Accreditation: Demonstrate care through POC 

Q. What is the difference between a Plan of Treatment and the Plan of Care?  

A. Accreditation organizations have separate standards related to the Plan of Treatment (POT) and the Plan of Care (POC), both of which have been confusing for not only lay people but also for clinicians. The two documents are used together in the care of a patient but have separate intents.  

The POT is provided to the HME provider by the physician and explains how the physician wants the patient treated. It is the physician’s order or prescription. The POC is not the prescription but rather is documentation demonstrating the actions you took to help the patient be compliant with the prescription. 

Many years ago, the POC was documented on a very formal documentation tool. Many times, we see just notes within the paper record or electronic record documenting POC type issues. These notes can be part of several documents or just a simple progress note. The important thing is that you demonstrate the following in your POC documentation: 

Have you satisfied the physician's orders? We will use oxygen as an example. If the patient was ordered on 2 LPM via bi-nasal cannula, does the record demonstrate that the staff set the patient up on 2 LPM?  

• Does the record demonstrate the equipment was functional at the prescribed liter flow?  
• Does the documentation demonstrate that the patient received instruction on use and care? 
• Does the documentation show that the environment was evaluated for safe use and, if there were concerns, is there documentation that the staff provided instructions regarding the safety concern? 
• Does the POC identify any other concerns – maybe a language barrier, a vicious dog, etc.? 

Harold Davis is director of survey services for HQAA. Reach him at Harold.Davis@hqaa.org.