Name of the Procedure:

Residential Care, Not Otherwise Specified (NOS), Waiver; Per Diem (T2033)

Summary

This service provides non-medical residential care for individuals who need support with daily activities but do not require intensive medical care. The term “not otherwise specified” indicates the care provided does not fall into predefined categories and is customized to meet the individual's needs on a daily basis (per diem).

Purpose

Residential care is primarily for individuals who are unable to live independently due to physical or cognitive impairments. The goal is to provide a safe, supportive environment that enables residents to live as independently as possible while receiving the help they need with daily activities.

Indications

• Patients with chronic conditions such as dementia, arthritis, or mobility impairments.
• Individuals recovering from surgery or illness who need short-term assistance.
• Those who may not be safe living alone due to significant impairments in daily living skills.

Preparation

• Ensure the patient’s medical history and current health status are reviewed.
• Conduct a needs assessment to develop a personalized care plan.
• No specific fasting or medication adjustments are required for admission.

Procedure Description

• Admission: Complete necessary paperwork and assessments.
• Room Assignment: The resident is assigned a room or living space suited to their needs.
• Care Services: Daily assistance with activities such as bathing, dressing, meal preparation, medication management, and supervision.
• Scheduling: Care provided on a per diem basis, with services tailored each day to meet the resident's needs.

Duration

Residential care is ongoing and can range from short-term (a few weeks) to long-term (several years) depending on the individual’s needs.

Setting

Residential care facilities, which can include assisted living facilities, group homes, or specialized housing.

Personnel

• Caregivers: Certified nursing assistants (CNAs) or personal care aides.
• Supervisors: Registered nurses (RNs) or licensed practical nurses (LPNs).
• Other Staff: Social workers, activity coordinators, and administrative staff.

Risks and Complications

• Common Risks: Falls, medication errors, and infections.
• Rare Risks: Psychological stress or decline due to the transition from home to facility care. Facilities manage these risks by providing high standards of care and a supportive environment.

Benefits

• Provides a supportive environment tailored to individual needs.
• Helps maintain or improve quality of life.
• Reduces the burden on family caregivers.

Recovery

Initial adjustment might take a few weeks as residents adapt to the new environment and routines. Continuous care ensures any minor health issues or adjustments needed are promptly addressed.

Alternatives

• Home Care: Receiving similar services at home through visiting caregivers.
• Day Programs: Daycare services that provide support but allow the individual to return home at night.
• Skilled Nursing Facilities: Higher level of medical care for those with more intensive needs.

Pros and Cons:

• Home Care: Offers personal comfort but may lack the socialization opportunities of residential care.
• Day Programs: Provide a middle ground but require daily transportation.
• Skilled Nursing Facilities: Offer higher medical care but can be more restrictive and less homely.

Patient Experience

Residents can expect assistance with their routine but are encouraged to participate in activities and socialize with others. Pain and discomfort are managed through regular monitoring and appropriate care measures tailored to individual needs.