for participants who are diabetic, prescribed anticoagulants, diagnosed with peripheral vascular disease or with a compromised immune system |
| Medically Related Household Tasks: Homemaker Services | Cleaning kitchen, bath, living areas, changing linens, laundry (home/off site), iron/mend, washing windows and blinds, trash, shopping/errands, essential correspondence | N/A | N/A |
*CDS may complete all Basic Personal Care and Advanced Personal Care tasks