Policy Manual sample

MDT Home Health Care Agency, Inc. DISCHARGE PLANNING CONTROL LOG Month: _________________ Year: __________ MR # Patient’s Name (Active) Assessment of Discharge Potential Case Conf. Discuss DC Potential / Plans for continuity of Care POC Update Plan of Care Update Family/Pt discussion of DC planning AFTER DISCHARGE DISCHARGE Nursing Assessment and Care plans POC Referral for follow support Contact with Pt Family after DC Full DC - Transfer Documented MD Informed Pt Instructed Report DON Agency any DC process problem Date Reason (Rehab to Pot, Hospital, etc) Comments:________________________________________________________________________________________________________ Home Health Agency - - Skilled Professional Services C-28