Authority: IC 12-9.1-2-3; IC 12-10.5-2-2

Affected: IC 12-10

Sec. 6. (a) A provider of case management shall do the following:

1. (1) Ascertain and document the:

   1. (A) quality;
   2. (B) timeliness; and
   3. (C) appropriateness;
2. of the care, services, and products delivered to an individual.
3. (2) Analyze and update the documentation at least every ninety (90) days, unless otherwise specified.

(b) The documentation required under this section shall include an appropriate assessment of the identified needs in the individual's plan of care.

(c) A provider of CMS shall assess and monitor the services and outcomes established for the individual in the individual's plan of care to ensure the health and welfare of the individual, including, but not limited to, the following:

1. (1) Providing follow-up on identified problems.
2. (2) Acting immediately to resolve critical issues and crises in accordance with this article.
3. (3) If concerns with services or outcomes are identified, addressing the concerns.

(d) A provider of CMS who is attempting to resolve a dispute shall follow the dispute resolution procedure in 455 IAC 2-9- 3.

(e) A provider of CMS shall specify the amount of contact required with an individual in an approved plan of care.

(Division of Aging; 455 IAC 2-17-6; filed Sep 1, 2006, 8:20 a.m.: 20060927-IR-460050119FRA; errata filed Aug 25, 2011, 1:41 p.m.: 20110914-IR-455110468ACA; readopted filed Nov 2, 2012, 8:32 a.m.: 20121121-IR- 455120508RFA; readopted filed Apr 9, 2018, 9:13 a.m.: 20180509-IR-455180111RFA; readopted filed Sep 25, 2024, 4:02 p.m.: 20241023-IR-455230818RFA) NOTE: Transferred from the Division of Disability and Rehabilitative Services ( 460 IAC 1.2-17- 6) to the Division of Aging ( 455 IAC 2-17-6) by P.L.153-2011, SECTION 21, effective July 1, 2011.