Developmental Disabilities Waiver Survey Field Tools
This page provides two different set of field tools. One is for Case Management and the other is for Living Supports, Community Supports and Employment Services. Please select the correct field tools for your specific purposes from below.
Case Management Survey
QMB utilizes multiple field tools when conducting compliance surveys of Case Management Agencies. These field tools are provided to the public for their use. Agencies may use the field tools as a quality assurance tool to conduct a self-test of their performance.
Disclaimer
These tools are provided as a sample of the QMB survey process and is not a complete tool set. They are not an all-inclusive of the DDSD standards and regulations, nor do they include all requirements for compliance. For a complete set of DDSD standards and rules please refer back to the actual DDSD standards, rules, regulations or policies.
QMB has the potential to cite any deficiency that we find on-site even if it is not on the tool, but there is a regulation, standard or policy to uphold it, including the providers own policy.
QMB reviews and updates the survey field tools on a regular basis to ensure their effectiveness in monitoring current requirements.
Case Management Tools
- DDW Field Tools – Case Management - Job Knowledge Interview Survey Tool
- DDW Field Tools – Case Management - Admin Interview and Requirements Tool
- DDW Field Tools – Case Management - Billing Tool
- DDW Field Tools – Case Management - Agency Individual Record Review Survey Tool
- DDW Field Tools – Case Management - CM Individual Specific Interview Survey Tool
- DDW Field Tools – Case Management - EAR, CCHS & Training Tool
Living Care Arrangements and Community Inclusion
The QMB living supports, community supports and employment services survey field tools are available to the public and living supports, community supports and employment services agencies. The living supports, community supports and employment services Survey Field tools identifies the criteria used to assess if an agency is in compliance with requirements. Living supports, community supports and employment services agencies my find them helpful when conducting a self-test to measure their own performance to identify opportunities for quality improvement.
LCA & CI Tools
- DDW Field Tools – LCA & CI - Residential Observation Survey Tool
- DDW Field Tools – LCA & CI - Agency Individual Record Review Survey Tool
- DDW Field Tools – LCA & CI - Residential Individual Record Review Survey Tool
- DDW Field Tools – LCA & CI - Nurse Interview Survey Tool
- DDW Field Tools - LCA & CI - Administrative Requirement Tool
- DDW Field Tools - LCA & CI - Billing Tool
- DDW Field Tools - LCA & CI - Healthcare & General Interview Survey Tool
- DDW Field Tools - LCA & CI - Individual Interview Tool
- DDW Field Tools - LCA & CI - Delivery Site Individual Record Review Tool
- DDW Field Tools - COR & CCHS - Substitute Care & Respite Personnel
- DDW Field Tools - COR & CCHS - Direct Service Professionals & Supervisors
- DDW Field Tools - COR & CCHS - Internal Service Coordinator