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How to use or fill out Nursing Addendum to Plan of Care (CCP) 1 of 10 - TMHP.com with our platform
- Click ‘Get Form’ to open the Nursing Addendum to Plan of Care in the editor.
- Begin by entering the client’s name, Medicaid number, and date at the top of the form. This information is crucial for identification and processing.
- Complete the Prior Authorization Request Submitter Certification Statement by checking 'We Agree' after reading the terms. Ensure that all information provided is accurate and complete.
- Fill out the Documentation Requirements section, ensuring all necessary documents are listed and attached as needed for review.
- In the Nursing Care Plan Summary section, outline the problem list, goals of care, specific measurable outcomes, and progress toward those goals.
- Provide a summary of recent health history detailing any hospitalizations or changes in condition that may affect care.
- Detail the rationale for PDN hours requested, indicating whether they will increase, decrease, or remain unchanged.
- Complete the Schedule of Services sections by filling in military time slots with caregiver codes for each day of the week.
- Finally, ensure that all signatures are obtained from clients/parents/guardians and nurse providers in the Acknowledgement section before submitting.
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