Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › CARE CLASSIFICATION › Section 388-106-0100 - How does the CARE tool measure mood and behaviors?

Current through Register Vol. 24-14, July 15, 2024
(1) When you do not meet the criteria for the
				  clinically complex classification group, or the criteria for exceptional care,
				  or for in-home only have a cognitive performance scale score of five or six,
				  then the mood and behavior criteria listed in subsections (3) and (4) below
				  determines your classification group. If you are eligible for more than one "B"
				  group classification based on the two methodologies, CARE will place you in the
				  highest group for which you qualify.
(2) For each behavior that was assessed and
				  documented in the CARE tool , the department will determine a status as
				  "current behavior" or "past behavior" as defined in WAC
				  388-106-0010.
(3) CARE places you in the mood and behavior
				  classification group only if you have one or more of the behavior/moods that
				  also meets the listed status, frequency, and alterability as identified in the
				  following chart:
Behavior/Mood
AND Status, Frequency &
								Alterability
Assaultive (not during personal care)
Current behavior
Combative during personal care
Current behavior
Combative during personal care
Past behavior, addressed with current
								interventions
Many incidences of uncontrollable crying
								tearfulness
Current behavior, frequency 4 or more days per
								week
Delusions
Past behavior, addressed with current
								interventions
Depression score of 14 or greater
N/A
Inappropriate nakedness
Current behavior and not easily altered
Easily irritable/agitated requiring
								interven-tion(s)
Current behavior and not easily altered
Eats nonedible substances/objects
								(Pica)(persistent for at least a month)
Current behavior
Eats nonedible substances/objects
								(Pica)(persistent for at least a month)
Past behavior, addressed with current
								interventions
Hallucinations
Current behavior
Hiding items
Past behavior, addressed with current
								interventions
Hoarding
Past behavior, addressed with current
								interventions
Mental health therapy/program
Needs
Nonhealth related repetitive anxious
								complaints/questions
Current behavior, daily
Nonhealth related repetitive complaints/questions
Past behavior, addressed with current
								interventions
Repetitive movement/pacing, hand wringing,
								fidgeting
Current behavior, daily
Resistive to care with words/gestures (does not
								include informed choice)
Current behavior
Resistive to care with words/gestures (does not
								include informed choice)
Past behavior, addressed with current
								interventions
Sexual acting out
Current behavior
Sexual acting out
Past behavior, addressed with current
								interventions
Inappropriate spitting
Current behavior and not easily altered
Inappropriate spitting
Past behavior, addressed with current
								interventions
Breaks/throws items
Current behavior
Unsafe smoking
Current behavior and not easily altered
Disturbs household at night when others are
								sleeping and requires intervention
Current behavior
Wanders exit seeking
Current behavior
Wanders exit seeking
Past behavior, addressed with current
								interventions
Wanders not exit seeking
Current behavior
Wanders not exit seeking
Past behavior, addressed with current
								interventions
Yelling/screaming
Current behavior, frequency 4 or more days per
								week
or
(4)
				  CARE places you in the mood and behavior classification group if you have a
				  behavior point score greater than 1, your CPS score (as defined in WAC
				  388-106-0090
				  ) is greater than 2, and your ADL score (as defined in WAC
				  388-106-0105
				  ) is greater than 1.
Status
Intervention
Frequency
Weight
Past
No intervention
N/A
0
Past
With intervention
N/A
0.25
Current
N/A
1-3 days per wk
0.5
Current
N/A
4-6 days per wk
0.75
Current
N/A
Daily
1
Each current behavior (as shown in the table below) has a
					 value from .5 to 6 depending on the severity and alterability. Each status
					 combination (shown in the table above) has a weight from 0 to 1. Behavior
					 points are determined by multiplying the value of each current behavior (from
					 the list below) by the weight of the status combination (above). Behavior
					 points for past behaviors will be determined by multiplying the easily altered
					 value of the behavior from the table below by the appropriate weight from the
					 table above (0 or .25).
The list of behaviors below is divided into categories.
					 Each category has a point limit of how many points can be counted toward the
					 total behavior point score as detailed below. The total behavior point score is
					 determined by totaling the weight-adjusted values for each category
					 below.
Behavior
Value
Easily Altered/Past
Not Easily Altered
1. Many incidences of uncontrollable crying ,
								tearfulness
.5
1
2. Easily irritable/agitated
.5
1
3. Obsessive regarding own health or body
								functions
.5
1
4. Repetitive physical movement/pacing, hand
								wringing, fidgeting
.5
1
5. Hiding items
.5
1
6. Hoarding
.5
1
7. Inappropriate verbal noise
.5
1
8. Wanders, not exit seeking
.5
1
Maximum total points after adjusting for status
								for behaviors 1-8 = 2
9. Repetitive anxious complaints/questions
1
2
10. Rummages/takes belongings of others
1
2
11. Verbally abusive
1
2
12. Yelling or screaming
1
2
13. Inappropriate spitting
1
2
14. Unrealistic fears and suspicions
1
2
15. Accuses others of stealing
1
2
Maximum total points after adjusting for status
								for behaviors 9-15 = 3
16. Resistive to care with words/gestures
2
3
17. Disturbs household at night when others are
								sleeping, requires intervention
2
3
18. Unsafe cooking
2
3
19. Inappropriate toileting/menses activity
2
3
20. Unsafe smoking
2
3
21. Left home and gotten lost
2
3
22. Inappropriate nakedness
2
3
Maximum total points after adjusting for status
								for behaviors 16-22 = 4
23. Intentional self-injury
4
5
24. Wanders/Exit seeking
4
5
25. Sexual acting out
4
5
26. Intimidating/threatening (no physical contact)
4
5
27. Assaultive (not during personal care)
4
5
28. Breaks, throws items
4
5
Maximum total points after adjusting for status
								for behaviors 23-28 = 10
29. Deliberate fire setting behaviors
5
6
30. Combative during care
5
6
31. Eats nonedible substances/objects
								(Pica)(per-sistent for at least a month)
5
6
32. Deliberate sexual violence
5
6
Maximum total points after adjusting for status
								for behaviors 29-32 = 12
Reviser's note:
The typographical error in
						the above section occurred in the copy filed by the agency and appears in the
						Register pursuant to the requirements of
						RCW
						34.08.040.