Nursing Addendum to Plan of Care (CCP) 1 of 7 - TMHP.com 2025

1. Click ‘Get Form’ to open the Nursing Addendum to Plan of Care in the editor.
2. Begin by entering the client’s name, Medicaid number, and date at the top of the form. This information is essential for identification and processing.
3. Complete the Documentation Requirements section by ensuring all necessary documents are checked off. This includes confirming that a responsible adult is available if the client is under 18.
4. In the Nursing Care Plan Summary section, outline the problem list, goals of care, specific measurable outcomes, and progress toward those goals. This provides a comprehensive overview of the client's needs.
5. Fill out the Summary of Recent Health History with any pertinent medical updates or changes in condition that may affect care.
6. Detail the Rationale for PDN Hours, specifying whether hours will increase, decrease, or remain unchanged based on current needs.
7. Complete the Schedule of Services sections by filling in military time slots with appropriate coverage details for each day of the week.
8. Finally, ensure that all required signatures are obtained in the Acknowledgement section before submitting your completed form.

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