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Plan of Care: Content, Patient Participation, and Practitioner Approval

Requires a written, individualized plan of care for every patient, developed with the patient, containing every item in 22-B DCMR §3914.3 (and, if the Agency is Medicare-certified, 42 CFR §484.60(a)(2)), approved and signed by the physician or other practitioner DC Health allows within 30 days of the start of care, followed by all staff, reviewed and revised as the patient’s condition requires, and explained to the patient in written care instructions.

Preview: full text with a package
About this policy
Policy number
DC-HH-CP-01
Version
1.0
Main rule
22-B DCMR §3914
Library
Washington, DC home health · 58 policies
Category
Service delivery
Sections
18

In short

  • Every patient has a written plan of care made with the patient. Give only the care in the plan, and only as ordered.
  • The physician (or another practitioner DC Health allows) must sign the plan within 30 days of the start of care.
  • Telephone orders are written down right away and sent for signature.
  • Give the patient written instructions: visit schedule, medicines, treatments, who to call, and what to do in an emergency.
  • If you cannot do part of the plan, write down why and tell the nurse the same day.

What's inside

18 sections. The full text comes with the One-time Policy Pack.

Full text with a package
  • Terms of Reference
  • 1. Purpose
  • 2. Scope
  • 3. Definitions
  • 4. Policy Statement (22-B DCMR §3914)
  • 5. Developing the Plan with the Patient
  • 6. Content of the Plan of Care
  • 7. Approval and Signature
  • 8. Following the Plan of Care
  • 9. Reviewing and Revising the Plan
  • 10. Written Care Instructions for the Patient
  • 11. Responsibilities
  • 12. Records and Compliance Monitoring
  • 13. Staff Training
  • 14. References
  • 15. Related Policies and Forms
  • 16. Approval
  • 17. Revision History

An inspector may ask

  • Show me this patient’s plan of care. Who took part in developing it?
  • When did care start, and when did the physician sign the plan of care? Was it within 30 days?

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