Visit Frequencies for each discipline associated to a patient's care are first established by completing the Initial Plan of Care documentation. The visit frequencies can be updated at any point in time for any discipline using the Change and Frequency Order. Visit frequencies are also updated during the IDG period which usually can occur every 15 days to reassess the need of the patient, family, and caregiver or more often as patient condition requires.
§418.56(c)(2) A detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs.
Interpretive Guidelines §418.56(c)(2)
The use of visit ranges in the patient plan of care should follow these parameters:
• The plan of care may include a range of visits and ’provide as needed’ orders for
visit frequencies to ensure the most appropriate level of service is provided to the
patient.
• A range of visits is acceptable as long as it continues to meet the identified needs
of the patient/family.
• Visit ranges with small intervals are acceptable (i.e., 1-3 visits/week; 2-4
visits/week) but ranges that include “0” as a frequency are not allowed.
• The IDG may exceed the number of visits in the range to address patient/family’s
needs. There should be documentation in the record to support the need for the
extra visit(s).
If the patient requires frequent use of PRN visits, the plan of care should be updated to include the need for additional visits.
Standing orders or routine orders must be individualized to address the specific patient’s needs and signed by the patient’s physician.
The IDG should be proactive in developing each patient’s plan of care by planning ahead for anticipated patient changes and needs. Decisions should reflect the patient/family preferences rather than be solely a response to a crisis.
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