🔒 Internal staff tool — NOT a public form, NOT an official DHS 1147. A quick estimate to decide: schedule the RN assessment, or refer out.
Score the caller
Pick the closest answer for each. It estimates their DHS 1147 functional points against the 15-point foster-home gate. Updates live as you go.
How is care paid for?
Estimated 1147 points0
Answer the questions aboveThe estimate + recommendation appears here.
Assessment Summary
Selected
Not Selected
This is a rough estimate only, built from the DHS 1147 functional-status sections (III–XIII). It is not an official Level-of-Care determination — only the RN's completed 1147 counts, and the RN can justify borderline points to the insurer. Use this to decide whether the full assessment is worth booking.
Adult Care Finder · internal triage tool · estimate, not a diagnosis