{"ref":"DC-HC-SP-01","title":"Client Service Plan and 90-Day RN Review","category":"Service delivery","summary":"Sets out how a registered nurse develops each client's written service plan on admission from the initial assessment and in agreement with the client, what the plan must contain under 22-B DCMR §9913.3 (including parameters for vital signs and measurements), how the client receives a copy and the assigned aides are oriented to it, how aides follow it, and how a registered nurse reviews and evaluates it at least every 90 days, and sooner whenever the client's needs change.","inShort":["A registered nurse writes each client's service plan with the client. Follow the current plan at every visit.","Do only the tasks in the plan. If the client or family asks for something else, say you will ask the nurse, and call the office.","Take vital signs only as the plan says, and call the nurse or 911 when a reading is outside the limits the plan gives.","You must be oriented to the plan before your first visit and after every change. If you were not, tell the office before you start.","A registered nurse reviews the plan at least every 90 days, and sooner when the client changes. The client cannot waive this."],"primaryCitation":"22-B DCMR §9913","citations":["22-B DCMR §9907.7(c)","22-B DCMR §9908.2(h)","22-B DCMR §9908.2(j)","22-B DCMR §9910.4","22-B DCMR §9911.1(a)(3)","22-B DCMR §9911.1(i)","22-B DCMR §9913.1","22-B DCMR §9913.2","22-B DCMR §9913.3","22-B DCMR §9913.4","22-B DCMR §9913.5","22-B DCMR §9913.6","22-B DCMR §9914.2(c)","22-B DCMR §9914.2(h)","22-B DCMR §9914.2(i)","22-B DCMR §9914.2(j)","22-B DCMR §9914.2(k)","22-B DCMR §9915.4","22-B DCMR §9916.2(d)","22-B DCMR §9916.2(e)","22-B DCMR §9916.2(g)","22-B DCMR §9916.6","22-B DCMR §9918.2","22-B DCMR §9918.4","22-B DCMR §9919.1(a)","22-B DCMR §9999.1"],"federalCitations":[],"surveyorAsks":["Show me this client's service plan. Who wrote it, when, and how did the client agree to it?","Where does the plan state the parameters for the blood pressure readings the aide takes, and what the aide does with a reading outside them?"],"forms":[{"ref":"DC-HC-SP-01-A","title":"Client Service Plan"},{"ref":"DC-HC-SP-01-B","title":"90-Day RN Service Plan Review"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (22-B DCMR §9913)","5. Developing the Plan on Admission","6. What the Plan Contains","7. Parameters for Vital Signs and Measurements","8. Agreeing the Plan with the Client","9. Orienting Assigned Staff","10. Following the Plan","11. The 90-Day Registered Nurse Review","12. Reviews Sooner Than 90 Days","13. Updating the Plan","14. When a Review Is Due but Cannot Take Place","15. Responsibilities","16. Records and Compliance Monitoring","17. Staff Training","18. References","19. Related Policies and Forms","20. Approval","21. Revision History"],"version":"1.0","sample":false,"pack":"dc-hca","state":"Washington, DC","service":"Home care","guides":[{"path":"/guides/home-care-agency-policies/","h1":"What policies does a home care agency need?"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}