1. Harvest Healthcare Cognitive Assessment Program

2. What is the Harvest Cognitive Assessment Program? Our Cognitive Assessment Program (CAP) is a structured cognitive testing program that augments our traditional behavioral health services i.e. mental health and medication management services.

3. Cognitive Assessment Program (CAP) So what exactly is a cognitive evaluation? Systematic Assessment of: mental activity (attention, and speed of information processing) visuo-constructive abilities short and long-term memory functioning executive functioning (organizing, sequencing, planning, flexible thinking, judgment, insight) motor skill functioning emotional well-being language

4. What is the value of having a cognitive evaluation? Differentiate normal aging versus pathology Early detection of pathology leading to earliest intervention to optimize quality of life Individualized intervention & treatment planning Onsite consultation & evaluation Level of care recommendations Family support and education Improved treatment compliance Interdisciplinary collaboration

5. When is a cognitive evaluation warranted? Establish baseline cognitive functioning Evaluate changes in mental status Augment interventions/ treatment Inform optimal level of care decisions Clarify diagnosis Assess changes in personality and/or behavior

6. What is the actual process involved in a cognitive evaluation? Record review & staff consultation Contact family or responsible party Interview patient & administration of tests Scoring & interpretation of measures Comprehensive but reader friendly report Feedback session with family/ responsible party/ staff Report faxed to PCP and filed in chart

7. What type of measures are utilized? Estimated IQ scale Immediate and remote memory tests Attention and concentration measures Executive functioning measures Apraxia scales Practical judgment measures Expressive and receptive language tests Visual motor assessment Mood & anxiety scales

8. Financial Considerations Most patients referred for cognitive evaluations can be seen at no out of pocket cost to them. Medicare usually covers the full cost of the evaluation. We also work with managed Medicare as well, and if there is to be any out-of–pocket expense, Harvest will notify the patient/ care-provider would know in advance so an informed decision can be made about proceeding or declining the referral.

9. Consent & MD Orders Harvest assumes responsibility for obtaining informed consent for testing from patient (if self- responsible), or from family, care-provider as appropriate. MD orders for the evaluation are required within skilled nursing facilities, but not for patients in assisted living facilities or for those living independent in the community. However, even when MD orders are not required by regulation, Harvest still attempts to obtain MD orders to assure good collaborative care with primary care physicians.