Plan of care

[RNCCMMS, RN]

I am looking for information on plans of care. I currently perform quality audits on case managers. These audits are based on NCQA/URAC standards. One area I am having difficulty with is plans of care and target dates (a timeliness standard). This has been going on for a long time. It seems many of these case managers do not understand the idea of updating your target date (neither do some of their supervisors lol). I have explained that if the goal is not met by the target date, either you update/adjust the goal, and extend the target date explaining why, or close out the problem stating the goal cannot be achieved for whatever reason. Sometimes they are not able to reach the member on a call; I have tried to explain if you can not evaluate the progress towards the goal, then simply extend your target date with a note stating you will evaluate once contact with member has been made. These are not new nurses, yet they state "I never knew that."

I am looking for articles or texts to which I can refer them.

I appreciate the help.:)