Caregiver Service Plan

MM slash DD slash YYYY
The Nurse Monitor - Develop a Caregiver Service Plan (CSP) that documents services or tasks the caregivers are required to perform for the participant. The nurse monitor must: ask the case manager for a copy of the Plan of Care/Plan of Service (POC/POS), use the POC/POS with appropriate input from the participant and caregivers to help develop the CSP, ensure that caregivers understand all CSP tasks and expectations, complete a new CSP when adding services or tasks, add additional pages as needed and give a CSP copy to both case manager and caregivers. Immediately contact the case manager and other appropriate professionals to report suspected health and safety concerns. (Adult Protective Services at 1-800-917-7383, emergency Personnel, Police, etc.)

Tasks

Personal Hygiene (i.e. bathing, hair, oral, nail, and skin care)

Toileting (i.e. bladder, bowel, and bed pan routines; movement to/from bathroom)

Dressing & Changing Clothes

Mobility & Transfers

Eating & Drinking

Medications

Place a check next to each required item

Light Housekeeping

Errands

Other

This field is for validation purposes and should be left unchanged.

Quick Inquiry

Schedule Consultation

This field is for validation purposes and should be left unchanged.

Quick Apply