Person-Centered Service Plan

One of the more important documents related to a resident’s care in your facility is the Person-Centered Service Plan. This is an all-encompassing document that lays out the resident’s needs and the services the facility will be providing for them. Take a look at the following regulation provided by the Louisiana Department of Health and Hospitals:

  • 6835. Person-Centered Service Plan
  1. An assessment shall be initiated upon entry to the ARCP and completed within seven calendar days of the date that the resident moves into the ARCP to determine the service needs and preferences of the resident.
  2. This assessment shall be kept in the resident’s record.
  3. If the resident’s person-centered service plan includes staff administration of medication or intermittent nursing services, the assessment for those services shall be completed by a registered nurse.
  4. Within 30 calendar days after the date the resident moves in, the ARCP designated staff in conjunction with the resident or the resident’s representative, if applicable, shall develop a PCSP using information from the assessment.

The PCSP shall include:

  1. the services required to meet the resident’s individual needs;
  2. the scope, frequency, and duration of services;
  3. monitoring that will be provided; and
  4. who is responsible for providing the services, including contract or arranged services.
  5. If the resident is enrolled in a home and community-based services waiver that includes ARCP as a service, a comprehensive plan of care prepared in accordance with policies and procedures established by Medicaid, or by a department program office, for reimbursement purposes may be substituted for the PCSP. If the resident needs services beyond those provided for in the comprehensive plan of care, the PCSP must be coordinated with the comprehensive plan of care.
  6. A documented review of the PCSP shall be made at least every 90 calendar days and on an ongoing basis to determine its continued appropriateness and to identify when a resident’s condition or preferences have changed. Changes to the plan may be made at any time, as necessary.
  7. All plans, reviews, and updates shall be signed by the resident or the resident’s representative, if applicable, and the ARCP staff. If the resident’s PCSP includes staff administration of medication or intermittent nursing services, a registered nurse shall also sign the plans, reviews, and updates.

Pro Tip:

  1. Pay close attention to the date parameters when it comes to when an assessment must be performed (7 days) and when the PCSP must be completed (within 30 days of admission).
  2. Do not list services on the PCSP that you are not providing (and documenting that you have provided those services).