CareWise - Senior Placement

The results of this calculator should not be relied upon to determine ALTCS class. Only the ALTCS program provider can made that determination. More information can be found about the tool by visiting https://www.azahcccs.gov

Bathing, Dressing, Grooming:

Independent or may participate in care, but requires assistance with bathing, dressing, and/or grooming.

Requires moderate assistance with bathing, dressing, and/or grooming.

Requires maximum assistance with bathing, dressing, and grooming.

Feeding/Eating:

Independent or requires minimum set up/prompting assistance with feeding/ eating.

Requires moderate assistance with feeding/eating

Requires maximum assistance with feeding/eating (for example, tube feeding).

Mobility:

Independent or requires minimum or stand by assistance to move from one location to another with or without assistive devices.

Requires moderate assistance to move from one location to another with or without assistive devices.

Requires maximum assistance to move from one location to another with or without assistive devices.

Transfering:

Can transfer to some or all surfaces independently. Requires the assistance of no more than one person to transfer from one surface to another with or without assistive devices.

Requires hands-on physical guidance or assistance of one person for all transfers with or without assistive devices. The client may participate by being able to bear weight and pivot.

Requires assistance of two or more people to be physically lifted or moved from one surface to another with or without assistive devices.

Bowel/Bladder:

Continent or occasionally incontinent (less than seven times per week) of bowel and/or bladder or may be continent at times with a training program.

Moderately (daily but some control) incontinent of bowel and/or bladder.

Totally incontinent of bowel and/or bladder, receives scheduled toileting on a daily basis to avoid incontinence and/or receives care of a catheter or ostomy.

Orientation/Behavior:

Requires no intervention or requires minimum staff intervention for episodes of confusion, memory deficits, impaired judgment, or agitation. May require temporary (24 hours or less) restraints to control a behavioral or medical problem and restraints for personal safety.

Requires moderate staff intervention. May have periodic emotional or mental disturbances, including combativeness.

Requires maximum staff intervention. May be disoriented, confused, combative, withdrawn, or depressed. May need restraints (physical/chemical) for personal safety or protection of others.

Medical Conditions:

Stable, with no or some routine nursing/medical monitoring and care.

Conditions require more frequent monitoring to maintain stability (for example, unstable hypertension needing frequent assessment and medication adjustment).

Conditions require intense professional intervention to maintain stability (for example, unstable diabetes, come, terminal medical condition).

Medical/Nursing Treatments:

None or routine, such as range of motion and injections, as well as routine medication administration and routine catheter care. ANYTHING MORE WOULD COUNT UNDER CLS 2.

Skilled nursing treatment in addition to routine medication administration. (Such as a treatment for skin condition.)

Relatively complex, with more than one professional or technical treatment, such as IV therapy, tube or parenteral feeding, care of recent wound, care of infected or stage 4 decubitus, deep suctioning or an extensive rehab regime.

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Universal Assessment Tool

This Calculator Is Intended For Educational And Illustrative Purposes Only.

Bathing, Dressing, Grooming:

Feeding/Eating:

Mobility:

Transfering:

Bowel/Bladder:

Orientation/Behavior:

Medical Conditions:

Medical/Nursing Treatments:

Results:

Level 1 Count: 0

Level 2 Count: 0

Level 3 Count:0

Estimate a Level 0