Transcription of Client Acuity Scale Worksheet - michigan.gov
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Client Acuity Scale Worksheet - michigan.gov
Client Name _____ Client Number _____ PAGE TOTAL _____ 1 Client Acuity Scale Worksheet Date of Assessment _____ Clients are assigned to a Level if they meet one or more of the criteria listed within each Level. Point values are different for different LIFE AREAS by page. Life Area Level #1 (1 point) Level #2 (4 points) Level #3 (6 points) Level #4 (8 points) Comments Basic Needs Level _____ Points _____ __ Food, clothing, and other sustenance items available through Client s own means. __ Has ongoing access to assistance programs that maintain basic needs consistently. __ Able to perform activities of daily living (ADL) independently. __ Sustenance needs met on a regular basis with occasional need for help accessing assistance programs. __ Unable to routinely meet basic needs without emergency assistance. __ Needs assistance to perform some ADL weekly. __ Routinely needs help accessing assistance programs for basic needs.
Client Name _____ Client Number _____ PAGE TOTAL _____ 1 Client Acuity Scale Worksheet
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