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N.D. Admin. Code 535-05-35 - Case Management (Comprehensive Plan of Care), Medicaid State Plan Personal Care Services Service Chapter 535-05

North Dakotasub-regulatoryNorth Dakota Department of Health and Human Services (Medical Services / Medicaid)

What this rule requires your agency to do

  • 1The plan of care must document all problems identified, including those that will not be addressed through the provision of personal care services. (535-05-35)(N.D. Admin. Code 535-05-35 - Case Management (Comprehensive Plan of Care), Medicaid State Plan Personal Care Services Service Chapter 535-05)
  • 2The case manager and the individual must work together to develop a plan for the individual's care based on the needs, situations, and problems identified in the assessment. (535-05-35)(N.D. Admin. Code 535-05-35 - Case Management (Comprehensive Plan of Care), Medicaid State Plan Personal Care Services Service Chapter 535-05)
  • 3The plan must document the desired outcome(s) for each problem and the type(s) of help needed to achieve each desired outcome. (535-05-35)(N.D. Admin. Code 535-05-35 - Case Management (Comprehensive Plan of Care), Medicaid State Plan Personal Care Services Service Chapter 535-05)
  • 4The plan must specify the amount of personal care service to be provided and the specific time-period. (535-05-35)(N.D. Admin. Code 535-05-35 - Case Management (Comprehensive Plan of Care), Medicaid State Plan Personal Care Services Service Chapter 535-05)
  • 5Where applicable, the plan must document the medical necessity to monitor vital signs and identify who is to be notified of an individual's vital signs readings. (535-05-35)(N.D. Admin. Code 535-05-35 - Case Management (Comprehensive Plan of Care), Medicaid State Plan Personal Care Services Service Chapter 535-05)
  • 6A reassessment of the individual's needs and care plan must be completed at a minimum of six-month intervals, and a comprehensive assessment must be completed initially and annually (or upon a significant change in personal care needs). (535-05-35)(N.D. Admin. Code 535-05-35 - Case Management (Comprehensive Plan of Care), Medicaid State Plan Personal Care Services Service Chapter 535-05)
  • 7The plan must identify the services and providers that can supply the needed help and the provider(s) the individual selects. (535-05-35)(N.D. Admin. Code 535-05-35 - Case Management (Comprehensive Plan of Care), Medicaid State Plan Personal Care Services Service Chapter 535-05)

Applies to: personal care services

North Dakota's Medicaid State Plan Personal Care Services chapter (Service Chapter 535-05, sec. 535-05-35, Case Management) requires the case manager and individual to jointly develop a comprehensive plan of care based on the assessment. The plan must document all identified problems, desired outcomes, types of help needed, services/providers available, the provider selected, the amount and time-period of personal care, and any medical-necessity monitoring of vital signs. A comprehensive assessment is required initially and annually, and the plan/needs must be reassessed at least every six months.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.