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Review and Audit Tools

Initial Review Tools

• DHHS Initial Rights Notification Review Tool
• DHHS Initial Funds Management Review Tool
• DHHS Initial Medications Mangement Review Tool
• DHHS Initial On-Site Health and Safety Review Tool
• DHHS Initial Personnel Review Tool
• DHHS Initial Record Review Tool

Routine Review Tools

• DHHS Routine Rights Notification Review Tool
• DHHS Routine Compliance Safety Review Tool
• DHHS Routine Consumer Record Review Tool
• DHHS Routine Funds Management Review Tool
• DHHS Routine Medications Review Tool
• DHHS Routine Personnel Review Tool

Licensed Independent Practitioner Review Tools

• DHHS LIP Site Quality Review Tool
• DHHS LIP Review Tool
  

Provider Performance Profile Review Tools

• DHHS Provider Performance Profile Grid
• DHHS Provider Performance Profile Review Tools
  • Preferred Provider Review Tool
  • Exceptional Provicer Review Tool
  • Gold Star Provider Review Tool

DHHS Unlicensed AFL Health and Safety Review Tool

• AFL Health and Safety Review Tool for Unlicensed Facilities

Domain Review Tool

• Domain Review Tool to Increase Level

Licensed Independent Practioners (LIP) Review Tools

• LIP Review Tool
• LIP Site Quality Review Tool

DHHS Application Policies and Procedures Review Tool

• DHHS Additional Service Policy and Procedure Review Tool

Payback/Billing Audit Tools

• Payback Form
• Self-Audit Payback Form
• Billing Audit Tool - Provider
• LIP Billing Audit Tool

 

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Additional Contact Information

• All waiver-related questions should be submitted by e-mail to DMA.waiver@dhhs.nc.gov.
• Additional information is also available on the DMH/DD/SAS website.