INFORMATION AND REFERRAL MONITOING

TOOL
201
4
Purpose: The purpose of this monitoring tool is to evaluate the functionality of current system,
to ensure accuracy, and constancy with all of the referrals or general calls that are received from
COSAs Information and Referral Unit
Process: Random selecting of consumers should occur through the SA!s data"ase
Outcome: Identify pro"lems and indicate corrective responses, to fulfill re#uirements for
#uality
$ SAMS% Are the following demographics completed in SA!S&
a' Is the consumer registered in SA!s& ((((((((((
"' Consumers name% ((((((
c' )ate of "irth% (((((((((
d' Social Security num"er% ((((((((((((
e' County% (((((((((((
f' Address% ((((((((((((
g' *hone +um"er% ((((((((((((
, ACTIVITY & REFRRAL% Are the following Activities and Referrals completed&
a' )ate of Referral% ((((((((((((
"' )ate of Inta-e% ((((((((((((
. JOURNAL ENTRY% )oes the /ournal entry state the following& (((((((((((((
a' 0hat is the reason call1referral was made to COSA& ((((((((((((
"' 0hat is the name of the person ma-ing the referral& ((((((((((((((((
c' Is the consumer aware that a referral is "eing made& ((((((((((((((((
d' )oes the consumer live alone& (((((((((((((((
e' 0as the consumer recently in a hospital or nursing home& ((((((((((
f' 0hat program1 services are "eing re#uested& (((((((((((((((((((
g' The name of the Assessor and time of the assessment (((((((((((((
INFORMATION AND REFERRAL MONITOING
TOOL
201
4
h' )id the Inta-e 0or-er electronically sign the referral& ((((((((((((((
2 ASSESSMENT SCHEDULIN% Appt *lus
a' Are appointments scheduled for Assessor using Appointment plus& ((((((
"' 0as the appt scheduled within five days of the initial call& ((((((((((
c' Is there a SA!S /ournal entry stating the date and time of the assessment
appointment& ((((((((
!" Vo#ce Mess$%es:
a' Are voice messages documented on an inta-e form and logged on a
daily "asis& ((((((((
"' Are call "ac-s made within ,2 hours& (((((((((
c' Are return calls documented in SA!s& ((((((((((((((((
&" Tr$c'#(% o) C$**s:
a' )oes every Inta-e 0or-er have a log3in num"er for the telephone&
((((((((((
"' Is there a daily log of phone inta-e calls and outcomes& ((((((((
c' Is the Inta-e 0or-er entering activity codes on s-illset once phone call ends&
(((((((((
d' Are the inta-e wor-er phones in 4not ready5 for five minutes or longer&
(((((((
e' Are the Inta-e 0or-ers individual s-illset averaging ,6 calls per day&
(((((((((((
+" ,$*' #(s:
a' Are wal- in referrals documented in SA!S& ((((((((
"' Are wal- in in#uiries noted on inta-e form and filed& (((((((((