SAMPLE POLICY WORK

documentation requirements that support a standardized approach throughout Simpl Care Services LLC.

a. Purpose and Rationale

Purpose Statement: The primary purpose of the Level of Care Assessment is to determine, before admission, the specific level of care required by each applicant in order to ensure optimal service provision. The process is essential for: • Ensuring that each CAC Waiver applicant receives personalized care that aligns with their functional, developmental, and medical needs. • Complying with Tennessee CAC Waiver e.g., TN.0357.R05.00 regulations by verifying that the individual meets the criteria for ICF/IID level care. • Promoting best practices in person-centered care by establishing a transparent, data-driven, and standardized evaluation framework. • Providing a reliable, auditable record of assessments and decisions that can be reviewed by regulatory authorities such as TennCare and state licensing boards. This evaluation is critical for directing resources efficiently and ensuring that every admitted individual receives the intensity of services, clinical oversight, and support necessary for their unique needs.

b. Detailed Policy Statements

Policy on Pre-Admission Evaluations (PAEs)

Policy Statement: All potential CAC Waiver applicants must undergo a Pre-Admission Evaluation (PAE) to determine their ICF/IID level of care requirements. The PAE process includes the use of standardized assessment tools, clinical interviews, and, when necessary, specialist consultations. Through a systematic evaluation, the assessment team gathers comprehensive data on the client’s cognitive, functional, adaptive, and emotional status.

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Principle: Consistent application of the PAE ensures that every applicant’s needs are properly identified, enabling the development of individualized care plans. Requirement: PAEs are mandatory for every prospective client and must be completed prior to admission into the program. Assessment findings are used both to confirm eligibility and to prescribe the appropriate level of service intensity within the ICF/IID framework.

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