Case Management of Medical Equipment Waivers Before and After DOH Approval


Although medical equipment waivers are being submitted to DOH on a regular basis, many residences are still struggling with meeting the requirements surrounding safety and ongoing case managing of the equipment.

Due to their inherent risk to residents, DOH requires, not only the submission of a full waiver request for each resident who wishes to use a hospital bed, Hi/Lo bed, half rail, trapeze, transfer pole, or enabling device, but also ongoing safety measures and resident evaluation to ensure that the equipment remains appropriate for the resident.

There are several elements required for creating an approvable waiver.  Additionally, there are requirements after waiver submission and approval, such as obtaining a new order and PT/OT/RN evaluation with each new required Medical Evaluation, as well as ongoing case management.   

In this workshop, the presenters will share guidance on preparing and submitting medical equipment waivers and review required supporting documentation, ongoing case management requirements, and the various DOH expectations both before and after submission and approval of the waiver. 

The presenters will also discuss the following topics:

  • What equipment is subject to the waiver process
  • Conditions for use of the medical equipment
  • Required documentation from the Medical Provider
  • Completion of:
  • DOH-4235 ACF Waiver Request - Equivalency Notification
  • DOH-4235a ACF Medical Equipment Waiver Checklist
  • DOH-4235b ACF Medical Equipment Waiver Addendum Form
    • Supporting documentation (PT, OT, RN Evaluation)
    • Common errors and DOH requests for edits and revisions
    • Initial and ongoing case management
    • Documentation requirements after waiver submission/approval
    • Renewal of the DOH-4235b ACF Medical Equipment Waiver Addendum

Re-evaluation of the use of medical equipment

Cost:  $30 Members, $60 Non-Members

Upon completion of the registration form and payment in full, you will receive an email with the link to the recorded video and the supporting materials within 1 business day of purchase.

If you do not receive your email, please be sure to double check your spam/junk folder.

Please be sure to mark ESAAL as a "safe sender" and have us whitelisted.  You may need to contact your IT department.

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Meet the presenters:

Headshot photo of Kathy Sindoni

Kathy A. Sindoni, RN, BSN, CLNC has been a registered nurse for 20+ years and has been professionally engaged in the assisted living network since 2001. She is the owner and chief consultant of Substantial Compliance Consulting Group, which provides professional assisted living service consultation and serves residences in various regions throughout New York State. As a consultant, Kathy provides assistance with regulatory compliance, DOH surveillance, quality assurance, team building, and many other such services. She is also a Certified Legal Nurse Consultant providing assistance to operators and/or attorneys on the medical or operational aspects of their cases. Kathy previously served as the Administrator and Case Manager of Bridges Cornell Heights, in Ithaca, New York from 2005-2013. Bridges became the first licensed EALR in NYS in April 2008. Additionally, Kathy serves on ESAAL’s Assisted Living Services Committee which acts as an advisory panel to the organization's Board of Directors. She has also served on the Department of Health EALR workgroup.


Jayne Perry, RN has been a registered nurse for 30+ years and has served in a professional leadership and management role for several years.  Jayne previously served as the Administrator in a 120-bed residence licensed as an Adult Home/Assisted Living Facility with an Assisted Living Program (ALP) and Enhanced Assisted Living Residence (EALR) program.  Jayne was also responsible for oversight of the Licensed Home Care Service Agency (LHCSA) that served the ALP population. While in this role, Jayne worked closely with RFR Consulting Group and Substantial Compliance Consulting Group to provide staff education and guidance regarding the NYSDOH rules and regulations for the Adult Home/Assisted Living Facility.   This included the creation of policies, forms, and systems specific to the various resident populations within the residence. Additionally, Jayne has experience in completing UAS-NY assessments and is NYS certified to perform PRI/Screen Assessments in the community and for Assisted Living residents.

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Please contact Cara Groff, CMP, Event Coordinator with questions: [email protected]