Home Health Aide Supervisory Visit Documentation

Inspection template for documenting the RN supervisory assessment of home health aide services at the required interval, including competency oversight, patient care review, and infection control observations.

Visit Identification and Scope

• Visit date and time recorded
• Patient and aide identifiers documented
  Record the patient name/ID and aide name/ID using agency-approved identifiers.
• Supervisory visit interval met
  Confirm the RN supervisory visit occurred within the required agency/regulatory interval for aide supervision.
• Visit type and setting confirmed
• Reason for supervisory visit documented
  Document routine supervision, follow-up on a concern, competency review, or other reason for the visit.

Aide Competency and Task Performance

• Aide demonstrated correct completion of assigned tasks
  Assess whether the aide performed assigned duties according to the plan of care and agency standards.
• Aide followed the plan of care and task limitations
• Aide communication with patient was appropriate and respectful
• Aide required prompting or retraining
• Competency concerns identified

Patient Care and Safety

• Patient condition and response to care reviewed
  Document the patient's observed condition, tolerance of care, and any changes requiring follow-up.
• Care delivered matched the care plan
• Safety hazards or non-conformances observed
• Patient environment was safe and accessible

Infection Control and PPE

• Hand hygiene performed at appropriate times
• PPE used correctly for observed tasks
• Clean and dirty supplies were separated appropriately
• Infection control deficiencies observed

Documentation, Follow-Up, and Signature

• Required documentation completed and legible
• Deficiencies and corrective actions documented
  List any deficiencies, retraining provided, escalation, and follow-up due dates.
• Follow-up plan established
• RN signature completed