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Run: CAA Documentation Worksheet

Document each triggered Care Area Assessment (CAA), the findings behind it, and whether care planning should proceed. Use it to keep the review traceable, co...

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Assessment Context

Resident Identifier (required)

Enter the resident's internal identifier or medical record number. Avoid collecting SSN or other unnecessary PII.

Assessment Date (required)

Date the CAA documentation was completed.

MDS Assessment Reference

Optional internal MDS reference, if used by your facility.

Triggered Care Area (required)

Select the care area that triggered this CAA documentation.

Other Care Area

Complete only if 'Other' was selected above.

Related Findings

Summary of Related Findings (required)

Summarize the relevant observations, history, and current status related to the triggered care area.

Records Reviewed (required)

Select the sources reviewed to support this CAA. Choose only what was actually used.

Other Records Reviewed

Specify any additional records reviewed.

Interdisciplinary Input

Select disciplines that contributed to this assessment, if applicable.

Supporting Evidence

Add specific evidence items that support the analysis. Use one row per finding.

CAA Analysis

Analysis of Triggered Care Area (required)

Explain why the care area was triggered, what the findings mean, and how they affect the resident's status.

Contributing Factors

Select factors that appear to contribute to the triggered care area.

Other Contributing Factor

Specify any other contributing factor.

Proceed to Care Planning? (required)

Indicate whether the triggered area requires inclusion in the care plan.

Rationale for Decision (required)

Explain the decision to proceed or not proceed with care planning.

Plan and Follow-Up

Immediate Actions Taken

Document any interventions or actions completed during or immediately after the review.

Referrals or Consults

Select any referrals or consults initiated.

Follow-Up Date

Date for reassessment or follow-up, if needed.

Follow-Up Notes

Document any monitoring instructions or next steps.

Attestation

Reviewer Name (required)

Enter the name of the person completing the worksheet.

Reviewer Role (required)

Enter the reviewer’s role or discipline.

Signature (required)

Electronic signature confirming the documentation is accurate and complete.

Review Timestamp (required)

Automatically captured submission time for the audit trail.

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