Initial Brief Assessment: Agency staff will initiate an intake within 5 business days of the referral, which should include: 

• Client’s support system
• Needs of the client
• Documentation supporting the need for respite care

1. Percentage of clients with documentation of an initial brief assessment completed within 5 business days of the referral.

2. Percentage of clients with documentation of the need for respite care.

Plan of Care: In collaboration with the client and client’s family, a plan of care will be developed within 10 business days of the initial brief assessment. The plan of care should be signed and dated by the client or the client’s legal guardian. A copy of the plan must be offered to the client and this must be documented in the client’s record.

The plan of care should include:

• The objective of respite care 
• The estimated number of respite care visits anticipated and the services to be provided 
• The setting respite services will be provided in

 
Documentation that the plan of care is being followed should be present in the record and include, at a minimum, a sign-in sheet documenting attendance in a facility or documentation of a professional support provider’s attendance in the home. 

The plan of care should be reviewed at least every 6 months to see if progress is being met toward the objective of the respite care, with documentation present in the client’s primary record.

3. Percentage of clients with a plan of care developed within 10 business days of the initial brief assessment. 

4. Percentage of clients with documentation that the plan of care was signed and dated by the client or the client's legal guardian, and that a copy of the plan was offered to the client.

5. Percentage of clients with documentation that the plan of care is being followed, including an attendance sign-in sheet or record of a professional support provider’s attendance in the home.

6. Percentage of clients with documentation that the plan of care has been updated and reviewed every 6 months.

Referrals: If the needs of the client are beyond the scope of the services provided by the agency, a referral to another level of care should be made. Documentation of the referral and the outcome of the referral should be present in the client’s primary record.

7. Percentage of clients with referrals for services beyond the scope of the respite care provider, as needed.

8. Percentage of clients who were referred to another level of care that have documentation of referral outcome.

Discharge: The agency and client will collaborate on a discharge plan once objectives have been met. The reason for discharge should be included in the plan, and may include: 

• Services are no longer needed 
• Services needed are outside the scope of respite care
• Client has moved out of the area 
• Unacceptable client behaviors as defined per agency policy 
• Client has not attended or received respite care per agency policy and procedure
• Client is deceased

9. Percentage of discharged clients with a discharge plan that includes the reason for discharge.