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Instructions for the endorsement check sheet used in the validation of business entities providing Medically Monitored Community Residential Treatment (MMCRT) services, ensuring compliance with state
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How to fill out NC DHHS – NC DMH/DD/SAS Medically Monitored Community Residential Treatment (MMCRT) Check Sheet Instructions

01
Begin by accessing the NC DHHS – NC DMH/DD/SAS MMCRT Check Sheet form.
02
Carefully read through the instructions provided at the top of the sheet.
03
Fill in the required patient identification information, including name and date of birth.
04
Provide details regarding the admission date and the referring clinician.
05
Answer all sections regarding the patient's medical history, including previous treatments and medications.
06
Describe the current clinical status and any ongoing issues the patient is facing.
07
Complete the risk assessment section by evaluating the patient's safety and health risks.
08
Ensure that all questions are answered thoroughly and accurately before submitting.
09
Double-check for any missing information or signatures.
10
Submit the completed Check Sheet to the appropriate authorities as instructed.

Who needs NC DHHS – NC DMH/DD/SAS Medically Monitored Community Residential Treatment (MMCRT) Check Sheet Instructions?

01
Individuals seeking community residential treatment for mental health or substance use disorders.
02
Clinicians and healthcare providers who are responsible for patient care and treatment planning.
03
Administrative staff involved in the processing and documentation of treatment referrals.
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The Department of Health and Human Services manages the delivery of health- and human-related services for all North Carolinians, especially our most vulnerable people – children, elderly, disabled and low-income families.
What is the Clinical Assessment Service? The Clinical Assessment Service (CAS) is for primary care practitioners to refer patients to secondary care services via the national Electronic Referral System (e-RS).
A Comprehensive Clinical Assessment is a biopsychosocial intensive clinical and functional face-to-face evaluation of a client's presenting mental health, developmental disability, and substance use disorder that results in the issuance of a written report that provides the clinical basis for the development of the
This intensive face-to-face assessment identifies a client's needs across various domains, including behavioral health, physical health, housing, education, and vocational needs.
A Psychiatric Residential Treatment Facility (PRTF) provides non-acute inpatient facility care for customers with a mental illness or substance abuse/dependency, and who need 24-hour supervision and specialized interventions.
Your CCA will include the following elements: (a) the presenting problems, (b) chronological general health and behavioral health history, (c) current medications; (d) biopsychosocial and developmental dimensions, (e) case formulation, (f) diagnoses from the DSM-5, and (g) recommendations for additional assessments,

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The NC DHHS – NC DMH/DD/SAS Medically Monitored Community Residential Treatment (MMCRT) Check Sheet Instructions provide guidelines for residential treatment facilities to ensure compliance with state regulations and standards for monitoring the health and safety of residents in medically monitored settings.
Residential treatment facilities that are licensed by NC DHHS and provide medically monitored community residential treatment services are required to file the MMCRT Check Sheet Instructions.
To fill out the MMCRT Check Sheet, facilities must provide detailed information about resident health status, treatment activities, staff observations, and any incidents that occur during the monitoring period, ensuring that all required fields are accurately completed and documented.
The purpose of the MMCRT Check Sheet Instructions is to establish standard protocols for monitoring residents' health and safety, documenting compliance with treatment plans, and ensuring that facilities provide appropriate care in accordance with state regulations.
The information that must be reported includes resident identifiers, health assessments, medication administration records, behavioral observations, treatment interventions, incidents or accidents, and any changes in the resident's condition.
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