Wednesday, December 21, 2016

CMS Issues New FAQs Regarding Medicaid Beneficiaries in Home and Community-Based Settings who Exhibit Unsafe Wandering or Exist-Seeking Behavior

Lilly Hummel

Last week CMS issued new guidance with information on how to adhere to the individualized nature of home and community-based services (HCBS) for individuals with dementia or other conditions in which unsafe wandering or exit-seeking behavior is exhibited. CMS emphasized that person-centered planning, staff training and care delivery are core components of provider operations to meet HCBS requirements for these individuals. In particular, CMS noted that controlled egress can comply with the HCBS settings rule in certain circumstances; the setting should assess the individual and document his or her choice and need for safety measures in his or her person-centered care plan. Similarly, while individual rooms in HCBS settings should generally have a lockable door, doors that are not lockable can be used when they are part of the resident’s person-centered plan and after less intrusive methods have been tried and did not work, as provided in the rule.

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