Form DMAS-99. Community-Based Care Member Assessment
The DMAS-99 Community-Based Care Member Assessment form is an essential tool used in the state of Virginia to evaluate the functional status and care needs of individuals receiving community-based care services. This comprehensive form is designed for those under agency-directed or consumer-directed services, aiming to provide a holistic understanding of the member's well-being and support requirements.
The form starts with a header section, clearly indicating whether it pertains to agency-directed or consumer-directed services. It requires key information, including the member's name, date of birth, Medicaid ID number, start of care date, current address, agency name, phone number, and provider ID. Ensuring patient confidentiality, it emphasizes that only authorized parties should review and use this sensitive information.
The core of the assessment lies in the Functional Status section, which meticulously evaluates the member's ability to perform Activities of Daily Living (ADLs), continence, mobility, orientation, and behavior. Additionally, it assesses joint motion and the administration of medications, crucial elements for providing tailored care.
In the Medical/Nursing Information section, caregivers meticulously record the member's medical diagnoses, current health status, medications, nursing needs, therapies, special medical procedures, hospitalizations, and critical incidents. This wealth of medical data allows healthcare professionals to gain a comprehensive overview of the member's health status and plan appropriate interventions.
The Support System section documents the range of waiver services the member receives, along with the identity of the primary caregiver, their relationship to the member, and the type of care they provide. It delves into the need for supervision and Personal Emergency Response System (PERS) to ensure the member's safety and well-being.
In cases where care is consumer-directed, the form records the person directing/managing the care and the caregiver, highlighting the importance of self-directed care.
Service Facilitators (SF) or Registered Nurses/Licensed Practical Nurses (RN/LPN) play a crucial role in supervising care. The form includes a section dedicated to SF/RN/LPN supervisory visits, their frequency, and an evaluation of care documentation and adherence to the service plan.
Ensuring consistency and continuity of care, the form tracks the number of days without service and the count of regular and substitute aides/attendants. It captures any problems or satisfaction issues with the care provided, allowing for prompt follow-up and resolution.
The DMAS-99 concludes with space for additional SF/RN/LPN notes and comments, allowing for a more detailed account of the member's care and specific observations.
Overall, the DMAS-99 Community-Based Care Member Assessment form is an indispensable instrument in ensuring quality care and support for individuals in need, fostering a patient-centered approach to community-based care services in Virginia.