# | Medical supports needed | No support needed | Some support needed | Extensive support needed |
1. | Inhalation or oxygen therapy | 0 | 1 | 2 |
2. | Postural drainage | 0 | 1 | 2 |
3. | Chest PT | 0 | 1 | 2 |
4. | Suctioning | 0 | 1 | 2 |
5. | Oral stimulation or jaw positioning | 0 | 1 | 2 |
6. | Tube feeding (e.g., nasogastric) | 0 | 1 | 2 |
7. | Parenteral feeding (e.g., IV) | 0 | 1 | 2 |
8. | Turning or positioning | 0 | 1 | 2 |
9. | Dressing of open wound(s) | 0 | 1 | 2 |
10. | Protection from infectious diseases due to immune system impairment | 0 | 1 | 2 |
11. | Seizure management | 0 | 1 | 2 |
12. | Dialysis | 0 | 1 | 2 |
13. | Ostomy care | 0 | 1 | 2 |
14. | Lifting and/or transferring | 0 | 1 | 2 |
15. | Therapy services | 0 | 1 | 2 |
16. | Hypertension | 0 | 1 | 2 |
17. | Allergies | 0 | 1 | 2 |
18. | Diabetes | 0 | 1 | 2 |
19. | Other(s) - specify | 0 | 1 | 2 |
Subtotal scores of 1s and 2s: | | |
Add subtotals scores for 1s and 2s for total exceptional medical support needs score: | |
[Statutory Authority: RCW
71A.12.030 and
71A.12.120. WSR 19-02-020, § 388-828-4360, filed 12/21/18, effective 2/1/19. Statutory Authority: RCW
71A.12.030 and Title
71A RCW. WSR 07-10-029, § 388-828-4360, filed 4/23/07, effective 6/1/07.]