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> Annual Redetermination Checklist
Annual Redetermination Checklist
Initial Documentation
Prepare Service & Safety Cover Letter
Write a Narrative outlining the individual’s care needs
Complete Personal Care Plan detailing service requirements
Medical Documentation
Compile Medication List for all prescribed medications
Complete CR Med Form for client records
Submit CR IA for individual assessments
Safety and Insurance Verification
Conduct Home Safety Checklist to assess living environment
Gather Home Insurance documentation
Collect PCG Auto Insurance information
Collect ACG Auto Insurance information
Identification and Background Checks
Obtain PCG ID/DL for identification verification
Obtain ACG ID/DL for identification verification
Conduct PCG BCI Verification for background check
Conduct ACG BCI Verification for background check
Health Screening Forms
Complete PCG Med Form for health assessment
Ensure PCG TB Screen is conducted and documented
Complete ACG Med Form for health assessment
Ensure ACG TB Screen is conducted and documented
Competency Assessments
Complete PCG Competency Checklist to evaluate caregiver skills
Complete ACG Competency Checklist for caregiver evaluation
Confirm PCG CPR certification is current
Confirm ACG CPR certification is current
Required Forms and Agreements
Complete RI CP-12 Form for regulatory compliance
Provide Bill of Rights to participants
Ensure Participant Agreement Form is signed and dated
Review CG Statement of Responsibilities for caregiver duties
Final Review and Submission
Review all documents for completeness and accuracy
Organize all documentation for submission
Schedule a follow-up to confirm receipt and discuss any issues
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