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RN Care Manager Assessment: The 4 Domains

RN Care Manager Assessment: The 4 Domains Medical Social Neighborhood Support Access to Care Home Environment Experience with Provider(s) Job & Leisure Getting Needed Services Social Support Coordination of Care Social Relationships Medical Home / Services Risk Social Support Risk Medications & Treatments . Engagement / Coping Chronicity Adherence to Treatment Symptom Severity & Mental Health History Condition Factors Mental Health Symptoms Diagnostic/Therapeutic Medical Status & Self Management Self Management &. Challenges Mental Health Risk Utilization Factors . Health Trajectory & Mental Health The Team = Patient, Providers, RN Care Manager , patient's support network Humboldt IPA PRIORITY CARE Domain Assessment Adapted from Care Oregon The 5 Domains and INTERMED Complexity Grid LAN02/2011 Social Support Domain TOTAL SCORE = Success Matrix Home Environment Consider the following: 0 Stable housing; able to maintain independent living Safe and consistent living 1 Stable housing with support of others (family, facility, situation Basic needs such as other).

Domain Levels Priority Care Domain Assessment Risk Stratification/Leveling and Interventions After conducting the Domain Assessment score each variable (0 – 3) and then total all areas.

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