CMS offers compliance guidelines to HCBS settings on wandering

The Centers for Medicare and Medicaid Services has released a compliance guideline fact sheet for home- and community-based providers who care for people who exhibit wandering or exit-seeking, in an attempt to balance the need for safety with the new home- and community-based settings (HCBS) criteria supporting resident autonomy and choice.

“As states, providers, beneficiaries and other stakeholders determine a strategy for complying with the setting requirements during a transition period that ends March 17, 2019, questions have arisen on how to adhere to the individualized nature of service provision for individuals with dementia or other conditions in which unsafe wandering or exit-seeking behavior is exhibited,” the CMS fact sheet states. Among the settings that may qualify are adult day centers, community-based residences and other settings that use or receive Medicaid-funded resources.

The fact sheet explains how community-based settings can provide safety and security while remaining in compliance with the home and community-based services criteria, many of which require providers to encourage independence and decision-making. The document also includes educational information on why wandering occurs and how caregivers can be more aware of physical or emotional needs that may act as triggers of wandering.

To remain in compliance with the HCBS criteria, safety isn’t as simple as locking the doors anymore. “Settings with controlled-egress should be able to demonstrate how they can make individual determinations of unsafe exit-seeking risk and make individual accommodations for those who are not at risk,” the fact sheet explains. “Should a person choose a setting with controlled-egress, the setting must develop person-centered care plans that honor autonomy as well as minimize safety risks for each person, consistent with his or her plan goals.”

Pamela Tabar

Pamela Tabar was editor-in-chief of I Advance Senior Care from 2013-2018. She has worked as a writer and editor for healthcare business media since 1998, including as News Editor of Healthcare Informatics. She has a master’s degree in journalism from Kent State University and a master’s degree in English from the University of York, England.