Get Lpn Supervisory Visit Form 2020-2025

Filling out the Lpn Supervisory Visit Form online is a streamlined process designed to capture vital information about nursing care. This guide will provide you with clear instructions on how to navigate and complete each section of the form effectively.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by entering the provider information in the designated field, making sure to include the name of the organization providing care.
3. Next, input the date of visit in the specified format to ensure clarity on when the supervision occurred.
4. Fill in the client's name and date of birth (DOB) to accurately identify the individual receiving care.
5. Enter the client’s CLTC number, which is essential for record-keeping and identification.
6. Document the name of the nurse responsible for the client's care during this visit.
7. Indicate whether the client is Medicaid eligible and describe the method used to verify this status.
8. Confirm if Care Call claims have been reviewed by selecting the appropriate option.
9. Specify whether the nurse is a Registered Nurse (RN) or Licensed Practical Nurse (LPN), and if applicable, list the tasks that the LPN requires supervision on.
10. Ensure to check and confirm if the nurse has completed the mandatory minimum of six hours of training for the calendar year.
11. Document if the nurse arrived on time for the scheduled visit and note any discrepancies.
12. Evaluate if the nurse has received training specific to the client’s needs, such as ventilator or tracheostomy care.
13. Describe how long the nurse has been caring for this specific client, along with whether they were properly oriented to the client’s care requirements.
14. Record whether you met with the responsible party (RP) during the visit and outline any concerns they may have regarding the client or the nursing care provided.
15. Indicate when the physician's orders were last updated and confirm if a copy is available in the client's chart.
16. Review and document whether the Plan of Care and Medication Administration Record (MAR) were checked during the visit.
17. Assess if the Disaster Plan was reviewed and provide confirmation.
18. Evaluate whether the client continues to have skilled needs and document your observations.
19. Outline whether a Discharge Plan has been created and include a tentative discharge date if applicable.
20. Determine if the client is a candidate for weaning, along with the reasons supporting your evaluation.
21. List the goals established for weaning and detail the weaning plan being implemented.
22. Ensure the RP is informed about the weaning plan and confirm their agreement or any concerns they may have about the process.
23. Address any additional concerns raised by the nurse regarding the client's care.
24. Finally, save your changes, and decide whether to download, print, or share the completed form as needed.

Complete your Lpn Supervisory Visit Form online today for efficient documentation of nursing care.