Documents that are available in the Select a Document drop-down menu coincide with the document list that has been setup in the Document Exclusion Editor.
Click a link below to view the clinical documents available:
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Documents that are available in the Select a Document drop-down menu coincide with the document list that has been setup in the Document Exclusion Editor. |
o Braden Scale
o Care Plan - PGI
o Comprehensive Discharge-Death at Home (C-2+)
o Comprehensive Transfer (C-2+)
o Face to Face Physician Encounter (C-2+)
o Missed Visit Note
o Discharge Summary Homecare
o 30 Day Summary
o 60 Day Summary
o Fall Risk Screening (Multi-Factor)
o Homecare Certification (485)
o Homecare Recertification (485)
o PRN Progress Note
o Telephone Progress Note
o HHRG Worksheet C-2.00
o Client Admission Summary - Coding Services
o Case Communication
o Custom Agency Documents
o Wound Addendum
o Patient Summary
o SN Comprehensive Discharge (C-2+)
o SN Comprehensive Discharge (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o SN Comprehensive Follow-up (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o SN Comprehensive Follow-up/Recertification (C-2+)
o SN Comprehensive Recertification (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o SN Comprehensive Resumption of Care (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o SN Comprehensive Start of Care (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o SN Comprehensive Start of Care/Resumption of Care (C-2+)
o SN Evaluation/Re-Evaluation (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o SN Routine Visit (Care Planning)
o SN Visit Note (NON-Care Planning Note)
o Skilled Nursing Visit Note
o SN Clinical Progress Note (B)
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SN Clinical Progress Note (B) is only available if turned on in System Control. |
o SN Clinical Evaluation (C-2.00)
o SN Daily Progress Note (C-2.00)
o SN Routine Cardiac Visit Note
o SN Routine Diabetes Visit Note
o SN Routine Cardiac Surgery Visit Note
o SN Routine Heart Failure Visit Note
o SN Routine IV Visit Note
o SN Routine Neurological Visit Note
o SN Routine Respiratory Visit Note
o SN Routine Symptom Management Visit Note
o SN Routine Urinary Visit Note
o SN Routine Visit Note
o SN Routine Wound Visit Note
o PT Comprehensive Discharge (C-2+)
o PT Comprehensive Discharge (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o PT Comprehensive Follow-up (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o PT Comprehensive Follow-up Recertification (C-2+)
o PT Comprehensive Recertification (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o PT Comprehensive Resumption of Care (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o PT Comprehensive Start of Care (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o PT Comprehensive Start of Care/Resumption of Care (C-2+)
o PT Evaluation/Re-Evaluation (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o PT Routine Visit (Care Planning)
o PT Visit Note (NON-Care Planning Note)
o PT Start of Care/Resumption of Care (C-2.00)
o PT Follow-up/Recertification (C-2.00)
o PT Discharge (C-2.00)
o PT Discharge-Death at Home (C-2.00)
o PT Transfer (C-2.00)
o PT Daily Visit Note
o PT Evaluation
o PT Daily Progress Note (C-2.00)
o PT Routine Rehab Neurological Visit Note
o PT Routine Total Joint Program Visit Note
o PT Routine Visit Note
o OT Comprehensive Discharge (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o OT Comprehensive Follow-Up (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o OT Comprehensive Recertification (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o OT Comprehensive Resumption of Care (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o OT Evaluation/Re-Evaluation (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o OT Routine Visit (Care Planning)
o OT Visit Note (NON-Care Planning Note)
o OT Daily Progress Note (C-2.00)
o OT Evaluation
o OT Routine Total Joint Program Visit Note
o OT Routine Visit Note
o ST Comprehensive Discharge (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o ST Comprehensive Follow-up (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o ST Comprehensive Recertification (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o ST Comprehensive Resumption of Care (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o ST Comprehensive Start of Care (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o ST Evaluation/Re-Evaluation (C2 Updates with more comprehensive questions that are compatible with Care Planning)
o ST Routine Visit (Care Planning)
o ST Daily Progress Note (C-2.00)
o ST Evaluation
o ST Routine Visit Note
o MSW Daily Progress Note (C-2.00)
o MSW Assessment
o MSW Routine Visit Note
o HHA Daily Progress Note (C-2.00)
o HHA Care Plan
o HHA Visit Note
o HHA Care Plan B
● Documents with OASIS Questions Only
o OASIS Only Discharge (OASIS-D)
o OASIS Only Discharge - Death at Home (OASIS-D)
o OASIS Only Follow-up/Recertification (OASIS-D)
o OASIS Only Start of Care/Resumption of Care (OASIS-D)
o OASIS Only Transfer (OASIS-D)
o SN
§ Pediatric SN Routine Visit Note
§ Pediatric SN SOC/Recert
§ Pediatric SN SUP Visit NB
o PT
§ Pediatric PT Eval
§ Pediatric PT Re-Eval
§ Pediatric PT Follow-up/Recertification
§ Pediatric PT Visit
§ Pediatric PTA Visit
o OT
§ Pediatric OT Eval
§ Pediatric OT Re-Eval
§ Pediatric OT Follow-up/Recertification
§ Pediatric OT Visit
§ Pediatric OTA Visit
o ST
§ Pediatric ST Eval
§ Pediatric ST Re-Eval
§ Pediatric ST Follow-up/Recertification
§ Pediatric ST Visit
§ Pediatric STA Visit
● Enhanced OASIS Documents — As part of the Care Planning feature, enhanced versions of several OASIS documents are available (if they have been included in the Document Exclusion Editor).
Listed below are all of the enhanced OASIS documents that are available for use and if they are compatible with care planning features (if enabled for the agency):
o Patient Summary
o SN Comprehensive Discharge
o SN Comprehensive Discharge (Compatible with Care Planning)
o SN Comprehensive Follow-up (Compatible with Care Planning)
o SN Comprehensive Follow-up/Recertification
o SN Comprehensive Recertification (Compatible with Care Planning)
o SN Comprehensive Resumption of Care (Compatible with Care Planning)
o SN Comprehensive Start of Care (Compatible with Care Planning)
o SN Comprehensive Start of Care/Resumption of Care
o SN Evaluation/Re-Evaluation (Compatible with Care Planning)
o SN Routine Visit (Compatible with Care Planning)
o SN Visit Note (NON-Care Planning Note)
o PT Comprehensive Discharge
o PT Comprehensive Discharge (Compatible with Care Planning)
o PT Comprehensive Follow-up (Compatible with Care Planning)
o PT Comprehensive Follow-up Recertification
o PT Comprehensive Recertification (Compatible with Care Planning)
o PT Comprehensive Resumption of Care (Compatible with Care Planning)
o PT Comprehensive Start of Care (Compatible with Care Planning)
o PT Comprehensive Start of Care/Resumption of Care
o PT Evaluation/Re-Evaluation (Compatible with Care Planning)
o PT Routine Visit (Compatible with Care Planning)
o PT Visit Note (NON-Care Planning Note)
o OT Comprehensive Discharge (Compatible with Care Planning)
o OT Comprehensive Follow-Up (Compatible with Care Planning)
o OT Comprehensive Recertification (Compatible with Care Planning)
o OT Comprehensive Resumption of Care (Compatible with Care Planning)
o OT Evaluation/Re-Evaluation (Compatible with Care Planning)
o OT Routine Visit (Compatible with Care Planning)
o OT Visit Note (NON-Care Planning Note)
o ST Comprehensive Discharge (Compatible with Care Planning)
o ST Comprehensive Follow-up (Compatible with Care Planning)
o ST Comprehensive Recertification (Compatible with Care Planning)
o ST Comprehensive Resumption of Care (Compatible with Care Planning)
o ST Comprehensive Start of Care (Compatible with Care Planning)
o ST Evaluation/Re-Evaluation (Compatible with Care Planning)
o ST Routine Visit (Compatible with Care Planning)
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All applicable OASIS documents have been updated to utilize the latest OASIS-D version. To view more specific details about these changes, please refer to the 18.9 release guide. The software will automatically use the new OASIS-D version for any applicable document (instead of the previous C-2.21 version) for any documents with a M0090 date of 1/1/2019 or after. The M0090 date should be the date the user completed entering information in the document. |