Functional Needs

Section 144 Section 144.175  Functional Needs Functional needs are the basic needs of all persons.  All functional needs of each individual residing in an ICF/MR must be addressed.  The individual's IPP must provide a current assessment of his/her developmental level in each area of functional need.  On the basis of the assessment outcome, the IDT determines if each area of an individual's functional needs can be addressed independently by the person, or is to be addressed as a service need or through a training program.  The IPP specifies the individual's level of dependence/independence, types of assistance needed, and developmental skill interventions (programs) designed to increase functional independence. The IPP shall address skill maintenance if the individual demonstrates any skill regression or loss of functional status.  The individual's preferences shall also be acknowledged (i.e., tub or shower bathing). Additional reimbursement is paid for an individual who needs and receives partial or total assistance in meeting functional needs (Section 144.275(c)(2)).  This reimbursement is provided only when an individual meets the criteria for mobility assistance and/or high personal care under Specialized Care-Health and Sensory Disabilities (Section 144.150(b) and (c)). The functional needs of all individuals are: a)         Bathing Bathing means bathing all, or some part of the body, including the hair, whether the bath occurs in a tub, shower, or bed. b)         Clothing Clothing means total dressing and undressing, including stockings or socks and shoes. c)         Eating Eating means to consume or assimilate food or nutriments to fulfill nutritional needs.  Eating includes both oral and tube feedings. d)         Grooming/Personal Hygiene Grooming/personal hygiene means bodily maintenance including combing hair, cleaning and clipping nails, shaving if applicable, tooth brushing and oral hygiene including denture care, daily deodorant use, hygiene associated with menstruation, makeup application when desirable and appropriate, daily hands and face washing. e)         Toileting/Continence Toileting means the appropriate use of a toilet, including related undressing/dressing activities, and necessary follow-up hygiene. f)         Mobility Mobility means the power of locomotion and includes transfers/movements which are accomplished by independent ambulation and via the employment of assistive devices such as walkers, wheelchairs, braces, and prostheses. g)         Psychosocial Mental Status Psychosocial mental status means the achievement of a sense of well-being and emotional balance in one's relationship with self, other persons, and one's daily environment.