Question: Are care plan summaries required with care plan review/revision following Quarterly, Annual, and Significant Change assessments? Is the care plan required to be signed by the resident or representative after each revision/update?
Answer: The care plan summary is only required with the baseline care plan. However, the resident does have the right to see and sign the care plan after significant changes are made to the plan of care.
According to F655 guidance from the advanced copy of Appendix PP of the State Operations Manual:
As the resident remains in the nursing home, additional changes will be made to the comprehensive care plan based on the assessed needs of the resident, however, these subsequent changes will not need to be reflected in the summary of the baseline care plan. Once the comprehensive care plan has been developed and implemented, and a summary of the updates given to the resident, the facility is no longer required to revise/update the written summary of the baseline care plan. Rather, each resident will remain actively engaged in his or her care planning process through the resident's rights to participate in the development of, and be informed in advance of changes to the care plan; see the care plan; and sign the care plan after significant changes. Refer to §483.10(c) for guidance related to Resident Rights and Facility Responsibilities regarding Planning and Implementing Care.
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