If the patient had ‘No’ Advanced Care Plan indicated on the completed OASIS, the ‘Advanced Directives’ information on the Plan of Care print-preview (PDF) is now displayed as follows:
This patient doesn’t have an advanced care plan or a surrogate decision maker AND is not able to provide legal documentation for the home health medical record.
The view/edit window of the 30/60 Day Summary/Case Conference visit opens correctly.
New Goals in ‘Therapy Need & Plan’
In the OASIS-C2 Start of Care or in the Plan of Care Profile, the skilled nurse is now able to select or add the Therapy Goals for PT, OT, and ST.
When clicking on the PT, OT, or ST Need for Therapy problem statements, new therapy Goals will be displayed (below the Orders). Each of the therapy Goals, if selected, will open a pre-populated and editable text box. Please note that the Additional PT (or OT, ST) Evaluation Goals allows the clinician to select the goals from the agency’s pre-defined templates. Information may also be entered manually in the text box. All information entered for the selected therapy Orders & Goals will flow to the Plan of Care.