Neuro Community Care - Full Effectiveness Assessment

Neuro Community Care

Comprehensive Effectiveness & Outcomes Assessment

Client Status Start Assessment

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Completion: 0%

1. ER Visits in past 6 months? 0 visits (4 pts) 1 visit (2 pts) 2+ visits (0 pts)

2. Hospital Admissions (Overnight)? None (4 pts) Yes, admitted (0 pts)

3. Crisis Center/Mobile Crisis usage? None (4 pts) Used services (0 pts)

4. Missed Medical/Therapy Appts? Never/Rarely (4 pts) Sometimes (2 pts) Often (0 pts)

5. Medication Management Confidence? High Confidence (4 pts) Moderate (2 pts) Low/Errors occur (0 pts)

6. Housing Stability? Stable (4 pts) Risk of eviction (2 pts) Unstable/Homeless (0 pts)

7. Food Security (Worry about running out)? Secure/No worry (4 pts) Insecure/Worry (0 pts)

8. Transportation Access? Reliable/Always (4 pts) Sometimes available (2 pts) Never/Significant barrier (0 pts)

9. Home/Community Safety? Feel Safe (4 pts) Occasionally Unsafe (2 pts) Unsafe (0 pts)

10. Ability to navigate resources? Excellent/Good (4 pts) Fair (2 pts) Poor (0 pts)

11. Social Outings (per week)? 2+ times (4 pts) 1 time (2 pts) None (0 pts)

12. Feeling of Isolation? Never/Rarely (4 pts) Sometimes (2 pts) Often/Always (0 pts)

13. Connection to Community? Yes, meaningful (4 pts) Somewhat (2 pts) No connection (0 pts)

14. Participation in Hobbies? Increased (4 pts) Same (2 pts) Decreased (0 pts)

15. Support System Availability? Yes (4 pts) No (0 pts)

16. Caregiver Stress Level? Low (4 pts) Moderate (2 pts) High/Burnout (0 pts)

17. Adequate Respite Received? Yes (4 pts) No (0 pts)

18. Caregiver Health vs 6 months ago? Better/Same (4 pts) Worse (0 pts)

19. Confidence in Supporting Goals? High (4 pts) Moderate (2 pts) Low (0 pts)

20. CM Understanding of Family Needs? Completely (4 pts) Somewhat (2 pts) Not at all (0 pts)

21. Goal Attainment? Achieved/Significant Progress (4 pts) Some Progress (2 pts) No Progress/Regression (0 pts)

22. Weekly Sessions Helpfulness? Very Helpful (4 pts) Somewhat Helpful (2 pts) Not Helpful (0 pts)

23. Case Manager Accessibility? Yes (4 pts) No (0 pts)

24. Overall Quality of Life? Improved (4 pts) No Change (2 pts) Worsened (0 pts)

25. Likelihood to Recommend (NPS)? Likely (9-10) (4 pts) Neutral (7-8) (2 pts) Unlikely (0-6) (0 pts)

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