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During a prospective review, services are reviewed before they are authorized to determine if the participant, the current processes, or both were followed.
The purpose is to ensure that:
- a participant meets eligibility requirements;
- services will meet the participant’s needs; and
- CRS program staff members are following CRS policies and procedures.
The review may include:
- a review of intake and assessment information;
- a diagnostic interview;
- a review of the participant’s records that support eligible diagnosis or diagnoses;
- a determination of eligibility by the CRS counselor;
- a review of the participant’s Individualized Written Rehabilitation Plan;
- a review of the participant’s records documenting the care of the participant provided by the provider, paraprofessionals and professionals;
- medical and nursing assessment and diagnoses;
- changes in treatment strategies based on data or assessments;
- a review of the interdisciplinary team meeting summaries;
- participant schedules;
- a review of the consents from the participant;
- a review of the participant restraints reports;
- on-site visits and outings;
- assessments made at the request of or by the CRS counselor;
- interviews held with the participant, participant’s family or guardian; and
- discharge planning.