Appendix D Case Manager Training Report Template.pdf
PDF 290 KB Posted
- Attached to
- SEP Services: Chaffee and Lake Counties
- Solicitation number
- RFP UHAA 2015000076 2
- Issued by
- Chaffee County, Denver City, Colorado
About this file
This is a Case Manager Training Report Template document from the Colorado Department of Health Care Policy and Financing related to Solicitation #RFP UHAA 2015000076 (Contract Routing Number 14-55349). The template is designed to track and document the completion of mandatory training topics for case managers within long-term care services. The training topics covered include Case Manager Long Term Care Eligibility, Intake and Referral, ULTC 100.2 Assessment, Service Plan Development, Notices and Appeals, BUS Documentation, Home Health, CDASS and IHSS, Waiver Programs and Services, CCT/Community Transition Services, Processing PARs HCBS-LTHH, Home Modification Process, Critical Incident Reporting, Conflict of Interest Education & Training, and Person-Centeredness/Cultural Awareness. The template captures individual case manager information including last name, first name, CMA Agency affiliation, dates covered during the reporting period, and completion status (Yes/No) for each training topic with corresponding attendance dates.
The document serves as a performance standard reporting tool that organizations must utilize to demonstrate compliance with training requirements for case managers operating under this contract. The template requires documentation of successful completion across all designated training modules, with each topic linked to specific date fields to verify attendance and completion. This systematic tracking mechanism ensures accountability and uniform training standards across case management agencies participating in the Colorado Department of Health Care Policy and Financing programs.
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Colorado Department of
Health Care Policy and Financing
SOLICITATION #:
RFP UHAA 2015000076
Appendix D
CASE MANAGER TRAINING REPORT TEMPLATE
APPENDIX D Page 1 of 2
Contract Routing Number 14-55349
APPENDIX D, CASE MANAGER TRAINING REPORT TEMPLATE
TRAINING TOPICS
Case Manager
Long Term Care
Eligibilit y
Successfull y
Completed ? (Y/N)
Intake and Referral
Successfull y
Completed ? (Y/N)
ULTC
100.2
Assessme nt
Successfull y
Completed ? (Y/N)
Service Plan
Developme nt
Successfull y
Completed ? (Y/N)
Notices and
Appeals
Successfull y
Completed ? (Y/N)
BUS
Documentati on
Successfull y
Completed ? (Y/N) Home Health
Successfull y
Completed ? (Y/N)
Last Name
First Name
Date Attende d Date
Attended Date
Attended Date
Attended
Date Attende d Date
Attended Date Attended
CMA Agency:
Dates Covered:
PERFORMANCE STANDARD - TRAINING
APPENDIX D Page 2 of 2
CDASS
and
IHSS
Successful ly
Complete d? (Y/N)
Waiver Progra ms and Services
Successful ly
Complete d? (Y/N)
CCT/Commun ity Transition
Services
Successful ly
Complete d? (Y/N)
Processin g PARs
HCBS-
LTHH
Successful ly
Complete d? (Y/N)
Home Modificatio n Process
Successful ly
Complete d? (Y/N)
Critical Incident Reporti ng
Successful ly
Complete d? (Y/N)
Conflict of Interest
Education & Training
Successful ly
Complete d? (Y/N)
Person- Centeredness/Cult ural Awareness
Successful ly
Complete d? (Y/N)
Date Attend ed
Date Attende d
Date Attended
Date Attended
Date Attended
Date Attende d
Date Attended
Date Attended
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