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Run: Quarterly Resident Care Plan Review

Quarterly Resident Care Plan Review template for documenting 90-day interdisciplinary updates, goal progress, intervention changes, resident participation, a...

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Review Period and Administrative Details

Resident Identifier (required)

Use the facility's resident ID or chart number. Do not enter SSN.

Review Date (required)

Date the quarterly review is completed.

Review Period Start (required)

Start date of the 90-day review period.

Review Period End (required)

End date of the 90-day review period.

Disciplines Present (required)

Select all disciplines that participated in the review.

Care Plan Type (required)

Identify the primary care plan area being reviewed.

Did the resident participate in the review? (required)

Did a resident representative participate? (required)

Goal Progress Review

Overall Progress Status (required)

Goals Reviewed (required)

Add one entry for each goal reviewed during this quarterly update.

Goal Status Summary (required)

Summarize the resident's progress, including objective observations and any measurable changes.

Intervention Changes and Barriers

Were any intervention changes made? (required)

Changed Interventions

Complete this section if interventions were added, removed, or modified.

Barriers to Progress

Barrier Details

Describe any barriers selected above and the plan to address them.

New Supports Needed

Document any additional services, referrals, equipment, or monitoring needed.

Resident or Representative Participation

Resident Preferences or Requests

Capture any resident or representative preferences that should be reflected in the care plan.

Concerns Raised

Summarize concerns discussed during the review and any follow-up needed.

Education or Updates Provided

Document any education, explanations, or care plan updates shared with the resident or representative.

Consent to Care Plan Updates

Record consent when the resident or representative agrees to the updated plan. If consent is not applicable, document the reason in the notes.

Plan Update, Attestation, and Follow-Up

Updated Plan Summary (required)

Summarize the final care plan updates, including any revised goals, interventions, or monitoring.

Follow-Up Actions

Add any action items assigned after the review.

Next Review Due (required)

Enter the next quarterly review due date.

Review Completed By (required)

Name and role of the person completing the review.

Attestation (required)

Signature confirming the review was completed and the care plan was updated as documented.

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