Get Hha Survey Investigation Worksheet 1

The Hha Survey Investigation Worksheet 1 is a crucial document that aids in the assessment and documentation of patient care in home health services. This guide will provide you with clear, step-by-step instructions to assist you in filling out this form accurately and efficiently online.

Follow the steps to fill out the Hha Survey Investigation Worksheet 1 online

1. Press the ‘Get Form’ button to access the Hha Survey Investigation Worksheet 1 and open it in your online editor.
2. Begin by filling out the Agency Name and CCN at the top of the form to identify the agency conducting the survey.
3. Enter the Surveyor Name and ID number, ensuring this information is accurate and reflects the surveyor conducting the investigation.
4. Input the Patient Name and Confidential ID number, making sure this data is correct for confidentiality reasons.
5. Record the survey date and, if applicable, the RR and HV dates where indicated.
6. Fill in the Referral Date and SOC (start of care), ensuring you provide details relevant to the patient's entry into care.
7. List the Primary and Secondary Diagnoses in the designated field, reflecting the patient's current health status.
8. Circle the relevant disciplines ordered such as Skilled Nursing (SN), Physical Therapy (PT), Occupational Therapy (OT), Speech-Language Pathology (SLP), Medical Social Work (MSW), or Aide.
9. Indicate which discipline was observed during the Home Visit by circling either RN, LPN, PT, PTA, OT, COTA, SLP, MSW, SW Assistant, or Aide.
10. Attach any necessary documentation that supports your findings such as the current plan of care, medication profile, ADL & IADL OASIS items, and any relevant orders.
11. Review the CoPs and Related G Tags provided in the document, and make any necessary comments based on your observations during the survey.
12. Once you have completed all relevant sections, save any changes you have made, and utilize options to download, print, or share the completed form as needed.

Complete the Hha Survey Investigation Worksheet 1 online to ensure accurate and timely patient assessments.