Our new Plan of Care system, scheduled for release January 2018, supports agencies with managing orders within AgencyCore.  The new Plan of Care system provides the ability to easily track all orders, including changes.  The ability to update the Plan of Care is a requirement of the new Medicare Conditions of Participation.  [CoP-484.60; CoP-484.50(c)4-5]

 

• Features ability to document certifying physician versus physician providing care plan oversight when the responsible physician is different than the ordering physician [CoP-484.50(d) (3); CoP-484.50(d)(5)(i)]
• Access to the medication profile to ensure all medication orders are documented [CoP-484.60 (a)(x)]
• Continues ability to code diagnosis inside the OASIS/NonOASIS document [CoP-484.60 (a)(2)(i)]

 

 

• Supplies documented within the supply worksheet flows to the plan of care [CoP-484.60 (a)(2)(iii)]
• All other pertinent elements represented [CoP-484.60 (a)(2)(v), (vii)- (viii), (ix)]

 

• Advanced Directive information flows to the plan of care
• Caregiver status readily identifiable on the plan of care
• New Section – Psycho-social Status flows from the Assessments [CoP-484.60 (a)(2)(ii)]

 

• Orders flow from the Assessments [CoP-484.60 (a)(2)(iii), (iv),(xiii), (xiv)]
• New: Interventions for high risk hospitalization flow from Assessment [CoP-484.60 (a)(Xii)]
• New: Ability to add/edit POC orders via the POC Orders Profile to maintain current orders
• New: All discipline evals pulled into plan of care (PT,OT,ST,MSW), January -February release

 

• Ability to add Admission Narrative as the F2F addendum on the Plan of Care if desired [CoP-484.60(a)(1)]
• Physician Certification Statements flow from Assessments into the Plan of Care and editable as required
• Ability to add Other Physicians on the case and document communication where indicated

 

POC Orders Profile

 

 

POC Orders profile is a current listing of all active orders for each discipline and encourages timely initiation of care and coordination of services.

• Snapshot of problem statements and corresponding orders
• All Plan of Care orders are added or resolved from this view
• Accessible from Plan of Care within 5-day window, Physician Orders and subsequent OASIS/Non OASIS Assessments
• Integral part of Orders Management System

 

POC Summary (Evolving Plan of Care)

 

The Plan of Care Summary (POC Summary) keeps track of all orders entered via the Plan of Care or Physician Orders.

• Accessible from clinician notes
• Accessible from Patient Chart (Quick Reports)
• Ability to view current and discontinued orders at a glance

• Printable and available for distribution to the patient