QAPI Program Utilization_Manual

CRITERIA SATISFACTORY UNSATISFACTORY 14. Was there evidence that agency staff brought the patients a copy of the Bill of Rights in accordance with section 504 of the Civil Rights Acts of 1964? 15. Did progress notes reflect quality and professional management of the patient? 16. Did the agency develop a Plan of Care that was jointly signed by the physician and agency staff? 17. Did Agency staff/nurse adhere to the Plan of Care in providing services to the patient? 18. Was the Patient Care Plan carefully developed, written (identified for functional limitations, problems, solutions, goals, and re-evaluation dates) 19. Did the patient sign an agreement/consent form? 20. Was the Plan of Care reviewed and updated for each certification period.? 21. Upon discharge, was a discharge summary sent to the physician to stipulate plans for continuing care? 22. Was there a discharge letter sent to the patient to advise of agency's termination of services and reasons for such termination, Instructionss? 23. Were there clinical records to reflect team conferences and conferences with the physician and with the patient as well? Final Comment: __________________________________________________________________________ __________________________________________________________________________ Signature: ______________________________ 27