Complete SOC if patient does not qualify?

Specialties Home Health

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So i did my 1st SOC yesterday and it was crazy. Long story short...the patient is bedbound and has a large stage 3 sacral pressure ulcer and the family does not want anything to do with changing/cleaning patient or wound. They want visits 7days/week and for us to change patient and her dressings. They also want PT,OT,ST,HHA. I believe the patient would be better off in LTC. I aksed MSW to consult with family. Do I still complete OASIS even though she doesn't qualify? No luck with trying to reach out to manager.

Specializes in Pediatrics Retired.

Complete the OASIS, clarify the MD orders for HH services and let the case manager sort it out.

Is the patient incontinent and the family is not willing to change them? If the family wants nothing to do with the patient's care and the patient requires more care than the agency can provide, my agency would not allow me to leave the patient without referring to EPS and potentially having them removed from the home, in which case they would not be admitted so no oasis, just a report of some kind on the situation and the referral. If the patient was not being neglected in the home and was admitted, then the oasis would have to be completed. I am sorry, these are sad situations and never easy.

Your first SOC? This is a great forum for all kinds of questions but that situation should be reviewed and answered within your agency with your supervisor consulted. If you haven't consulted your supervisor, you need to immediately to make sure that you acted appropriately in patient's interest as well as how to proceed re the oasis.

ETA just re read that your manager isn't available. Hopefully you've since spoken with your supervisor but you should always be able to have a supervisor or other mentor available within a reasonable amount of time, especially when you're new. I'd flip if my staff were referring to an Internet forum for how to proceed. If you don't regularly have someone, then you should flip.

First- clarify the VNA role in care of the pt- which is not indefinite 7 days per week care. This patient is bed bound and has a stage 3 so they qualify for services. Ensure, especially if they are elderly or disabled, that there is no abuse/neglect going on, if even suspected, report it. Stage 3's mean some very serious teaching is needed at a minimum.

Getting all disciplines involved is actually a good idea, this patient needs help and the family needs a lot of training.

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