(Revised 6/1/12 ML #3335)
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Purpose: The Medicaid Waiver Quality Review process is used to obtain information from clients/responsible parties that is related to quality and quantity of services. The information is aggregated and reviewed by the Department to develop quality measures and services.
When Prepared:
Complete on an annual basis during one of the quarterly contacts (this visit should not occur during the annual or 6-month assessment) for current clients, and at the first quarterly contact for new clients.
The review is required to be completed with clients who are receiving services under the HCBS Wavier (does not include SPED/EXSPED/TD Waiver or MSP-PC).
By Whom Prepared:
The HCBS Case Manager completes the "Medicaid Waiver Quality Review.
SPECIFIC INSTRUCTIONS:
Enter the client’s name and date, if the client is not the individual providing the response to the questions enter the respondents name and their relationship to the client. Enter the client ID and list the wavier services the client is currently receiving.
Ask each question and score by circling or marking an X by the boxes scored: Yes-No-N/A-Other. If the response is: No, N/A, or other please explain.
If the response results in an answer that requires an immediate response and is related to abuse, neglect or exploitation, follow monitoring policy outlined in the service of Case Management.
Complete the Narrative as appropriate and sign your name and enter the name of the County the client lives in.
File a copy in the client's case record. Forward the original to the Department.
An electronic copy is available through the state e-forms (SFN 1154).