RNonWheels

Learn how home health RNs manage orders, handoffs, and before-visit checklists to streamline Start of Care (SOC) visits and ensure Medicare compliance.

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Introduction: Why Prep Is Half the Battle

In home health, the Start of Care (SOC) visit can feel like running a marathon. Between OASIS, med rec, risk screens, and education, there’s a lot to juggle. But the truth is—half the work happens before you even step through the door.

That’s where three tools come in: orders, handoffs, and the before-visit checklist. When used together, they set you up for a smoother visit, fewer errors, and stronger compliance.

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Orders: Clarity Before Chaos

Every SOC begins with physician or practitioner orders. These define the scope of services you can provide.

• Admission Orders: Include diagnosis, frequency of visits, and skilled disciplines.
• Specific Orders: Wound care, labs, IV therapy, catheter care, etc.
• Standing Orders: Sometimes used by agencies for standard protocols.

👉 Need more on aligning orders with compliance? Check out my post on F2F & Practitioner Coordination in Home Health.

📌 Pro Tip: Always verify orders against the hospital discharge summary. If something doesn’t make sense—clarify it before walking in.

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Handoffs: Passing the Baton Smoothly

Handoffs are the transition of patient information between clinicians. In home health, this usually happens when:

• A hospital nurse gives info to the home health intake team.
• An intake RN triages the case for field staff.
• You pass updates to therapy or the next visiting nurse.

Strong handoffs prevent dangerous gaps in care. Make sure to document:

• Recent hospitalizations.
• Med changes.
• Pending labs or follow-up appointments.
• Red-flag symptoms to monitor.

👉 Curious about the front-end of this process? Read my post on Intake Triage: The RN’s Secret Superpower.

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Before-Visit Checklist: Your Secret Weapon

A before-visit checklist is your personal game plan. It keeps you organized and ensures nothing slips through the cracks. Key items include:

• 📞 Call Ahead: Confirm visit time and remind patient to gather meds (see Pre-Charting & Call-Ahead).
• 💊 Review Medications: Cross-check hospital paperwork with referral list.
• 📑 Review Risk Screens: Prep for falls, depression, nutrition, pain, and skin (see Risk Screens in Home Health).
• 🧾 Supplies: Confirm you have wound dressings, lab tubes, or equipment.
• 🧠 Patient Goals: Note potential goals to confirm with patient during visit (see Teaching With Teach-Back & Goal Setting).

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Why This Prep Matters

• For Patients: Smoother visits, less confusion, better engagement.
• For Agencies: Fewer errors, stronger compliance, faster billing.
• For RNs: Less stress, more confidence, and cleaner documentation.

👉 Want to see how these steps fit into the SOC workflow? Don’t miss my post on Timelines, Roles, and Required Elements for SOC.

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Final Thoughts: Prep = Professionalism

Orders, handoffs, and before-visit checklists may not feel glamorous, but they are the difference between chaotic visits and confident, compliant nursing practice. Prep time isn’t wasted time—it’s what makes you efficient, effective, and trusted by both patients and providers.

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✨ Want step-by-step guidance for every part of the SOC visit, from orders to education?
Check out my RN Home Health SOC Guidebook on Kindle. It’s filled with real-world strategies, compliance tips, and checklists to make SOC visits smoother, faster, and more effective.