{"ref":"DC-HC-SP-03","title":"Changes in Condition and Needs Beyond Personal Care Services","category":"Service delivery","summary":"Sets out what aides watch for and report about a client's condition and how fast, how a registered nurse responds to each report, and the Agency's written criteria, procedure and time frames for referral, transfer or discharge when a client is found to need services beyond personal care services, as 22-B DCMR §9912.1 requires. It also covers what happens when a client declines a referral.","inShort":["Watch for changes at every visit: falls, pain, confusion, skin sores, not eating, breathing trouble, or readings outside the plan limits.","Emergency: call 911 first, then the on-call person.","Urgent change: call the registered nurse or on-call person before you leave the home, and stay with the client until you get instructions.","Record every change in your visit notes. Routine changes go to the office before the end of your shift.","Never do a skilled task such as wound care, injections or giving medications, even if asked. The nurse arranges a referral."],"primaryCitation":"22-B DCMR §9912.1","citations":["22-B DCMR §9908.2(c)","22-B DCMR §9910.3","22-B DCMR §9910.4","22-B DCMR §9912.1","22-B DCMR §9912.2","22-B DCMR §9912.3","22-B DCMR §9913.4","22-B DCMR §9913.6","22-B DCMR §9914.2(c)","22-B DCMR §9914.2(k)","22-B DCMR §9914.2(p)","22-B DCMR §9916.2(g)","22-B DCMR §9918.4(g)","22-B DCMR §9999.1","D.C. Code §44-501(a)(7)","D.C. Code §7-1903"],"federalCitations":[],"surveyorAsks":["What does an aide do if a client has a new sore on the heel or is more confused than usual?","Show me a change-in-condition report and what the registered nurse did about it."],"forms":[{"ref":"DC-HC-SP-03-A","title":"Change in Condition Report"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (22-B DCMR §9912.1)","5. What Aides Watch For","6. How Fast to Report","7. How the Registered Nurse Responds","8. When a Client Needs Services Beyond Personal Care Services","9. The Agency's Time Frames","10. When the Client Declines a Referral","11. Keeping Everyone Informed","12. Responsibilities","13. Records and Compliance Monitoring","14. Staff Training","15. References","16. Related Policies and Forms","17. Approval","18. 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}}