Cal. Code Regs. tit. 22 § 74697

Current through Register 2024 Notice Reg. No. 45, November 8, 2024

Section 74697 - Plan of Treatment; Plan of Care; Plan for Personal Care Services

(a) A written plan of treatment (or plan of care for home health agencies participating in the Medicare and/or Medi-Cal program) shall be established for each patient whose care requires medical orders. A plan of treatment or plan of care for patients requiring medical orders shall be:

(1) Approved and signed within 30 working days by the attending physician, dentist, podiatrist, or other licensed and legally authorized practitioner within his or her scope of practice.

(2) Developed in consultation with agency health professional staff.

(3) Modified and added to only with approval of the attending physician, dentist, podiatrist, or other licensed and legally authorized practitioner within his or her scope of practice.

(4) Reviewed and updated by the attending physician, dentist, podiatrist, or other licensed and legally authorized practitioner within his or her scope of practice in consultation with the agency health professional personnel as frequently as the patient's condition warrants and at least every 62 days.

(5) In compliance with applicable federal requirements for a plan of care when the home health agency participates in the Medicare and/or Medi-Cal program.

(b) The plan of treatment or plan of care for patients requiring medical orders shall include, but not be limited to, the following pertinent information:

(1) Diagnosis.

(2) Types of services and equipment required.

(3) Statement of treatment goals.

(4) Medications and treatment.

(5) Functional limitations.

(6) Mental status.

(7) Activities permitted.

(8) Nutritional requirements.

(9) Rehabilitation potential.

(10) Any safety measures required to protect against injury to the patient.

(11) Proposed frequency of services.

(12) Discharge and referral plan.

(13) Instructions to patient and family.

(14) Food or drug allergies.

(c) If after the evaluation visit it is determined that the initial plan of treatment or plan of care for patients requiring medical orders does not meet the patient's needs, the attending physician, dentist, podiatrist or other licensed and legally authorized practitioner within his or her scope of practice shall be consulted to approve additions or modifications to the original plan.

(d) The professional person responsible for any specific treatment shall notify the attending physician, dentist, podiatrist or other health professionals and responsible agency staff of significant changes in the patient's condition. "Significant changes" means those changes that suggest the need to modify or develop a plan of treatment or plan of care. The agency shall develop and implement policies and procedures stating when notification is required for a significant change.

(e) All plans of treatment or plans of care and notification to the attending physician, dentist or podiatrist or other health professionals and responsible staff shall be made a part of the patient's health record.

(f) Personal care services may be provided without a plan of treatment prescribed by a physician, pursuant to a written plan for personal care services.

(g) Personal care services for home health agencies participating in the Medicare and/or Medi-Cal program shall be in compliance with applicable federal requirements.

Cal. Code Regs. Tit. 22, § 74697

1. Amendment of section heading, section and NOTE filed 4-28-95 as an emergency; operative 4-28-95 (Register 95, No. 17). A Certificate of Compliance must be transmitted to OAL by 8-28-95 or emergency language will be repealed by operation of law on the following day.
2. Amendment of section heading, section and NOTE refiled 8-14-95 as an emergency; operative 8-14-95 (Register 95, No. 33). A Certificate of Compliance must be transmitted to OAL by 12-12-95 or emergency language will be repealed by operation of law on the following day.
3. Amendment of section heading, section and NOTE refiled 12-12-95 as an emergency; operative 12-12-95 (Register 95, No. 50). A Certificate of Compliance must be transmitted to OAL by 4-10-96 or emergency language will be repealed by operation of law on the following day.
4. Amendment of section heading, section and NOTE refiled 4-11-96 as an emergency; operative 4-11-96 (Register 96, No. 15). A Certificate of Compliance must be transmitted to OAL by 8-9-96 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 4-28-95 order transmitted to OAL 8-7-96 and disapproved 9-19-96 (Register 96, No. 38).
6. Amendment of section heading, section and NOTE filed 9-19-96 as an emergency; operative 9-19-96 (Register 96, No. 38). A Certificate of Compliance must be transmitted to OAL by 1-17-97 or emergency language will be repealed by operation of law on the following day.
7. Editorial correction of HISTORY 6 (Register 97, No. 3).
8. Amendment of section heading, section and NOTE refiled 1-16-97 as an emergency; operative 1-16-97 (Register 97, No. 3). A Certificate of Compliance must be transmitted to OAL by 5-16-97 or emergency language will be repealed by operation of law on the following day.
9. Amendment of section heading, section and NOTE refiled 5-15-97 as an emergency; operative 5-15-97 (Register 97, No. 20). A Certificate of Compliance must be transmitted to OAL by 9-12-97 or emergency language will be repealed by operation of law on the following day.
10. Certificate of Compliance as to 5-15-97 order, including amendment of section heading, section and NOTE, transmitted to OAL 8-26-97 and filed 10-8-97 (Register 97, No. 41).
11. Editorial correction of subsection (b)(10) (Register 97, No. 50).

Note: Authority cited: Sections 1734 and 100275, Health and Safety Code. Reference: Sections 1727.5(a), 1727.5(e) and 1734, Health and Safety Code.

1. Amendment of section heading, section and Note filed 4-28-95 as an emergency; operative 4-28-95 (Register 95, No. 17). A Certificate of Compliance must be transmitted to OAL by 8-28-95 or emergency language will be repealed by operation of law on the following day.
2. Amendment of section heading, section and Note refiled 8-14-95 as an emergency; operative 8-14-95 (Register 95, No. 33). A Certificate of Compliance must be transmitted to OAL by 12-12-95 or emergency language will be repealed by operation of law on the following day.
3. Amendment of section heading, section and Note refiled 12-12-95 as an emergency; operative 12-12-95 (Register 95, No. 50). A Certificate of Compliance must be transmitted to OAL by 4-10-96 or emergency language will be repealed by operation of law on the following day.
4. Amendment of section heading, section and Note refiled 4-11-96 as an emergency; operative 4-11-96 (Register 96, No. 15). A Certificate of Compliance must be transmitted to OAL by 8-9-96 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 4-28-95 order transmitted to OAL 8-7-96 and disapproved 9-19-96 (Register 96, No. 38).
6. Amendment of section heading, section and Note filed 9-19-96 as an emergency; operative 9-19-96 (Register 96, No. 38). A Certificate of Compliance must be transmitted to OAL by 1-17-97 or emergency language will be repealed by operation of law on the following day.
7. Editorial correction of History 6 (Register 97, No. 3).
8. Amendment of section heading, section and Note refiled 1-16-97 as an emergency; operative 1-16-97 (Register 97, No. 3). A Certificate of Compliance must be transmitted to OAL by 5-16-97 or emergency language will be repealed by operation of law on the following day.
9. Amendment of section heading, section and Note refiled 5-15-97 as an emergency; operative 5-15-97 (Register 97, No. 20). A Certificate of Compliance must be transmitted to OAL by 9-12-97 or emergency language will be repealed by operation of law on the following day.
10. Certificate of Compliance as to 5-15-97 order, including amendment of section heading, section and Note, transmitted to OAL 8-26-97 and filed 10-8-97 (Register 97, No. 41).
11. Editorial correction of subsection (b)(10) (Register 97, No. 50).