Page 25 - Pointcare Rehab Process and Tips

Unplanned agency discharge-visit planned-
• The clinician writes a d/c order via “New Order” and syncs
o Call your scheduler
• CFM reviews order and scheduler changes service code to 18,
• Clinician syncs twice to receive the correct code.
• CFM reviews dc note.
Unplanned agency discharge –NO visit planned-
• If the patient is refusing further care from VNSNY, there is a service code for a non-visit agency d/c, 66, which
will be completed by the last clinician to see the patient. The scheduler will add a visit with the 66 service code.

***IF your patient has more than 2 MDs that should receive the d/c information to be
compliant with the Condition of Participation, be sure to make your CFM aware.

IMPORTANT NOTES FOR USING POINTCARE:

Tablet Maintenance:
o Every Wednesday, and as instructed, Selective Refresh (VNSNY updates) AND Valet (HCHB updates). Medical
Records will always include the Initial visits and the last 5 visits from each discipline.
View all visits plotted for the week in the PointCare Rolling Calendar.

User Tips:
o Use Tap and Hold/Release, if clicking on a field does not produce a result. E.g in Medical Records Attachment
sections- Tap and Hold on specific attachment listed to open/ download. When adding supply orders, Tap and
Hold and select Add…
o Use the Back Arrow on the tablet, If you are not sure where you are or what to do.

• Please double check that you are documenting on the correct patient. If you document in the wrong patient’s
record prior to completing the visit, you can restart the visit by going to the 3 dot menu button and choosing
“restart visit. YOU WILL LOSE ALL DATA ENTERED.

• Infection Control
After every visit, use an alcohol swab to wipe tablet clean. Pick up alcohol swabs at the supply room.

• Visit Verification Sign off
o If on Contact Precautions- Choose caregiver signature option- write in CONTACT PRECAUTIONS instead
of getting signature and add to reason details.
o If in Facility- and staff refuse to sign the visit verification: Choose caregiver signature option- write in
REFUSED. Add specifics to reason details.

o Difference between “Plan of care update” and “Physician order”.
o Physician Order: when you are adding an order to an already existing problem.
 Eg. There is already a pressure ulcer present, and a new pressure ulcer needs to be added. It is a
POC update.

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