The Centers for Medicare & Medicaid Services recently posted a FAQ sheet on guidance for wandering and exit-seeking behavior in Medicaid recipients in home and community-based settings (HCBS). The criteria requires HCBS institutions to facilitate the independence and decision-making of beneficiaries. These FAQs include guidance for provider-controlled settings with memory care units. In summary: Person-centered planning: Taking a person-centered approach to services means knowing a patient’s conditions, needs, and history, in order to create strategies that allow them to meet basic needs such as for human contact, without putting them at risk for harm. This can be achieved through: •Discussions with family members about the beneficiary’s daily routines and rituals.•Focusing on the beneficiary’s strengths and interests.•Noting how the beneficiary reacts to certain communication styles.•Identifying and including the beneficiary’s preferred kinds of activities. Person-centered staff training: Education about how to communicate with beneficiaries at risk for wandering and exit-seeking behavior may include: •Identifying common conditions, diseases, and disorders that lead to wandering behavior; how this can change over time; and the potential impact of these conditions on functioning.•Assessing individuals for co-occurring conditions that increase the risk for wandering or exit-seeking.•Strategies for identifying and handling behavioral expressions of need or distress. Person-centered service plans: These are developed with the individual at risk for wandering and exit-seeking behavior and their representatives, and may include: •Identifying the patterns, frequency, and triggers for unsafe wandering or exit-seeking.•Using this baseline information to develop, implement, and measure the person-centered plan.•Periodic assessments to update the person-centered plan as necessary. HCBS settings with memory care units: Once the state ensures controlled-egress compliance, the beneficiary’s choices for safety measures, as well as for opportunities for beneficiary engagement in the community, must be documented in the patient-centered plan, along with how these preferences will be accommodated without imposition on those not at risk for wandering. The safety measures applied may not be used for punishment or staff convenience. CMS offered these tips to inhibit wandering and exit-seeking behavior: •Ensure that staff have adequate training in how to effectively engage with individuals in planned and spontaneous activities, as well as strategies for addressing the underlying needs and preferences that may motivate wandering or exit-seeking.•Support individuals to move about freely with staff (e.g., provide a walking companion).•Ensure adequate staffing for activities outside the facility.•Ensure staff regularly escorts individuals to locations and activities outside of the setting as described in the person-centered services plan. •Prevent understimulation by offering activities that engage the beneficiary’s interest, such as art, music, or gardening.•Provide a wellness program to help people exercise, eat more healthy foods, manage stress, improve balance and gait, and stimulate cognition.•Develop meaningful daily activities that minimize passive entertainment, such as TV watching.•Encourage interaction with others.•Ensure that family and friends have unrestricted access to the individual if that is what the beneficiary wants. •Eliminate overstimulation, such as visible doors that people use frequently, excessive noise, and clutter.•Offer places for individuals to sit and rest in large spaces within a setting that allow for safe wandering.•Disguise exit doors using murals or covering door handles as safety codes permit.•Use unobtrusive technological solutions, such as electronic coding lock systems.•Enable people to leave the premises when they are not at risk of doing so unsafely.•Ensure beneficiaries who may wander carry identification with their name and the service provider’s location and contact information.•Create a back-up plan or lost-person plan that describes roles and responsibilities when an individual has exited in an unsafe manner. The transition period for complying with the final rule ends on March 17, 2019. For more information, visit www.medicaid.gov/federal-policy-guidance/downloads/faq121516.pdf. Helen Jones is a NJ-based freelance writer.