288824 outcome facilitation team indd - iConnect 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the date and LOS day at the top of the form. This information is crucial for tracking patient progress.
3. Fill in the Primary Diagnosis section with a detailed description of the patient's condition, ensuring clarity for future reference.
4. Select the appropriate Center for Medicare & Medicaid Services (CMS) items relevant to the patient's care, marking any unresolved issues clearly.
5. Indicate the Discharge Destination by selecting one of the options provided, or specify another if necessary.
6. Identify any Discharge Planning Barriers/Needs that were recognized today. Use bullet points for clarity if multiple barriers exist.
7. List any referrals needed by checking off from the provided options and adding any additional referrals as required.
8. Document Open Issues that need attention, ensuring all concerns are noted for follow-up.
9. Finally, have a team member sign and date at the bottom of the form to validate completion and accountability.

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