SECTION 450:65-3-8. Continuing care plan  


Latest version.
  • (a)   In discharge planning, the facility shall assist the consumer to obtain services that are needed but not available within the facility and/or in transitioning from one program to another. A written plan of recommendations and specific referrals for implementation of continuing care services shall be prepared for each consumer. Continuing care plans shall be developed with the knowledge and cooperation of the consumer. The continuing care plan may be included in the discharge summary. The consumer's response to the continuing care plan shall be noted in the plan, or a note shall be made that the consumer was not available and why. In the event of the death of a consumer, a summary statement including this information shall be documented in the record.
    (b)   Compliance with 450:65-3-8 may be determined by a review of the following:
    (1)   Policy and procedures;
    (2)   Continuing care plans;
    (3)   Discharge assessments;
    (4)   Discharge summaries;
    (5)   Progress notes;
    (6)   Consumer records;
    (7)   Interviews with staff and consumers; and
    (8)   Other facility documentation.
[Source: Added at 23 Ok Reg 1628, eff 4-25-06 (emergency); Added at 24 Ok Reg 2623, eff 7-12-07]