RNonWheels

Learn the essential first steps for RNs during a home health Start of Care (SOC) visit: arrival, safety, patient identity verification, and consent.

---

Introduction: First Impressions Count

The Start of Care (SOC) visit sets the tone for everything that follows in home health. Before you dive into OASIS assessments, med recs, or wound checks, the way you arrive, establish safety, confirm identity, and obtain consentlays the foundation for trust, compliance, and effective care.

Let’s break down these four essential steps—and why they matter so much.

---

1. Arrival: Setting the Tone

Your arrival isn’t just about showing up—it’s about establishing professionalism and trust.

• Always call ahead (see my post on Pre-Charting & Call-Ahead).
• Introduce yourself clearly: “Hi, I’m [Your Name], an RN with [Agency Name]. I’ll be starting your care today.”
• Be mindful of body language—smile, make eye contact, and show confidence.

First impressions reassure patients and families that they’re in capable hands.

---

2. Safety: Protecting Everyone

Safety comes first—for you and your patient.

• Assess the environment: Is there clutter, poor lighting, or pets that may pose risks?
• Ensure your own personal safety: park smart, stay aware, and trust your instincts.
• Prepare patients for emergencies: reinforce their emergency preparedness plan (see Timelines, Roles, and Required Elements for SOC).

Safety isn’t just a box to check—it’s the foundation of ongoing, successful visits.

---

3. Identity: Confirming the Right Patient

Medicare (and common sense) requires you to verify identity before providing care.

• Ask for two patient identifiers (full name and DOB are most common).
• Cross-check with the referral documentation or hospital discharge papers.
• If the patient cannot respond (e.g., due to dementia), confirm with the caregiver.

Identity verification ensures compliance and prevents serious medical errors.

---

4. Consent: Formalizing the Agreement

Before any hands-on care begins, you need patient consent for services.

• Explain the plan of care and what home health entails.
• Review the consent forms (paper or electronic, depending on agency policy).
• Encourage questions, clarify expectations, and confirm the patient/caregiver understands.

Pro tip: This is also a perfect moment to reinforce eligibility, homebound status, and skilled need (check out my post on Eligibility, Homebound & Skilled Need).

---

Why These Four Steps Matter

Arrival, safety, identity, and consent may seem simple, but they:

• Build trust with patients and families.
• Ensure compliance with Medicare and agency standards.
• Prevent errors, delays, and denials.
• Set the stage for a smooth SOC visit and ongoing care.

👉 Curious about what happens before you even walk through the door? Read my post on Intake Triage: The RN’s Secret Superpower to see how the process begins.

---

Final Thoughts: First Steps, Lasting Impact

The first 15 minutes of an SOC visit—arrival, safety, identity, and consent—are some of the most important. They don’t just check boxes; they set the tone for the entire episode of care. Do them well, and you’ll have smoother visits, happier patients, and stronger compliance.

---

✨ Want to master SOC visits from start to finish?
Check out my RN Home Health SOC Guidebook on Kindle. It’s packed with real-world tips, compliance checklists, and step-by-step strategies to make every SOC visit efficient, thorough, and stress-free.