The Participant 18 years or older has one or more chronic, medical, cognitive, or mental health condition(s) identified by the participants physician. If there are limitations in the performances of two or more Activities for Daily Living (ADLs), with the need for assistant or supervision in the performing ADLs.
The Participant does not have sufficient care or supervision.
A high potential risk exists for the deterioration of the participant medical, cognitive, or mental health condition(s) in a manner likely to result in emergency room visits, hospitalization or other institutionalization if ADHC services are not provided.
The participant condition(s) require all the ADHC services.