CMS SOM App. H, Tag V510

The patient’s comprehensive assessment must

include, but is not limited to, the following: (7) Evaluation of psychosocial needs by a social

worker.

Interpretive Guidance §494.80(a)(7):

The evaluation of psychosocial needs must be conducted by a qualified social worker as defined

by these regulations at § 494.140 (d)(1)(2) (V691). Examples of psychosocial parameters to be

addressed by the qualified social worker include, but are not limited to:

• Cognitive status and capacity to understand;

• Ability to meet basic needs;

• Ability to follow the treatment prescription;

• Mental health history, capacities, and needs for counseling;

• Substance abuse history, if any;

• Current ability to cope with and adjust to dialysis;

• Expectations for the future, and living with kidney failure and treatment;

• Educational and employment status, concerns, and goals;

• Home environment, including current living situation;

• Legal issues ( e.g., court-appointed guardian, advance directive status, and health care

proxy);

Page 200 of 420

• Need for advocacy with traditional (nursing home) and non-traditional housing (e.g.,

homeless shelters, group homes);

• Financial capabilities and resources;

• Access to available community resources; and,

• Eligibility for Federal, State, or local resources.

Other members of the IDT may contribute to portions of the comprehensive assessment that

correlate with the psychosocial evaluation (e.g., patient preferences for modality and self-care at

V512, evaluation for transplant referral at V513, family/support systems at V514, and evaluation

for referral to rehabilitation services at V515).

Requirements for the plan of care related to psychosocial status are listed at V552.