A Baseline Care Plan is a critical initial step in the care planning process within Long-Term Care (LTC) facilities, designed to provide immediate guidance for the care of a new resident. Under the regulations set forth by the Centers for Medicare & Medicaid Services (CMS), particularly under the revised Requirements of Participation for skilled nursing facilities, LTC facilities are required to develop and implement a Baseline Care Plan for each resident within 48 hours of their admission. This requirement is part of a broader effort to ensure that all residents receive person-centered care that meets their needs from the moment they enter the facility.

Objectives of a Baseline Care Plan

The primary objectives of a Baseline Care Plan include:

• Immediate Care Needs: To address the resident's immediate healthcare and psychosocial needs.
• Resident Preferences: To document the resident's preferences and goals as understood during the initial assessment.
• Interim Protection: To provide interim protection and guidance for the resident's care before the completion of the comprehensive care plan.

Key Components of a Baseline Care Plan

According to CMS guidelines, a Baseline Care Plan must include, but is not limited to, the following elements:

1. Initial Goals for Care: Short-term objectives that focus on the resident's immediate healthcare needs and preferences.
2. Physician Orders: Including medications, dietary orders, and therapy services required by the resident.
3. Dietary Information: Specific dietary needs, preferences, and any nutritional goals for the resident.
4. Services and Treatments: A summary of the medical and personal care services that will be provided to meet the resident's needs.
5. Advance Directives: Documentation of any known advance directives or similar preferences regarding future care.
6. Resident and Representative Involvement: Information on the extent to which the resident and their representative were involved in the care planning process.

Compliance with Federal Regulations

The requirement for LTC facilities to develop and implement a Baseline Care Plan within 48 hours of admission is grounded in federal regulations, specifically 42 CFR §483.21(a)(1-3). This regulation emphasizes the importance of promptly addressing a resident's needs and preferences and ensuring a smooth transition into the facility. It also underscores the commitment to providing person-centered care from the outset of a resident's stay.

Transition to a Comprehensive Care Plan

The Baseline Care Plan serves as an interim plan while the comprehensive care planning process is underway. LTC facilities are required to complete a comprehensive assessment of each resident's needs using the MDS within 14 days of admission. Based on this assessment, a more detailed and personalized Comprehensive Care Plan must be developed within 7 days after the completion of the comprehensive assessment, replacing the Baseline Care Plan.

This comprehensive care plan takes a deeper dive into the resident's medical, social, psychological, and rehabilitative needs, establishing long-term goals and detailed interventions designed to meet those goals. The transition from a Baseline Care Plan to a Comprehensive Care Plan ensures that care is continuously tailored to the evolving needs and preferences of the resident.

Conclusion

The Baseline Care Plan is a foundational element of the care planning process in LTC facilities, ensuring that residents receive immediate, personalized care upon admission. By complying with federal regulations and focusing on the resident's immediate needs and preferences, LTC facilities lay the groundwork for ongoing, resident-centered care that adapts to the changing needs of each individual throughout their stay.