Status: Semantic source register
Source-record contract#
Every source used by a rule or SOP must have a stable source ID, title/version, locator, authority classification, exact relied-on sections, verification date, and any limitation. A public source can support a public requirement; it cannot substitute for a missing executed agreement or resolve a participant-specific operating choice.
Primary GUIDE sources#
| Source ID | Title/version | Relied-on sections | Authority/status | Verified | Review |
|---|---|---|---|---|---|
| SRC-CMS-GUIDE-ONGOING | CMS GUIDE RFA; current PMP v3.0 | RFA Care Team Requirements and Appendix B §§4.1–4.4; PMP §3.1 | Public minimum: individual human navigator, ongoing support purposes, tier cadence and permitted live modalities; SMS does not count. Low-dyad/RCC quarterly/bimonthly touchpoints and real off-contact non-contact service months remain distinct from infrastructure, passive feeds and reminders. No fixed minutes, full checklist, universal clinical encounter or Proxi-specific result/attestation test is established. O-063/O-064/O-065 and the executed Agreement govern unresolved details; paid workforce ownership and contact evidence design are Proxi choices. | 2026-10-04 | |
| SRC-CMS-GUIDE-COORDINATION | CMS GUIDE RFA, targeted coordination interpretation | Care Delivery summary Table 3, PDF pp. 24–25; Appendix B §§5.1–5.5, PDF p. 71 | Public source distinguishes outside-PCP notice/current-and-revised-plan access; conditional specialist route, shall PCP notice, should active co-management consultation, may specialist notice/plan sharing, must returned documentation/plan changes; requested care-team introduction; residence/care-setting transition coordination, medication support and other needed coordination. The summary lists specialist referral as needed while §5.2 says may; final Participant interpretation remains O-020/O-PA-001. The text does not prescribe fixed minutes, automatic new reviews of current professional products, live explanation for every faithful approved delivery, a 48–72-hour clock, or continuous Proxi clinical/PR staffing. Proxi's exact closure, reuse, communication and follow-up design remain separately labeled | 2026-10-03 | |
| SRC-CMS-GUIDE-MEDICATION | CMS GUIDE Request for Applications, targeted Medication minimum | Appendix B §§7.1–7.5 and transition §5.4 | Primary public basis for prescribing-authority review occasions, conditional Participant APN/PA/physician prescribing/deprescribing, separate recommendation sharing/relevant-provider agreement, navigator schedule-support information and transition medication support. It does not establish monthly reconciliation, fixed minutes, a new clinician every time a known provider basis is retrieved, mandatory live counseling for every proposal, Proxi's exact pharmacy/teach-back/monitoring/safety protocol, or a universal order-before-choice rule. Those operating acts, authority/release routes and completion milestones require their actual law/Agreement/approved design; future follow-up does not erase an already attributable professional result | 2026-10-03 | |
| SRC-CMS-GUIDE-CARE-PLAN | CMS GUIDE Request for Applications, targeted Care Plan minimum | Appendix B §§2.1–2.4 and relevant §5 sharing requirements | Primary public CMS basis for assessed-domain and beneficiary-led content, goals/strengths/preferences/needs, providers/payment responsibility, applicable caregiver support, revision, EHR incorporation and sharing. These clauses do not expressly specify a universal RN co-signature, paid navigator confirmation of every clear response, monthly whole-plan review or a case-specific nondelegable human signer. That limited absence does not itself approve AI-only delivery, every digital choice mode or automatic closure; current human-role duties, professional scope, actual Agreement and approved completion/release policy remain controlling | 2026-10-03 | |
| SRC-CMS-GUIDE-24-7-ACCESS | CMS GUIDE Request for Applications, targeted human-access and caregiver-support interpretation | Appendix B §§3.1–3.2, 8.2.4 and 8.3.4 | Primary public CMS anchor: care-team access or human helpline, expressly naming an engaged third party during off-duty hours; every applicable off-duty third-party communication is shared with the care team. Public wording does not clearly establish sole non-care-team third-party on-duty coverage; actual weekday/off-duty acceptance remains O-001/O-PA-001. Proxi's sharing of accepted daytime third-party calls is separately labeled company continuity design; ad hoc caregiver calls are received and substantive support is furnished directly by a care-team member. These clauses do not expressly prescribe continuous Proxi-employed clinical or Puerto Rico staffing. That limited absence does not grant offshore care-team membership, clinical licensure, a particular response deadline, permitted delay, disclosure authority or Participant-specific activation. Those depend on the actual Agreement, approved scope and response policy. Required sharing/release/receipt/acceptance must be operational before launching the selected third-party route. Supports D-026, X-019 and AC-E01..06 | 2026-10-04 | |
| SRC-CMS-GUIDE-ASSESSMENT-HOME | CMS GUIDE RFA, targeted assessment/residence visit; current PMP v3.0 | RFA Appendix B §§1.1.3 and 1.3.1–1.3.3; PMP §§2.1 and 2.10–2.11 | Required moderate/high-tier residence work has an onsite interdisciplinary-care-team visitor; other care-team members may participate remotely. Low-tier in-person visits are not universally required; permitted remote/optional delivery still follows current assessment/PAAF requirements. RFA's two-calendar-month visit expectation and PMP's initial 60-day staging-to-completion/PAAF deadline are distinct clocks. Supports D-028's approved onsite worker plus actual clinical telehealth act, not blanket qualification of a job title/vendor, approval of every remote procedure, free contracted labor or a universal RN plan blessing. Actual Partner, jurisdiction, scope, modality and executed Agreement remain necessary | 2026-10-04 | |
| SRC-CMS-GUIDE-CAREGIVER-TRAINING | CMS GUIDE RFA, caregiver program; current CMS FAQ | Appendix B §§8.1–8.5, especially §§8.2.1/8.3.1–8.3.4; current caregiver/Partner FAQ | Public minimum: responsive four-service menu, nine training topics, caregiver choice, virtual/in-person and individual/group training; care-team member or reimbursed vendor/community provider for skills training; direct care-team one-on-one diagnosis information at entry and support calls; trained facilitator and a distinct free-community support-group route. Does not establish a quiz/score/certificate, clinical co-signature, fixed minutes, mandatory live demonstration, patient compliance or AI-only acceptance. D-019 application, later usefulness and actual paid work remain Proxi design; O-036/O-001/O-PA-001 retain real approval boundaries | 2026-10-04 | |
| SRC-CMS-GUIDE-RFA-V1 | CMS GUIDE Request for Applications | Care Team Requirements and Care Navigator Training at PDF pp. 25-27; Appendix B 1.1-1.3, 2.1-2.4, 3.1-4.4, 5.1-5.5, 6.1-6.4, 7.1-7.5, 8.1-8.5 | Primary public CMS source; supports beneficiary leadership, care-team composition, dementia-proficient clinician, human care navigator, navigator training, home visits, no-caregiver safeguards, minimum contact frequency, care-plan content/sharing, 24/7 human access, clinical consultation, coordination, medication, and caregiver-service obligations. Section 7.1 places prescribing-authority reconciliation at the initial assessment, future assessments, and periodic reviews requested by the care team, beneficiary, or caregiver as appropriate; it does not create a monthly reconciliation requirement. Appendix B 2.1-2.4 requires beneficiary-led care-plan content, revision, EHR incorporation, and sharing, but does not expressly require a generic whole-plan RN co-signature; that absence does not settle any additional executed-agreement, state-law, or Participant-policy requirement. CMS specifies frequencies and qualifications but not contact minutes. It does not establish this project's P0 taxonomy, exact US emergency-routing design, operational retry limits, staffing geography, caseload, or route-specific evidence standards | 2026-07-14 | |
| SRC-CMS-GUIDE-FAQ | CMS GUIDE Frequently Asked Questions, current page, modified September 25, 2026 | Patients and Caregivers Q4 and Q8; Care Delivery Requirements Q12-Q13; Partner Organizations Q14 | Primary current CMS explanatory source; supports current RCC/memory-care eligibility and approved-partnership context beginning July 1, 2026; the required caregiver-service menu; caregiver choice; and virtual delivery. It does not prescribe training minutes, a quiz, a synchronous instructor for every topic, or AI-only completion. Subordinate to controlling law, current model documents, and the executed agreement | 2026-10-03 | |
| SRC-CMS-GUIDE-PMP-3.0 | CMS GUIDE Payment Methodology Paper v3.0, effective June 1, 2026 | §§1.4.1–1.4.3, 2.4–2.14, 3.1; Exhibits 5/6/8/9/10; Appendices D–K | Primary current public methodology. Supports approved practitioner and paid Partner arrangements, current dementia-proficiency bases, documented discussion/consent before assessment, roster-clinician diagnosis attestation, staged PAAF timing/fields, HDR or approved FHIR submission, preliminary versus final alignment, written notices, reassessment/annual deadlines, monthly actual-service/contact rules, claimless unalignment and transfers. §2.12's 60-day RCC trigger is approval absent AND no compliant arrangement, from awareness of an already aligned move; ordinary RCC eligibility needs both prerequisites, and §1.4.2 separately bars unapproved Partner delivery. Mixed combinations, day-60 approval-only gaps and the FAQ/Agreement reconciliation remain O-024/O-PA-001. CMS portal custody is not clinical authorship or proof of a nondelegable human review. No CMS task-minute, caseload or AI-only caregiver-training acceptance is established. | 2026-10-03 | |
| SRC-CMS-GUIDE-REFERRAL-6 | CMS GUIDE RFA Appendix B§6 | §§6.1-6.4; current PMP v3.0§§1.4.2/3.1 | Direct referral/connection and/or written local AAA/TitleVI assistance route; HRSN inventory and actual navigator referral/connection; relevant resource inventory/sharing; eligible AND receiving state Medicaid HCBS contact/attempt coordination, GUIDE information and service review. No guaranteed outside success, universal live call, CMS first-use/usefulness definition, task minutes or Proxi clinical review is prescribed. Actual Partner approval/terms/payment and local service result versus monthly qualification remain separate; executed Agreement still controls exact activation. | 2026-10-04 | |
| SRC-ACL-AAA | ACL Area Agencies on Aging | State designation; planning/service area; local identity and Eldercare Locator | Official source for mapping the actual AAA by service area, not proximity or an aging-brand name. A directory identity does not prove current offering, capacity, individual's eligibility, assistance or connection. | 2026-10-04 | |
| SRC-ACL-OAA-TITLE-VI | ACL Services for Native Americans, OAA TitleVI | Eligible Tribal programmes; community/population-specific supportive and caregiver services | Official programme context and illustrative services; programme allocation/eligibility is not a universal beneficiary criterion, local availability or approved GUIDE Partner arrangement. Do not force a generic nearby aging agency into the TitleVI counterpart. | 2026-10-04 | |
| SRC-CMS-MEDICAID-HCBS | CMS Medicaid HCBS1915(c) | State/waiver-specific programme, service, person-centred planning and case-management variability | Illustrates programme-specific criteria/coverage/service facts. GUIDE§6.2 concerns eligible AND currently receiving HCBS through a state Medicaid programme, not only1915(c), dual eligibility, authorization, claim or directory label. The actual programme determines its own eligibility/authority and case-management responsibility. | 2026-10-04 | |
| SRC-CMS-GUIDE-PMM | CMS GUIDE Performance Measurement Manual v3.0, published May 18, 2026 | §1.5 QPP/MIPS separation; §§2.1–2.2 measure sources and PROMIS-10/ZBI-22 reporting windows; §2.3 claims-based DAE and retired HRRx participant submission; §§2.4–2.5 DFT/PBA results | Primary current public measurement source for the exact named reporting tasks in Manual 18. Survey collection, source correction, accepted reporting and clinical assessment remain separate. DAE concerns high-risk medication fills, not an individual treatment/deprescribing protocol. Retrieving a performance result or clinical data field does not itself require new clinical judgment; selected clinical improvements use the actual clinical authority. Current portal/Guide Connect instructions and the executed Agreement remain necessary for the actual interface and required signers. | 2026-10-03 | |
| SRC-GUIDE-PA-PY2026 | Acquired participant's executed PY2026 Amended and Restated GUIDE Participation Agreement and appendices | All participant-specific terms | Controlling participant document; BLOCKED -- not available yet, confirmed directly by Leon on 2026-10-04. See O-PA-001; public requirements remain labeled working determinations | Contract content not verified; owner-confirmed absence 2026-10-04 |
Interoperability and privacy#
| Source ID | Title/version | Relied-on use | Authority/status | Verified | Review |
|---|---|---|---|---|---|
| SRC-TEFCA-TREATMENT-1.2 | TEFCA Exchange Purpose Implementation: Treatment v1.2 | Exchange-purpose and transport/channel implementation context | Interoperability guidance; does not decide who belongs on a care-plan recipient manifest or what satisfies distribution | 2026-07-11 | |
| SRC-TEFCA-EP-5.0 | TEFCA Exchange Purposes v5.0 | Exchange-purpose definitions | Interoperability guidance; not a substitute for privacy, consent, state-law, or executed-PA review | 2026-07-11 | |
| SRC-HHS-HIPAA-TPO | HHS Uses and Disclosures for Treatment, Payment, and Health Care Operations | Provider-treatment disclosure basis and minimum-necessary distinction | Primary federal guidance, rechecked read-only. Covered-entity provider-treatment disclosure may proceed without individual HIPAA authorization; minimum necessary does not apply to provider-treatment disclosures/requests. This is not blanket permission for Proxi/BA handling, a wrong recipient/purpose, caregiver-owned content or narrower legal/contract/special-data restrictions. A narrower provider-treatment packet is Proxi data minimization or another applicable requirement, not that HIPAA standard | 2026-10-04 | |
| SRC-HHS-HIPAA-MIN-NEC | HHS Minimum Necessary Requirement | Routine protocol versus covered non-routine individual review; neither is inherently clinical | Primary federal guidance, rechecked read-only. Standard protocols may govern qualifying routine/recurring disclosures; non-routine disclosures subject to minimum necessary require individual review under established criteria. HHS does not thereby designate a clinician or expressly a natural-person reviewer; that silence does not approve automation. Treatment exceptions, special data, state law, restrictions, contract/Agreement and accepted class policy still control | 2026-10-04 | |
| SRC-HHS-HIPAA-BA | HHS Business Associates | Actual covered-entity/business-associate/subcontractor relationship and agreement terms | Primary federal guidance, rechecked read-only. Distinguish provider-to-provider treatment exchange from a vendor handling PHI as a business associate. The actual applicable written agreement chain and permitted uses/disclosures must be established; a treatment purpose or Proxi role title does not prove its handling/delegation authority | 2026-10-04 | |
| SRC-HHS-PART2-2024 | HHS 42 CFR Part 2 Final Rule fact sheet | Part 2 issue identification only | Primary federal summary; a fact sheet does not replace case-specific Part 2/privacy analysis | 2026-07-11 | |
| SRC-HHS-TELEHEALTH-LICENSURE | HHS Licensing Across State Lines | Actual clinical-recipient location and available cross-jurisdiction authorization paths | Primary federal explanatory guidance: verify the actual patient/clinical recipient's current location. Apply beneficiary-location authority for beneficiary care; caregiver-location authority for a separate licensed act on the caregiver. Caller/reporter identity is not automatically the clinical subject. U.S. geography alone does not establish professional permission; exact state, scope and applicable provider-location rules remain to be checked | 2026-10-04 | |
| SRC-HHS-TELEBEHAVIORAL-LICENSURE | HHS Licensure for Behavioral Health | Patient- and provider-location requirements for licensed behavioral care | Current federal explanation: the provider must meet applicable rules where located and be licensed or legally permitted where the actual patient is located. A caregiver's own licensed assessment uses that caregiver's location; reporting beneficiary facts does not change the beneficiary's clinical location. Supports explicit subject/act/location separation, not an approved Proxi jurisdiction matrix or a licensed requirement for ordinary nonclinical caregiver coaching | 2026-10-04 | |
| SRC-HHS-OVERSEAS-EPHI | HHS Overseas ePHI FAQ | Offshore ePHI geography and risk-analysis boundary | Primary federal guidance. HIPAA has no separate geographic prohibition, but overseas processing/storage may increase risk and requires appropriate BAA, risk analysis, risk management, and safeguards. This does not approve offshore GUIDE service delivery | 2026-07-12 | |
| SRC-HHS-AUDIO-TELEHEALTH-2026 | HHS OCR Guidance on Audio-Only Telehealth, content reviewed June 23, 2026 | Telephone/VoIP privacy and security analysis; conduit versus business-associate boundary; recordings, transcripts, and translation | Primary federal guidance. A transmission-only provider with only transient PHI access may be a conduit, but an app/vendor that creates, receives, maintains, records, transcribes, or translates PHI is more than a conduit and requires a BAA when used on behalf of a covered entity. It supports vendor/retention/security controls; it does not itself authorize a call, recording, AI participation, offshore processing, GUIDE service, or clinical act | 2026-07-14 | |
| SRC-FCC-AI-VOICE-24-17 | FCC Declaratory Ruling FCC 24-17, released February 8, 2024 | TCPA treatment of outbound AI-generated/artificial voice | Primary federal ruling. AI-generated human voice falls within the TCPA's artificial/prerecorded-voice restrictions; prior express consent is required absent an emergency purpose or exemption. The ruling also identifies initiating-entity disclosure requirements and applicable telemarketing opt-out requirements. It does not establish that a proposed Proxi call fits an exemption, settle all federal/state calling rules, or authorize PHI disclosure | 2026-07-14 | |
| SRC-CA-PEN-632 | California Penal Code section 632 | Example state all-party rule for covered confidential communications and electronic eavesdropping/recording | Primary state statute. Use only as a legal-review trigger; application depends on facts, location, communication type, expectations, exceptions, and current law. It supports the conservative national all-participant-disclosure/permission design but does not itself create a universal national rule | 2026-07-14 | |
| SRC-FL-934-03 | Florida Statutes section 934.03 | Example state all-party prior-consent rule for covered interception | Primary state statute. Use only as a legal-review trigger subject to facts and exceptions. It supports a conservative national operating path; it is not a universal legal conclusion | 2026-07-14 | |
| SRC-WA-RCW-9-73-030 | Washington RCW 9.73.030 | Example state all-participant rule for covered private communications/conversations and announced recording/transmission | Primary state statute. Use only as a legal-review trigger subject to facts and exceptions. It supports disclosed permission before AI transmits/listens/records; it does not settle every call configuration | 2026-07-14 | |
| SRC-ONC-TEFCA-2026 | ONC TEFCA overview and ONC connection overview, updated June 5, 2026 | Nationwide-exchange capability, exchange-purpose assertion, and Participant/Subparticipant connection path | Primary federal program guidance. TEFCA can support treatment, payment, health-care-operations, public-health, government-benefits, and individual-access requests; each request asserts a purpose, and organizations connect through a QHIN or connected network/technology provider after agreement, directory, technical, and compliance onboarding. It is not an unrestricted or automatically complete GUIDE data feed | 2026-07-14 | |
| SRC-CMS-ADT-COP | CMS ADT Patient Event Notification FAQ | Event-time ED/inpatient admission, discharge, and transfer triggers; established or patient-identified responsible recipient routes | Primary CMS implementation guidance. Applicable hospitals may send event notifications directly or through an intermediary to an established PCP/practice, patient-identified responsible practitioner/entity, and other qualifying recipients for treatment, care coordination, or quality improvement, subject to identity and privacy conditions. An ADT event is a trigger and minimal notification, not a discharge record, diagnosis, medication reconciliation, or completed transition | 2026-07-14 |
Beneficiary-authorized payer, claims, and provider-discovery data#
| Source ID | Title/version | Relied-on use | Authority/status | Verified | Review |
|---|---|---|---|---|---|
| SRC-NC-MEDICAID-PCP-ASSIGNMENT | NC Medicaid: Enrollee Report Updates for Primary Care Practices, current page | Official state example of Medicaid PCP assignment data containing provider name, NPI or atypical ID, assigned practice location, enrollment dates, assignment effective date, and active status | Primary state Medicaid operational source. It directly supports the administrative assignment recorded by NC Medicaid at the practice-location level; it does not establish the beneficiary-identified PCP, an actual current treatment relationship, GUIDE-team membership, or national Medicaid availability. Other states and MCOs require source-specific verification | 2026-07-12 | |
| SRC-CMS-PATIENT-ACCESS-API | CMS Patient Access API FAQ, current page | Beneficiary-authorized access through a chosen application to claims, encounters, and clinical data maintained by impacted MA, Medicaid, CHIP, and FFE payers | Primary federal implementation guidance. It supports payer-specific candidate discovery and dated utilization, not a central Medicaid lookup or a universally required beneficiary-to-individual-PCP field. Payer data can corroborate a treating relationship but does not by itself establish the current PCP, GUIDE-team membership, or a clinical endpoint | 2026-07-12 | |
| SRC-CMS-PROVIDER-DIRECTORY-API | CMS Provider Directory API FAQ, current page | Public payer network data including contracted provider name, address, phone, and specialty | Primary federal implementation guidance. Directory data supports provider discovery and routing candidates; it does not establish member assignment, a treatment relationship, GUIDE-team membership, disclosure authority, or that a listed endpoint accepts a GUIDE notice or care plan | 2026-07-12 | |
| SRC-CMS-NPI-FACT-SHEET | CMS NPI Fact Sheet, December 2024 | NPI/NPPES identity normalization for individual and organization healthcare providers | Primary CMS identity source. An NPI is an identifier; CMS states that having one does not ensure licensure or credentialing, guarantee payment, or enroll the provider in a health plan. It also does not establish a beneficiary relationship, PCP assignment, current practice location, GUIDE-team membership, or a usable clinical endpoint | 2026-07-12 | |
| SRC-CMS-BLUE-BUTTON | CMS Blue Button 2.0 API, current page | Beneficiary-authorized Medicare Parts A, B, and D claims data, including dated primary-care treatment and prescription activity | Primary CMS API source. It supports Medicare utilization and provider-candidate discovery; it is not Medicaid data and does not provide an authoritative current-PCP designation, beneficiary preference, GUIDE-team membership, current medication use, or a clinical routing endpoint | 2026-07-12 | |
| SRC-CMS-HETS-13-0 | CMS HETS 270/271 Companion Guide v13.0, July 2025 | Real-time Medicare eligibility inquiry and returned A/B, MA, Part D, MSP, QMB, hospice, hospital/SNF, and selected benefit information | Primary CMS transaction guide. Access requires an authorized trading partner, Medicare-provider relationship/NPI predicates, registration/testing, production approval, and Medicare-business use. Data is refreshed once daily early each Eastern morning and is true/accurate only at transaction time; it is not GUIDE alignment, a current-PCP lookup, a guarantee of payment, or a current clinical record | 2026-07-14 | |
| SRC-CMS-PROVIDER-ACCESS-2027 | CMS Interoperability and Prior Authorization Final Rule fact sheet | 2027 payer Provider Access API and expanded Patient Access API design horizon | Primary CMS final-rule summary. Beginning with applicable 2027 compliance dates, impacted payers must support specified APIs; Provider Access is for in-network/enrolled providers with a treatment relationship and patient opt-out, and includes claims/encounters, USCDI data, and certain non-drug prior-authorization information. It does not establish current Proxi entitlement, universal payer participation, or drug-PA access | 2026-07-14 |
Workforce geography and professional authority#
| Source ID | Title/version | Relied-on use | Authority/status | Verified | Review |
|---|---|---|---|---|---|
| SRC-NLC-CURRENT-MAP | Nurse Licensure Compact Current Map | Current participating-jurisdiction check | Official NLC source. Puerto Rico is not listed as an NLC jurisdiction; absence does not replace a current board verification for a specific nurse | 2026-07-12 | |
| SRC-PR-NURSING-BOARD | Puerto Rico Board of Nurse Examiners | Puerto Rico nursing regulation and licensing authority | Primary Puerto Rico government source | 2026-07-12 | |
| SRC-PR-TELEHEALTH | Puerto Rico Telemedicine and Telesalud Practice and Certification | Puerto Rico health-professional telehealth authority and certification | Primary Puerto Rico government source. It governs practice in Puerto Rico and does not create nationwide professional authority | 2026-07-12 | |
| SRC-USA-TERRITORIES | USAGov: Visiting U.S. territories | Puerto Rico's status as a U.S. territory | Official U.S. government explanatory source; territory status does not itself establish professional authority outside Puerto Rico | 2026-07-12 | |
| SRC-HIPAA-STATE-DEFINITION | 45 CFR 160.103 definition of State | HIPAA definition that includes the Commonwealth of Puerto Rico | Primary regulatory text for HIPAA terminology only; it does not collapse distinct professional-licensing jurisdictions | 2026-07-12 | |
| SRC-ALZ-DCN-TRAINING | Alzheimer’s Association Dementia Care Navigation Training | Official program title, audience, curriculum, GUIDE-training claim, price, credential wording, and two-year certification term | Primary issuer source. The official credential is essentiALZ® certification for dementia care navigation. It recognizes dementia-navigation knowledge but does not create professional licensure, clinical authority, or Medicare billing eligibility | 2026-07-12 | |
| SRC-ALZ-DCN-OBJECTIVES | Alzheimer’s Association Dementia Care Navigation Training Learning Objectives | Person-centered care, navigation, ADLs, behavior/communication, safety, abuse/neglect, planning, caregiver well-being, assessment/care planning, transitions/coordination, and cultural-competency curriculum | Primary issuer curriculum source. Training scope supports broad nonclinical navigation but does not establish authorization for diagnosis, treatment, prescribing, nursing, social work, medication reconciliation, or other licensed acts | 2026-07-12 |
Clinical operating design guidance#
| Source ID | Source | Intended use and limitation | Verified | Review |
|---|---|---|---|---|
| SRC-AHRQ-RED-2025 | AHRQ Re-Engineered Discharge overview, delivery guidance, and postdischarge follow-up Tool 5, Tool 5 last reviewed March 2025 | Patient-safety design support for transition packets, medication and appointment review, pending results, equipment/home services, problem-contact plans, accessible instruction, teach-back, and proposed 48-to-72-hour recovery contact. Hospital discharge guidance, not a GUIDE mandate, universal clinical protocol, or substitute for the discharging/treating clinician | 2026-07-12 | |
| SRC-AHRQ-IDEAL | AHRQ IDEAL Discharge Planning, content last reviewed December 2017 | Patient/family-engagement design support for discussing home life, medications, warning signs, test results, follow-up appointments, plain-language education, teach-back, and beneficiary/family goals. Not a GUIDE requirement or current prescribing standard | 2026-07-12 | |
| SRC-AHRQ-TEACH-BACK-3E | AHRQ Health Literacy Universal Precautions Toolkit, 3rd Edition, Tool 5, current public version | Design support for non-shaming teach-back/plan-back and show-me checks, correction, and repeat explanation | Primary federal patient-safety/health-literacy guidance. Teach-back checks whether the educator explained clearly; it is not a quiz or memory test. It supports Proxi's focused caregiver application touchpoint but is not a CMS GUIDE completion mandate and does not establish clinical authority |
Ambulatory clinic procedure-design references#
These sources shape procedure language and closed-loop operating design. They do not create GUIDE requirements, settle Proxi workforce authority, or replace the controlling source order in README.md.
| Source ID | Source | Adopted drafting or operating pattern | Limitation | Verified | Review |
|---|---|---|---|---|---|
| SRC-AHRQ-AMB-LAB | AHRQ Improving Your Laboratory Testing Process, step-by-step ambulatory toolkit; last reviewed January 2018 | Map the office process from order through result notification and follow-up; pair each real performer with an observable action; assess, improve, implement, and reassess. The revised toolkit was pilot-tested in a small internal-medicine practice and a family-medicine residency practice | Ambulatory quality-improvement design, not a current clinical protocol, GUIDE rule, or delegation authority | 2026-07-14 | |
| SRC-AHRQ-HL-UPT6 | AHRQ Follow Up with Patients: Tool 6, last reviewed February 2024 | State the reason for follow-up, assign the responsible staff by purpose, honor contact preference, schedule and track the work, and record what the contact achieved | Primary-care health-literacy guidance; its example staff assignments and clinical thresholds are not automatically Proxi policy | 2026-07-14 | |
| SRC-AHRQ-HL-UPT21 | AHRQ Make Referrals Easy: Tool 21, last reviewed April 2024 | Explain why the referral matters; ask whether scheduling help is wanted; address barriers; provide written instructions; confirm understanding; track completion; obtain the returned result; follow up when incomplete | Primary-care referral guidance, not a GUIDE completion rule or blanket authorization to disclose information | 2026-07-14 | |
| SRC-CDC-OUTPATIENT-CHECKLIST | CDC Infection Prevention Checklist for Outpatient Settings, version 2.3 | Tailor procedures to services actually performed; identify not-applicable work; use observable assessment items; require job-specific competency; record gaps and corrective action | Infection-prevention checklist, not a GUIDE clinical protocol. The document version is older, so current underlying clinical guidance must be verified before clinical use | 2026-07-14 | |
| SRC-ONC-SAFER-2025 | ASTP/ONC 2025 SAFER Guides | Prioritize common high-risk failures; name individual and organizational responsibilities; separate clinical communication, test-result follow-up, patient identification, contingency, and system-management controls; use self-assessment for improvement | Recommended health-IT safety practices, not law or automatic conformance evidence | 2026-07-14 | |
| SRC-HRSA-QIQA-CH10 | HRSA Health Center Program Compliance Manual, Chapter 10: Quality Improvement/Assurance | Separate authority, requirements, demonstrating compliance, and related considerations; designate responsibility; implement operating procedures; monitor outcomes; update procedures when change is required | Applies to HRSA Health Center Program compliance, not GUIDE. Proxi adopts the document-structure pattern only unless another source independently controls the substance | 2026-07-14 |
Medication and claims infrastructure#
| Source ID | Source | Intended use and limitation | Review |
|---|---|---|---|
| SRC-SURESCRIPTS-MHA | Surescripts Medication History for Ambulatory | Product capability/procurement evidence, not clinical ground truth or authority | |
| SRC-SURESCRIPTS-MHP | Surescripts Medication History for Populations | Product capability/procurement evidence, subject to O-007 | |
| SRC-CMS-EPCS | CMS Electronic Prescribing for Controlled Substances Program | EPCS program context only; cite exact rule when relied on | |
| SRC-CMS-EPRESCRIBING-STANDARDS | CMS E-Prescribing Standards and Requirements, current page | Relied-on use: NCPDP SCRIPT, formulary/benefit, real-time prescription benefit, medication-history, and ePA transaction context. Primary CMS standards summary; it does not prove network or product access, dispensing, possession, actual use, reconciliation, prescribing-clinician agreement, or clinical appropriateness. Verified 2026-07-14. | |
| SRC-AHRQ-MATCH-2022 | AHRQ MATCH Toolkit, Chapter 3 process design, and Chapter 7 high-risk situations, chapters last reviewed July 2022 | Patient-safety design support for a shared intended medication list, defined multidisciplinary roles, source verification, medication-by-medication comparison, prescriber discrepancy resolution, patient/caregiver participation, transition reconciliation, clear communication, and teach-back for cognitive or health-literacy risk. Not a GUIDE mandate, current drug-specific clinical rule set, participant-specific policy, or substitute for prescribing authority | |
| SRC-HL7-FHIR-MED-R5 | HL7 FHIR MedicationRequest boundaries and related medication resources, FHIR R5 | Interoperability-semantic distinction among medication request/order, dispense/supply, administration, and reported medication statement. Does not prove clinical truth, authority, ingestion, or select the eventual US implementation profile/version | |
| SRC-NLM-RXNORM | NLM RxNorm Overview | Normalized drug names and identifiers across terminologies. Does not establish therapeutic equivalence, interaction, appropriateness, regimen status, or complete coverage of supplements/natural products; ambiguous/out-of-scope content remains unresolved | |
| SRC-FDA-AEMS-2026 | FDA Adverse Event Monitoring System data limitations, current as of March 11, 2026 | Supports the boundary that a report or temporal association does not establish product causation and may be duplicate, incomplete, or unverified. Does not define ProxI urgency, diagnosis, treatment, or reporting policy |
Enhanced service-design evidence#
These support bounded design ingredients, not proof of Proxi AI efficacy, a CMS requirement, a U.S. license/scope decision or an activated service promise. Direct-access limits below are preserved; indexed publisher text is not represented as a full current-page verification.
| ID | Primary source and relied-on use | Limit and verification | Review |
|---|---|---|---|
| SRC-ENH-NICE-NG97 | NICE dementia recommendations, §§1.4,1.7,1.8,1.10-1.12: activity/rehabilitation, distress cause assessment, pain observation alongside clinical assessment, sensory care, eating/drinking, caregiver support and transitions | UK clinical design evidence, not GUIDE or U.S. law. Retain offer/consider strength and mild-to-moderate populations for the cited structured cognitive/rehabilitation interventions. Indexed official text inspected2026-10-04; direct page/PDF returned403. No universal intervention, diagnostic tool or U.S. legal authority inferred. | |
| SRC-ENH-NICE-CG76 | NICE medicines adherence, §§1.1-1.3: accessible shared decisions, nonjudgmental reported use, targeted practical support and agreed review | Professional-facing UK design evidence; no single support works for every patient. Not authority for AI medication advice, missed-dose instructions, packaging compatibility or U.S. professional scope. Indexed official text inspected2026-10-04; direct page returned403. | |
| SRC-ENH-WHO-ISUPPORT | WHO iSupport,2019 manual overview: optional self-help lessons/examples/exercises for caregivers | Supports selectable practical education, not efficacy or acceptance of Proxi AI, clinical counseling or AI-only furnished GUIDE training/support. Page directly read2026-10-04;273-page manual was not fully reviewed. | |
| SRC-ENH-CDC-STEADI | CDC clinical resources and STEADI-Rx: screening, domain-specific assessment/intervention and pharmacist-to-provider response | Older-adult provider framework, not dementia-specific protocol or authority for AI/navigator risk interpretation. Page directly read2026-10-04; actual instruments/population/training/modality require their own approved use. | |
| SRC-ENH-NIA-WANDERING | NIA Wandering and Getting Lost: identification, current photo, contacts and practical preparedness | Caregiver education, not GPS/representative authority, restraint/fire-code, public-safety command or clinical disposition law. Official indexed text inspected2026-10-04; old URL returned405 and current direct page required robot verification. No automated emergency disclosure approval inferred. | |
| SRC-ENH-ASHA-DYSPHAGIA | ASHA Adult Dysphagia and diet-texture guidance: SLP assessment, individualized swallowing recommendations and multidisciplinary coordination | Professional design evidence, not a Proxi texture/fluid algorithm or individual clinical order. Official indexed text inspected2026-10-04; direct portal returned403. Actual state scope, adequacy of assessment and each professional's authored component remain required. | |
| SRC-ENH-US-PLANNING | Medicare voluntary advance care planning and National POLST state-form guidance: voluntary discussion, legal directive versus medical order, state-specific form/authority | Medicare page directly read and official POLST indexed text inspected2026-10-04. Not a state execution/capacity/signature rule, GUIDE qualification decision or authorization for duplicate/separate billing. Current actual state sources and permitted signer must be checked before execution; naming a supporter does not appoint an agent. |
AHRQ RED Tool5 (SRC-AHRQ-RED-2025) and MATCH (SRC-AHRQ-MATCH-2022) were directly rechecked2026-10-04. RED describes a clinical-staff recovery call; the Proxi L2 nonclinical conversation plus separate exact U.S. clinical acts is a Proxi adaptation, not proof of RED fidelity. MATCH supports the process, not a prescriber-only rule for every sub-act; CMS/jurisdiction/organization authority remains O-028.
Service-offer evidence#
| ID | Primary source and relied-on use | Limit and verification | Review |
|---|---|---|---|
| SRC-CMS-GUIDE-OFFER-COST-SHARING | Current CMS GUIDE FAQ, Payment Q11 and caregiver/Partner sections; page last modified September25,2026 | Aligned patients may not be charged any amount for GUIDE services; naming covered work an enhancement supplies no payment authority. Caregiver menu/choice and Participant-paid Partner services do not establish Proxi's optional offer, clinical/field capacity or a separate patient price. Main directly checked2026-10-04; independent outside non-GUIDE care retains actual lawful benefit/payer terms, not automatic free care or duplicate billing. |
Offer recommendations use WHO iSupport selectable lesson/exercise design, NICE preference-tailored activities, NIA identification/current-photo preparedness and AHRQ actual clinical-staff recovery structure. These are bounded service-design ingredients, not Proxi/AI efficacy or a new clinical protocol. Main reread WHO/CMS/AHRQ directly2026-10-04; NICE/NIA official indexed text checked with the prior direct-access limits retained. No full WHO manual, universal population fit, clinician replacement, rescue guarantee, ROI or licensed scope is inferred.
Workload and paid-capacity evidence#
| ID | Primary source and relied-on use | Limit and verification | Review |
|---|---|---|---|
| SRC-CMS-GUIDE-WORKLOAD | CMS RFA, care-team/training requirements PDF pp.25–27; PMP v3.0, alignment start §2.3, annual timing §2.11 and monthly contact §3.1 | Public facts: initial staging date defines successful alignment start; annual assessment/submission uses306–425 days and the earlier60-days-from-annual-start/day425 deadline; tier contacts are calendar-window duties, not time units; initial navigator training includes at least20 hours split10 didactic/10 live experiential plus comprehension assessment and2 annual hours; a nonphysician dementia-proficient clinician needs additional part-time physician medical-director oversight. Rechecked2026-10-04. No contact minutes, role split, event incidence, FTE/load, turnover or wage is prescribed here. Executed Agreement/actual provider/Partner acceptance remains separate. |
Manual22's reach/frequency, role-minute,70% utilization, replacement and fixed-program inputs are explicit Proxi planning assumptions, not statistics derived from CMS. D-029's$22 scheduled-paid-hour basis is Leon's business input. Other rates/fee units, actual capacity and contract scope remain unverified; no complete quote is claimed.
Controlling-document warning#
The source-of-truth order in README.md applies. The acquired participant's executed Participation Agreement and appendices control where they differ from generalized public material. Any rule dependent on nonpublic or participant-specific terms remains PROVISIONAL or BLOCKED until SRC-GUIDE-PA-PY2026 is obtained, verified, and linked to a recorded decision.
The whole-goal requirements map in Manual17 was rechecked on 2026-10-04 against current RFA Appendix B §§1–9 and Care Team/Training, PMP v3.0 §3.1, PMM v3.0 Appendix B and the current FAQ. PMM's care-delivery/performance material is supportive, not an exhaustive or formal protocol; it expressly directs Participants to contractual Appendix D, including RCC differences. Public human service, clinical acts, standing availability, actual furnishing and payment remain distinct. Respite's exclusion from Proxi fulfillment does not remove the Participant's applicable §9 obligation. The map does not assert a state-specific license, accepted offshore/Partner route, AI-only service, actual provider capacity or final Agreement compliance. An unreadable external trial outcome was not used to support Proxi efficacy or the revised map.