Dhmh 4659 Form – Fill Out and Use This PDF

Dhmh 4659 Form PDF Details

At the heart of providing targeted, personalized care under Medicaid Home and Community-Based Services Waiver Programs lies the essential documentation requirement fulfilled by the DHMH 4659 form. This detailed Caregiver Time Sheet/Caregiver Service Record serves as a critical record that bridges the communication between caregivers, participants, and administrative bodies overseeing caregiving services. It applies to specific waivers, notably the Waiver for Older Adults (WOA) and the Living at Home Waiver (LAH), ensuring that elderly participants receive the support they need to live an independent and dignified life at home. The form captures daily caregiving activities ranging from personal hygiene to medication management, and it meticulously records the start and stop times of service each day. By initialing their service hours, caregivers confirm that their assistance aligns with the participant's authorized Plan of Service/Plan of Care. This process not only ensures accountability but also fosters transparency by requiring signatures from both the caregiver and the participant or their representative. Importantly, it guides caregivers on the correct procedure for submitting their recorded hours for payment, differentiating between independent and agency caregivers. Furthermore, it underscores the imperative of reporting any serious issues, including potential abuse, neglect, or exploitation, thereby prioritizing participant safety and well-being. The distribution of form copies serves as an organized method to keep all involved parties informed, making the DHMH 4659 form a cornerstone of efficient caregiving within Medicaid's waiver programs.