Skilled Nursing Facility Chart Review Skilled Nursing Facility Chart Review form 2026

1. Click ‘Get Form’ to open the Skilled Nursing Facility Chart Review form in the editor.
2. Begin by entering the patient information, including the medical record number, resident name, and dates of admission and unplanned transfer. Ensure accuracy for effective tracking.
3. In the '72 Hours Prior to Transfer' section, check off any signs or symptoms that were present. Use the text fields to provide detailed descriptions where necessary.
4. For 'Actions Taken Prior to Transfer', indicate whether a physician or nurse practitioner was contacted and if an evaluation occurred within 72 hours. Answer all questions truthfully.
5. Document any specific medications, lab tests, or diagnostic tests related to the transfer in their respective fields.
6. In the 'Outcome' section, provide a comprehensive explanation regarding the transfer and whether it could have been avoided.
7. Complete the 'Action Plan' by suggesting improvements for identifying and managing changes in resident health status based on this transfer.
8. Finally, fill in your name and position/title at the bottom of the form before saving your work.

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