Diagnosis: Hemiparesis
Treatment: Increase in consumer directed personal care assistance from 24 to 42 hours per week

The proposed treatment of an increase in consumer directed personal care assistance from 24 to 42 hours per week is not deemed medically necessary.

The patient is a male with a history of CVA with residual hemiparesis. For these reasons, he requires assistance with performing the majority of his activities of daily living (ADLs). However, his currently approved plan of consumer directed personal care assistance 24 hours/week is sufficient to meet all of the patient's needs and ADLs. Furthermore, there is no medical documentation which demonstrates additional functional decline or worsening medical status to support an increase in hours. For these reasons, the proposed treatment of an Increase in consumer directed personal care assistance from 24 to 42 hours per week to better assist with completion of the patient's ADLs is not deemed medically necessary.