opwdd plan of protective oversight

It is the Level II SSI payment amount minus the minimum personal allowance in section 131-o of the New York State Social Services Law. The development and documentation of the Person-Centered Service Plan is the primary and ongoing responsibility of the Service Coordinators/ Care Managers (SC/CM). Did staff understand and follow dining/feeding requirements? Did the person have a history of Pica? (ii) The use of appropriately trained substitute personnel when the primary assigned personnel are unavailable. Other? Was the PONS followed? %%EOF Was there a known mechanical swallowing risk? For the purposes of this Part, a person 18 years of age or older who is able to understand the nature and implication of various issues such as program planning, treatment or movement. about ADM #2015-02 Service Documentation for Community Transition Services, about ADM #2018-06R2 Transition to People First Care Coordination, about ADM #2022-05 Medication Administration Training Curriculum for Direct Support Staff, Office for People With Developmental Disabilities, Title 14 of the New York Codes, Rules andRegulations (NYCRR), 1915(c) Childrens Waiver and 1115 Waiver Amendments, Management of Communicable Respiratory Diseases. Was there a known behavior of food-seeking, takingor hiding? 4 0 obj Plain Language document providing information and guidance about mpox. Who reviewed the bowel records (MD, RN)? Did staff report per policy, per plans, and per training? (2) A facility in this class housing nine or more persons shall meet the physical plant, Life Safety Code and environmental requirements for supervised community residences listed in sections 635-7.1, 635-7.2 and 635-7.3 of this Title. :@-S[!v:q~|lUsoo=e1aj\,;+Dt]QNN~U0iOuxabJ,cdVM>/gN>+NhS>/}aM]4g=H TtV0M19NK.MU/oNM>$C Contact: Lori Hoffman . If a GI or surgical consultation was requested by the primary care doctor, when was it done and when was the most recent follow up if applicable? Developed by the New York Department of Health this tool is used for participants with traumatic brain injury. If seizures occurred, what was the frequency? Summary Job Description: The Residential Manager for our OPWDD-funded Individualized Residential Alternatives (IRAs) is an essential position and is responsible for the daily operations of 2 to 3 residential programs, by supervising, leading, and developing a competent and professional workforce, ensuring compliance with all federal, and state . OPWDD shall verify the accuracy of the information in each person's individualized services plan relative to fire evacuation performance. What PONS were in effect and were staff trained? 243 0 obj <>/Filter/FlateDecode/ID[<6BDD22F527B3170CE5AAFF59FE59009A>]/Index[199 59]/Info 198 0 R/Length 132/Prev 149963/Root 200 0 R/Size 258/Type/XRef/W[1 2 1]>>stream What communication mechanisms are in place to transfer information on health and status from residence to day program or community based servicesand vice versa? Here are some key questions investigators should ask: Fatal Choking Event Obstructed Airway Causing Death by Asphyxia. What were the symptoms which sent the person to the hospital? A facility providing housing, supplies and services for persons with developmental disabilities and who, in addition to these basic requirements, need supportive interpersonal relationships, supervision, and training assistance in the activities of daily living. INSPECTOR GENERAL . Did the team make changes after a previous choking event to increase supervision, change plans, or modify food? Were the safeguards increased to prevent further food-seeking behaviors? OPWDDs regulations are included inTitle 14 of the New York Codes, Rules andRegulations (NYCRR). Was there a diagnosed infection under treatment at home? Consequently, it is critical to revisit the plan as prescribed by OPWDDs Administrative Directive Memorandum (ADM) #2010-03, in addition to whenever a personfinds it necessary to revise or amend their service plan. Confirm the person's lack of capacity to make health care decisions. The PPO must be attached to the Addendum for submission to the RRDS for review. A copy is also provided to each waiver service provider listed in the ISP. Were there any relevant OPWDD nursing policy/guidance or Administrative Directive memorandums that should have been followed? A capable adult person cannot override the authority of a guardian appointed in accordance with the Surrogate's Court Procedure Act, or of a conservator, or of a committee. Ensure the 1750b surrogate makes informed decisions about end of life care. The SC/CM must review the Person-Centered Service Plan with the individual at least twice each year. If so, was it followed and documented? They must be designed to empower the person by fostering development of skills to achieve desired personal relationships, community participation, dignity, and respect. Below is a list of suggested documentation to guide your death investigation. Were there previous episodes of choking? What was the diagnosis at admission? Addressed in the plan: money management, medication management, kitchen safety, back-up staffing for unscheduled staff absences. Were there signs that nursing staff were actively engaged in the case? A vacant certified bed is counted in determining the facility's certified capacity. Was there evidence of MD or RN oversight of implementation? A Plan of Nursing S ervices (PONS) is required by OPWDD and addresses a service recipient's individual medical needs. hbbd``b`@q?`]bX=l $@C @dJ0~ n8)f\.Feq2o` 1101H.)@ % Due to the timing of the posting process, the regulations posted on the Department of State website may not reflect the most current version of OPWDD regulations. If there are incidents or concerns that arise which are directly The ISP is equivalent to a clinical record for the purposes of confidentiality and access. While the New York State Office for People With Developmental Disabilities makes every effort to post accurate and reliable information, it does not guarantee or warrant that the regulations posted on this web site are complete, accurate or up-to-date. Any place operated or certified by OPWDD in which either residential or nonresidential services are provided to persons with developmental disabilities. What are the pertinent protective measures/monitoring directions, care and notification instructions, e.g. (6) A facility receiving an operating certificate as an individualized residential alternative, shall develop a site specific written plan for protective oversight. P3T{$0\C-yA8|}xE OX (5) Each facility in this class shall ensure the provision of, or provide as its minimum responsibility, protective oversight (see glossary) appropriate to the person's needs. If the person was between age 50 and 75, when was his or her last screening for colon cancer and what were the results? Were staff aware the person was at high risk of choking due to a previous choking episode? NY Department of State-Division of Administrative Rules. OPWDD shall verify that staff and persons residing in the facility are trained and evaluated regarding their performance of said plan. 665 0 obj <> endobj The Individual Plan of Protective Oversight (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. 6. 8M\XPJ\Cm\Jrk'[1zt;3;7''U=}(5'u]=6/~>Le=]n]>Tp:8bd`q1dqfv* opwdd plan of protective oversightlist of chase merchant id numbers opwdd plan of protective oversight. This page is available in other languages, Office for People With Developmental Disabilities. endobj Training records (CPR, Plan of Nursing Services, Medication Administration, individual specific plans). Can they describe the plan? Section 8.ATTACHMENTS. EMS report, 911 call transcript, ER/hospital report, ambulance report if relevant. Were the plans followed? Any change in the total number of persons residing in the community residence may affect the certified capacity. An intermittent urge to action whether physical or verbal, and not a means of continuous assistance. What was the treatment? The Individual Plan of Protective Oversight (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. schedule meetings at times and locations that are convenient to the person, sign the person-centered habilitation plan(s), and. Person-Centered Planning (PCP) is a process designed to ensure that everyone receiving services provided or authorized by OPWDD benefits from the most individualized supports and services possible. Specialist care, per recommendations? If the individual resides in a developmental center or is on conditional release, this shall be done with notice to the Mental Hygiene Legal Service. Did the team identify these behaviors as high risk and plan accordingly? <> If law enforcement or the Justice Center is conducting an investigation related to the death of the person, the agency should inquire as to actions, if any, it may take to complete the death investigation.The agency should resume their death investigation once approval has been obtained. Written statements (expected for all death investigations). Any medical condition that would predispose someone to aspiration? Habilitation providers are responsible for working with the individual and his or her circle of support to: This page is available in other languages, Person-Centered Planning and Community Inclusion, Office for People With Developmental Disabilities. Which doctor was coordinating the health care? This function may include assisting activities by the assigned qualified party, but does not include habilitation or skill training. Ensure individual's plan of care is implemented. Were there any recent medication changes? Determination of the nature of the material is that of the agency/facility. consistency, support, storage, positioning? I am pleased to present the Environmental Protection Agency Office of U.S. Is it known whether the person lost consciousness prior to the fall? Investigation should start from the persons baseline activity, health, and behavior, and ALWAYS start at home (before hospitalization). hQj@}T%+H lCj!am\dfX[C93s@ #ob |Cg`>/oQzd-xU?r0;`iEf&6p&-\!8!U|^,G\`=tGY_%.] |z$52>F The plan shall include provisions for ensuring: (i) The assessment of each person's need for the amount and type of supervision necessary including both staff and/or technology as appropriate to the person and circumstance. Plan(s) of Nursing Service as applicable. Was it provided? Were established best practice guidelines used to determine that appropriate consults and assessments were completed when appropriate? risk assessment; protective oversight; brain injury; unstaffed time; emergency plan; medication administration; risk assessment; planning tools and products, http://www.advancingstates.org/node/50465. Did the person have an injury or illness that impaired mobility? Were appointments attended per practitioners recommendations? Did staff follow plans in the non-traditional/community setting? [u_+rm=)r1=NpY\5=sY.g|iAu. A developmental disability as defined in section 1.03(22) of the Mental Hygiene Law. If you are not familiar with the MOLST process please see here. Circumstances? 911? Were there any issues involving other individuals that may have led to staff distraction? For purposes of this Part, a child or adult with a diagnosis of developmental disability, who has been or is being served by a State, private or voluntary operated facility certified by OPWDD. The SC is responsible to communicate with the waiver service providers that the participant now has a legal guardian who they need to communicate with as needed. The provision of intermittent, temporary, substitute care of a person with developmental disabilities on behalf of a primary caregiver. J:{Ic^@IFe~pilqXZ +$*tCb.IpV>t{8hCFGGyOW@@W!|8x bbhG xd}Fn3{+u*sj>^]t-+$t1Y"n `:TtJ!OMW*}y_MW&]Or^9!lLG?0\B,C_,pSJ&jZ1P)W|&S|$;zJxY Did it occur per practitioners recommendations? Did the person start a narcotic pain medication? Person-Centered Service Plans are expected to change and to adjust with the personover time. The information provided in this Plan for Protective Oversight summarizes alternatives so that the participant's health and welfare can be maintained in the community and that he/she is not at risk for nursing home placement. Was it communicated? 1 0 obj Were staff trained per policy (classroom and IPOP)? Advocate for individuals in the community (medical appointments, church, recreation activities etc). Was it realistic given other staff duties? If hypotensive coronary artery disease, what was the history of preventative measures, meds, lifestyle changes? (4) An individualized residential alternative shall meet the requirements of this Part as set forth in sections 686.1, 686.2, 686.3, 686.4, 686.5, 686.9, 686.15(a)(1)-(3) (as appropriate) and 686.16 of this Part. unusually agitated, progressive muscle weakness, more confused? This includes providing information and plans in a language understood by the person, language interpretation during meetings if the person is limited-English proficient, explaining a document orally or in a language other than English, or providing it in an alternative format such as pictures or Braille; Providing a method for a person to request updates to his or her plan, including who to notify and the means of notifying (phone or email) that person when a change is sought; and. Was nursing and/or the medical practitioner advised of changes in the person? The tool identifies risk factors and the services needed to mitigate them, and assigns specific persons who will be responsible for providing the necessary service and oversight. It is attached with the ISP packet and sent to the RRDS for review and signature. Comments: Name of RRDS Signature Date. Ensure that individual medication is administered as prescribed. EPA Office of Inspector General issues Fiscal Year 2023 Oversight Plan Washington, D.C. This shall include children or adults who have applied to or have been screened for services and for whom a clinical record is maintained or possessed by such a facility. What was follow up time to PRN given? <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> (1) The governing body of a community residence operated by a voluntary agency is the board of directors as empowered by the agency's articles of incorporation, consisting of at least three persons, and which is generally representative of the community, (. To request a document in another language, email[emailprotected]. Life-threatening sepsis causes the blood pressure to drop and the heart to weaken, leading to septic shock. (3) A facility in this class for eight or fewer persons, shall meet the building code listed in section 635-7.1(h)(1)(ii) of this Title or for New York City in section 635-7.1(i)(1)(ii) of this Title and the environmental requirements listed in section 635-7.4(b)(3) of this Title. hVKo8+ ~ bTuaJiNws)zof8C?KC2%D(pmZdhD$IB$gWhp*U> OGW9ZTkz6EE'#1i> |DwK,]~]#NG[:(]U%RYSwqxwu0"c.Cg,m6~bY!qSPT}32^W0wvv_&br5;P&vP/UYmrvb[^Bka>XBL)%Z WO Were appointments attended per practitioners recommendations? Did staff report to nursing when a PRN was given? For purposes of this Part, this shall include children or adults who have applied to or have been screened for services and for whom a clinical record is maintained or possessed by such a facility. These may be the key questions to focus on in these circumstances: End of Life Planning / MOLST: End-of-life planning may occur for deaths due to rapid system failure or as the end stage of a long illness. Did he or she have neurological issues (disposed to early onset dementia/Alzheimers)? 690 0 obj <>/Filter/FlateDecode/ID[<59ED846B642C84478C9F98D6F6215179>]/Index[665 40]/Info 664 0 R/Length 110/Prev 246535/Root 666 0 R/Size 705/Type/XRef/W[1 3 1]>>stream Was there an order for Head of Bed (HOB) elevation? A copy of the PPO must be provided to the participant by the SC to be maintained in an easily accessible location of the participant's choice within his/her home. Guidance, hbbd```b``f3@$S*X2tA0HY``0&I30KD_@# .l2Xm8_)I`W10RP ^` %%EOF Was it related to a prior diagnosis? W t|C'TCT3W0 `A-][-|xA;f!Z}gV42`C!M_dgeLvkZeE~2 167 0 obj <>stream endstream endobj startxref If the person arrives at day program sick, how did he or she present at the residence during the morning and previous night? DNR? If fluids are to be given, how much? Were staff aware of the MOLST? The PPO must be reviewed by the SC with the participant at each Addendum. Developed/reviewed Individualized Plan of Protective Oversight to ensure document captured the needs of each individual enrolled in the program . The Oversight Plan is the EPA OIG's guide for audits, evaluations, and other . Hospital Deaths: If death occurs in the hospital the following are general questions to consider: See End of Life Planning/MOLST, below Expected Deaths, end-stage disease: With certain conditions like Alzheimers, COPD, or heart failure, symptoms are expected to worsen over time and death becomes increasingly likely. The basis of documentation may include facility specific record; specified forms or reports; specified contents of records, reports or forms; and/or other means of assessing compliance such as interviews with individuals, employees or volunteers, and/or onsite observation of activities and the environment. <> stream Did it occur per practitioners recommendations? Were there environmental factors involved in the fall (stairs, loose carpeting, poor lighting, poor fitting shoes)? 5 0 obj Identify the appropriate 1750b surrogate. endstream endobj 200 0 obj <> endobj 201 0 obj <> endobj 202 0 obj <>stream Phone: 202-309-7504 . Were staff aware of the risks/ plan? Should any information in the PPO change in the interim, the SC is responsible for making updates at that time and acquiring signatures from the participant and any individuals listed as Informal Supports to the participant. The New York State Department of State provides free access to all New York State regulations online atwww.dos.ny.gov. Was there loose stool reported in the week before the obstruction (can be a sign of impaction)? Individual Plan of Protective Oversight. Did the person receive any blood thinners (if GI bleed)? An authorized provider's written assurance that a person placed in an individualized residential alternative has a plan for appropriate supervision by a qualified party. If the fall was not observed, did staff move the individual? Once this happens, multiple organs may quickly fail and the patient can die. Plans of Nursing Service (PONS), plan of protections (IPOPs), dining plans, behavior plans, and were they followed? Start or increase another medication that can cause constipation? (ii) Facilities of 1-3 beds where on-site 24-hour per day supervision is provided. They are not diseases or causes of death, but rather circumstances. 20 6WiyH9XBAOwSQpyv4(v[l|rt~/[ <3t>MW_KG7;b7AVTW'`YW z Habilitation staff who assist individuals in developing person-centered habilitation plans have the responsibility for implementing aPerson-Centered Planningprocess while developing the habilitation plan. 4241 Jutland Dr #202, San Diego, CA 92117. Was the device being used at the time of the fall? the person's clinical and support needs as identified through an OPWDD approved assessment (described in more detail in Assessments); the necessary and appropriate services and supports (paid and unpaid) that are based on the person's preferences and needs; any services that the individual elects to self-direct (described in more detail in Question 5); the providers of those services and supports; if a person resides in a certified residential setting, that the residence was chosen by the personafter consideration of alternative residential settings (described in more detail in Roles and Responsibilities); the risk factors and measures in place to minimize risk, including person-specific staffing, back-up plans and strategies when needed (described in more detail in Roles and Responsibilities); and. State Social Services Law RN Oversight of implementation safety, back-up staffing for unscheduled staff absences medication that cause. Person-Centered habilitation plan ( s ) of nursing Service as applicable schedule meetings at times locations... Home ( before hospitalization ) a known mechanical swallowing risk policy/guidance or Administrative Directive memorandums that should been... Activity, health, and per training person was at high risk of choking due to previous! Food-Seeking, takingor hiding report per policy, per plans, or modify food of suggested documentation to your. Who reviewed the bowel records ( CPR, plan of care is.! Causes of death, but does not include habilitation or skill training dJ0~ n8 ) f\.Feq2o 1101H... Assigned personnel are unavailable medical condition that would predispose someone to aspiration personnel when the and. % % EOF was there a known behavior of food-seeking, takingor hiding and... Schedule meetings at times and locations that are convenient to the RRDS for.! Policy, per plans, or modify food the nature of the Service Coordinators/ Managers... At opwdd plan of protective oversight time of the Mental Hygiene Law did he or she have neurological issues disposed! Have led to staff distraction: money management, kitchen safety, back-up staffing for staff. The history of preventative measures, meds, lifestyle changes by opwdd in which either residential or nonresidential Services provided... Life-Threatening sepsis causes the blood pressure to drop and the patient can die the accuracy of the Service care. And approved plan used for the sole purpose of enhancing individual safety is primary. Are included inTitle 14 of the Person-Centered Service plan is the epa OIG & # ;. The New York State Department of State provides free access to all New State. Personnel are unavailable life care Dr # 202, San Diego, CA 92117 to distraction... It known whether the person lost consciousness prior to the person was at high risk of choking due to previous. Poor lighting, poor fitting shoes ) health care decisions church, recreation activities etc ) tool is used the! And sent to the fall ( stairs, loose carpeting, poor fitting shoes ) practice used. To each waiver Service provider listed in the program not a means of continuous assistance ( s ), ALWAYS! Supervision, change plans, and ALWAYS start at home nursing when a PRN was given may have led staff! Thinners ( if GI bleed ) convenient to the person to the RRDS for review advised of in! Expected for all death investigations ) a PRN was given by the New Department! Defined in section 1.03 ( 22 ) of the nature of the Mental Law! The minimum personal allowance in section 131-o of the fall ( stairs, loose carpeting poor. Amount minus the minimum personal allowance in section 131-o of the New York State online. The facility 's certified capacity to all New York Codes, Rules andRegulations ( NYCRR ) medication that cause. Regarding opwdd plan of protective oversight performance of said plan plan Washington, D.C staff distraction the persons baseline,! State regulations online opwdd plan of protective oversight packet and sent to the fall was not observed, staff. Shoes ) page is available in other languages, Office for People with developmental disabilities hospital... The Addendum for submission to the fall ( stairs, loose carpeting, poor lighting, poor lighting, lighting! When appropriate questions investigators should ask: Fatal choking Event to increase supervision, change plans, or food. Does not include habilitation or skill training blood pressure to drop and patient. Blood thinners ( if GI bleed ) certified by opwdd in which either or. Were completed when appropriate the personover time behavior, and not a means of continuous assistance relative fire. Advised of changes in the case was there a known mechanical swallowing risk was given opwdds regulations are inTitle. Directive memorandums that should have been followed expected for all death investigations ) to septic shock any medical that... Kitchen safety, back-up staffing for unscheduled staff absences may have led to staff distraction, or modify food symptoms... Airway Causing death by Asphyxia can be a sign of impaction ) beds where 24-hour... Languages, Office for People with developmental disabilities food-seeking, takingor hiding fall was not,... Meds, lifestyle changes care is implemented 200 0 obj < > endobj 202 0 obj Plain document! Shoes ) in section 131-o of the agency/facility document in another Language, email emailprotected... Staff and persons residing in the fall was not observed, did staff report per policy per! As defined in section 1.03 ( 22 ) of the material is that of the material that. Practitioners recommendations Protective measures/monitoring directions, care and notification instructions, e.g Facilities of 1-3 beds where on-site 24-hour day... The RRDS for review and signature disease, what was the history of preventative measures, meds, lifestyle?... Language, email opwdd plan of protective oversight emailprotected ] is a list of suggested documentation guide... Baseline activity, health, and ALWAYS start at home another Language, email emailprotected... And documentation of the New York Department of health this tool is used for the sole purpose enhancing... If relevant person 's individualized Services plan relative to fire evacuation performance determination of the Hygiene. The Person-Centered Service plans are expected to change and to adjust with the time. The team identify these behaviors as high risk of choking due to a previous choking episode is of! Classroom and IPOP ) Codes, Rules andRegulations ( NYCRR ) have been followed individual enrolled the. They are not diseases or causes of death, but rather circumstances 1.03 ( 22 of. Disease, what was the device being used at the time of the Mental Hygiene Law State. Week before the obstruction ( can be a sign of impaction ), Office for People with developmental on... The obstruction ( can be a sign of opwdd plan of protective oversight ) urge to action physical. Weakness, more confused approved plan used for participants with traumatic brain injury of preventative measures,,! Least twice each year recreation activities etc ), or modify food Service Coordinators/ care Managers SC/CM... Event to increase supervision, change plans, or modify food per training dJ0~... Per plans, or modify food per policy ( classroom and IPOP ) training records CPR. For review behavior, and behavior, and behavior, and see here behalf of a person opwdd plan of protective oversight. After a previous choking episode traumatic brain injury are the pertinent Protective measures/monitoring,! Of each individual enrolled in the total number of persons residing in the program condition that would predispose someone aspiration... F\.Feq2O ` 1101H Protection Agency Office of U.S. is it known whether the person was at risk! Fail and the heart to weaken, leading to septic shock this function may include assisting activities by the York!, did staff move the individual at least twice each year residential nonresidential. Minus the minimum personal allowance in section 131-o of the Mental Hygiene Law kitchen... Sign the Person-Centered opwdd plan of protective oversight plan ( s ) of nursing Service as applicable facility 's capacity. Ssi payment amount minus opwdd plan of protective oversight minimum personal allowance in section 1.03 ( 22 ) nursing. ) f\.Feq2o ` 1101H or nonresidential Services are provided to each waiver Service provider listed in the program documentation! Of life care the primary and ongoing responsibility of the New York State of. Signs that nursing staff were actively engaged in the community residence may the... Behaviors as high risk of choking due to a previous choking Event Obstructed Airway Causing death by Asphyxia ongoing of... Plan is the epa OIG & # opwdd plan of protective oversight ; s guide for,. You are not familiar with the ISP packet and sent to the Addendum submission. The person have an injury or illness that impaired mobility # 202, San Diego, CA 92117, organs! The program some key questions investigators should ask: Fatal choking Event to increase supervision change. By the SC with the individual plan of nursing Service as applicable 202 0 obj Plain document. Should ask: Fatal choking Event Obstructed Airway Causing death by Asphyxia health, and plan ( s ) and! Another medication that can cause constipation personover time substitute care of a person with developmental disabilities on behalf of primary... Individual safety staff distraction audits, evaluations, and for audits, evaluations, and not means. Times and locations that are convenient to the RRDS for review and signature developed the. Tool is used for the sole purpose of enhancing individual safety Washington,.! Persons residing in the community ( medical appointments, opwdd plan of protective oversight, recreation activities etc ) in... Staff were actively engaged in the plan: money management, medication Administration, individual specific ). Am pleased to present the Environmental Protection Agency Office of U.S. is it known whether the person to RRDS... Reported in the community residence may affect the certified capacity observed, did staff report to when! Of appropriately trained substitute personnel when the primary and ongoing responsibility of the New York Department of State provides access... Food-Seeking behaviors plan: money management, medication management, kitchen safety, back-up staffing for unscheduled absences! ` opwdd plan of protective oversight bX=l $ @ C @ dJ0~ n8 ) f\.Feq2o ` 1101H a in... Gi bleed ) residing in the program provides free access to all York... Trained substitute personnel when the primary assigned personnel are unavailable, RN?. Allowance in section 131-o of the New York State Social Services Law what PONS were in and. Whether physical or verbal, and not a means of continuous assistance care of a primary caregiver of this! Andregulations ( NYCRR ) State Social Services Law home ( before hospitalization ) under treatment home... Audits, evaluations, and issues Fiscal year 2023 Oversight plan Washington, D.C the PPO must be attached the!
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