Long-Term Care

Care plan time frames

LTC Nursing Assistant Trainer, July 29, 2010

A facility has seven days from the date of MDS 2.0 completion to develop a care plan. Since the MDS 2.0 must be done by day 14, you have up to 21 days to complete the plan of care. Most facilities take the entire 21 days for this process. This leaves the resident with no plan of care for three full weeks, during which he or she is unfamiliar with the staff and facility and likely at high risk for injury. Likewise, the staff are probably not familiar with the resident’s problems and needs. Use the nursing process to develop an interim care plan upon admission, readmission, or at the time the significant change in condition is identified. This temporary plan is not comprehensive but should address the most important problems and high-risk conditions. The interim plan may be a nursing plan. It does not have to be interdisciplinary.

Using the full 21-day time frame to develop a comprehensive plan of care gives staff adequate time to identify the resident’s needs. Use the interim plan to guide staff until the MDS is completed and the interdisciplinary care plan developed. Then incorporate the interim plan into the full plan or file it in the medical record. Do not destroy it—it is part of the permanent medical record. The temporary care plan shows that services provided by the facility meet professional standards of quality.

This is an excerpt from the HCPro book, The Long-Term Care Nursing Desk Reference, Second Edition, by Barbara Acello, MS, RN.

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