> ## Documentation Index
> Fetch the complete documentation index at: https://docs.imaracare.com/llms.txt
> Use this file to discover all available pages before exploring further.

# HHSC assessments

> Conduct Initial and Annual HHSC eligibility assessments for residents using the guided Assessment Engine.

**HHSC Assessments** determine whether a resident meets the legal eligibility criteria for placement in a Type B boarding home under Texas 26 TAC §553.41. Every resident requires an **Initial Assessment** at admission and an **Annual Assessment** each subsequent year.

<Info>
  Only **Managers** and **Administrators** can create assessments. Staff have read-only access to assessment results in the resident profile.
</Info>

***

## Open the Assessment Engine

<Steps>
  <Step title="Open the resident profile">
    Go to **Residents** and click any resident's row to open their profile.
  </Step>

  <Step title="Click the Assessments tab">
    Select the **Assessments** tab in the profile tab bar.
  </Step>

  <Step title="Start a new assessment">
    Click **New Assessment** to launch the Assessment Engine modal.
  </Step>
</Steps>

***

## Assessment Engine — 5 steps

The engine walks you through a structured form. All fields in each step are required before you can advance.

### Step 1 — Basic info

| Field           | Description                                                     |
| --------------- | --------------------------------------------------------------- |
| Assessment type | **Initial** (at admission) or **Annual** (each year thereafter) |
| Assessment date | Date the assessment is being conducted                          |
| Assessor name   | Pre-filled from your profile; editable                          |

### Step 2 — ADL Assessment

Rate the resident's independence across all five Activities of Daily Living required by HHSC:

| ADL                   | Rating options                    |
| --------------------- | --------------------------------- |
| Eating / Feeding      | Independent · Needs Help · Unable |
| Bathing / Hygiene     | Independent · Needs Help · Unable |
| Dressing / Grooming   | Independent · Needs Help · Unable |
| Mobility / Ambulation | Independent · Needs Help · Unable |
| Toileting             | Independent · Needs Help · Unable |

### Step 3 — Medication self-administration

Answer **Yes / No** for each of the six HHSC criteria:

1. Can identify their medications by name
2. Knows the reason / purpose for each medication
3. Can identify each medication by color, shape, or markings
4. Knows the correct dosage for each medication
5. Knows the correct administration time / schedule
6. Can read prescription labels independently

### Step 4 — Results

The engine automatically calculates eligibility based on your answers:

| Result              | Condition                                                                |
| ------------------- | ------------------------------------------------------------------------ |
| **Eligible**        | All 5 ADLs are **Independent** AND all 6 medication criteria are **Yes** |
| **Action Required** | Any ADL is Needs Help or Unable, OR any medication criterion is **No**   |

Care level is also computed automatically:

| Care level             | Criteria                                          |
| ---------------------- | ------------------------------------------------- |
| Independent            | All 5 ADLs independent                            |
| Minimal support        | Exactly 1 ADL rated Needs Help                    |
| Personal care required | 2+ ADLs rated Needs Help, or any ADL rated Unable |

<Warning>
  A **Personal care required** rating or a failed medication self-admin criterion means the resident does not currently meet the HHSC Type B boarding home standard. Document the corrective plan in Step 5.
</Warning>

### Step 5 — Action plan

Only shown when the assessment is flagged. Record the plan to address identified needs:

| Field                     | Purpose                                          |
| ------------------------- | ------------------------------------------------ |
| Outside services provider | Agency or individual providing supplemental care |
| Provider contact          | Phone or email for the outside provider          |
| Services agreed date      | Date the outside services agreement was signed   |
| Findings                  | Free-text summary of assessment findings         |
| Recommendations           | Next steps or referrals                          |

Click **Save Assessment** to complete. Results are saved immediately and appear on the Assessments tab.

***

## Assessments tab

Each completed assessment is shown as a card with:

* Assessment type (Initial / Annual) and date
* **Eligible** or **Action Required** badge
* Care level badge (color-coded)
* Assessor name
* Flagged issues (personal care need detected, medication self-admin criteria not met)
* Outside services provider and contact (if recorded)

***

## Annual reassessment

Upcoming reassessment due dates appear on the [Reassessment schedule](/compliance/reassessment-schedule) page and generate alerts on the compliance dashboard when an assessment is overdue (more than 12 months since the last completed one).

***

## Permissions

| Role          | Capability           |
| ------------- | -------------------- |
| Administrator | Create, view, delete |
| Manager       | Create, view, delete |
| Staff         | View results only    |

Configure access under [Role permissions](/administration/role-permissions).