CHANGING A CONSUMER LEVEL OF NEED (LON)
The documented LON (Level of Need) can change a consumer’s eligibility for services as billable rates for the service provider. Quality checks/notifications are part of the LON change process to enable quality assurance (QA) notifications to be sent to specific staff when a client’s Level of Need (LON) changes please perform the following steps.
First search for the consumer whom you would like to change their LON. Next, click on “Edit Details” (red circle) to open a pop-up menu.
Choose a QA Officer (red arrow below) who will receive notifications regarding changed LONs etc. Remember to scroll down to the bottom of the window and click ‘Save.
The LON Change process in the EHR is modeled on the clinical process depicted below.
The initial LON saved during the consumer’s admission will be greyed out and can only be
edited by creating a new IDRC and putting in an LON change request to the chosen QA officer.
To change a consumer’s LON first have an ICAP available then create a new IDRC reflecting the desired LON change (see IDRC user guide if needed). Once the IDRC is saved a notification appears on the relevant ‘To Do’ lists (named QA Officer and named CM/QIDP) as well as a flagged notification (red arrow) on the consumer’s chart (visible to the consumer’s named CM and QA officer) that an IDRC exists that does not match the consumer’s chart information. The system administrator is also notified of any discrepancies between consumer IDRCs and primary chart info. Clicking on the Homepage notifications opens a list of consumers with a mismatched LON in their current IDRC and the consumer’s Edit Detail window.
Still in the consumer’s chart the CM click on the “Case Manager/Program Coordinators” tab (purple circle). Then click on the ‘Level Of Need Change’ button (green arrow). Once this is highlighted click on the ‘Change Level Of Need’ button in the yellow bar (red arrow).
When the Change of LON window opens fill out the necessary fields and any comments that might be applicable. Files can be attached e.g., ICAP document. When complete please click on the big blue ‘Submit To QA’ button.
A new line item under the ‘LON Change’ tab will now appear below the yellow bar (red arrow below). Only the staff member who originated the LON change request can edit it by clicking on the date to the right of the entry.
Once the QA Officer logs into Focused, they will see a notification regarding the LON change request (green arrow below). They will click on the red text (green arrow) in the LON change notification and at the very bottom of the page a summary line at the bottom of the page with a PENDING icon (red arrow below) will open up.
The QA Officer must now review the data in the popup window (as well as any attachments) and ensure that the ICAP and IDRC are complete and accurately reflect the consumer’s current clinical state. Once satisfied they will click on the big blue Approve button at the bottom and then separately send off the documents for regulatory review. The QA Officer must now wait for state approval of the LON change.
If the QA Officer denies the LON change request they simply click on the big red ‘Deny’ button (we recommend adding an explanation in the comment section). This will automatically send a notification to the originator of the LON change request AND the LON in the consumer’s chart (and therefore any subsequent/renewed ID/RCs or individual profile sheets) will remain unchanged.
Remember even if the QA Officer approves the LON change request you’re not done until the regulatory body gives a final decision so read on!!
Regulatory Body APPROVES LON change: If the regulatory body approves the LON change (usual situation) then the QA Officer accesses the consumer’s chart and goes to the ‘LON Change’ tab. From there he/she clicks on the date of the approved LON change request and once the popup window opens, they check off the little “Approved By Regulatory Body” box (red circle) and click the big blue ‘Finalize’ button at the bottom. The LON in the consumer’s ‘Edit Details’ window will automatically change to the new LON and you’re done!!
Regulatory body DENIES LON change: Once the QA Officer receives notification that the LON request has been denied then he/she must access the consumer’s chart, go to the ‘LON Change’ tab and click on the date of the denied LON change request. Once the popup window opens, they simply click on the big Red Deny button (we recommend adding an explanation in the comment section). This will keep the previous LON in the consumer’s chart (and therefore any subsequent/renewed ID/RCs or individual profile sheets) back to the previous level.
