a) Clinical criteria used to make the diagnosis of probable Alzheimer's disease shall include at a minimum:

1. 1) A history of gradually declining cognitive function over at least six months;
2. 2) A general physical and neurological examination;
3. 3) A mental status examination reflecting deficits in more than one area of cognition;
4. 4) A laboratory evaluation to rule out other causes of dementia;
5. 5) No evidence of other physical or psychiatric illnesses which could explain the dementia picture.

b) Psychiatric and psychosocial tests to provide the information to meet the criteria for clinically probable Alzheimer's disease, shall include at a minimum:

1. 1) Brief assessment of cognitive state, with emphasis on memory;
2. 2) Brief assessment of social function, activities of daily living, and instrumental activity of daily living;
3. 3) Global assessment of dementia stage;
4. 4) An assessment of depression and agitation.

c) Consultation among the patient, family caregivers and evaluation team (attending physician, nurse and/or social worker) shall include at a minimum consideration of the following:

1. 1) Diagnosis;
2. 2) Patient's prognosis (when determined appropriate by the multi-disciplinary team);
3. 3) Explanation of findings in subsections (a) and (b);

4. 4) Recommendations to patient and family caregivers, including:

   1. A) Medications;
   2. B) Community support services/systems;
5. 5) Plan of care.